Behavioural Medicine

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Define and discuss the following components of the doctor-patient relationship

Transference

  • This is when a patient brings in emotions from a previous relationship, and transfers them onto the provider.

counter transference

  • This is where the provider, provoked by the transference of a patient, then transfers their own emotions or experiences back

paternalism versus autonomy

  • Paternalism is trying to do something that one believes to be in the best interest of the recipient without the explicit approval or consent of the recipient.
  • Autonomy is essentially independence.

Describe appropriate boundaries within the doctor-patient relationship

  • If involved in a therapeutic relationship with a patient, a provider cannot also have a personal relationship
  • If the provider has provided mental care, this is a lifetime ban.
  • If the provider has only provided physical care, there is some sort of time limitation (like a year or such)

Define the basic defence mechanisms, and categorize them from primitive to mature

Narcississtic

  • denial
  • projection
  • idealization
  • projective identification
  • splitting

Immature

  • acting out
  • somatization
  • blocking
  • passive-aggressive behaviour
  • regression
  • hypochondriasis
  • schizoid fantasy

Neurotic

  • displacement
  • reaction-formation
  • dissociation
  • repression
  • isolation of affect
  • intellectualization
  • controlling

Mature

  • sublimation
  • altruism
  • humour
  • suppression

List the factors that contribute to compliance/adherence

Discuss Prochaska's stages of change

  1. Precontemplation
  2. contemplation
  3. preparation
  4. action
  5. maintenance

Define the basic components of motivational interviewing and discuss how this approach may be used in preventative health care

  • Essentially, this seems like a politically correct term for doing the used-car-salesman thing with patients.. Basically, one convinces them that what they want is what you have
  • Used to increase medical compliance
  • Currently, compliance is split into thirds:
    1. 1/3 of patients comply with medications
    2. 1/3 comply "more or less"
    3. 1/3 not at all

Describe the sick role, illness behaviour, and how people respond differently or similarly to chronic illness

Resources

  • Behavioural medicine lecture notes (1 | 2)