Year 2018, Volume 4, Issue 3, Pages 1064 - 1073 2018-12-15

Psikiyatri Pratiğinde Zor Hasta: Bir Vaka-Kontrol Çalışması
Difficult Patient in Psychiatry Practice: A Case-Control Study

Murat Eren Ozen [1] , Mehmet Hamdi Orum [2] , Aysun Kalenderoglu [3]

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Amaç: Bazı hasta-hekim karşılaşmaları ilgili hekimler tarafından "zor" olarak kabul edilir. Somatik belirtiler, madde kötüye kullanımı, saldırganlık, düşmanlık ve işbirliği eksikliği, zor hastalarla ilgili en sık görülen özelliklerdir. Yani, psikiyatri pratiğinde zor hastalarla karşılaşma riski yüksektir. Zor ilişki hastaya olduğu kadar hekime de bağlı olabilir. Biz bu çalışmada hasta ile ilgili zor hasta özelliklerini araştırmayı amaçladık.

Gereç ve Yöntem: Zor ilişki “psikiyatrist-hasta ilişkisinin sorunlu olarak algılandığı durumlar” olarak tanımlanmaktadır. Olgular, çalışmakta olan psikiyatristlerin en az iki tanesi tarafından zor ilişki olarak tanımlandı. Kontroller bu hekimlere göre zor ilişkileri olmayan hastalardan oluşuyordu. Çalışmaya 45 olgu ve 90 kontrol dahil edildi.

Bulgular: İki grup arasında yaş, cinsiyet, medeni durum, eğitim durumu ve çalışma durumu açısından anlamlı bir fark yoktu. Olgu grubunda hastaneye yatış sayısı, kullanılan ilaçlar, psikoterapi ve sosyal müdahale, kontrol grubuna göre daha yüksekti. Olgu grubunda kişilik bozuklukları anlamlı olarak yüksek bulundu.

Sonuçlar: Daha fazla ilaç kullanımı, daha fazla sosyal müdahale, daha fazla hastane yatışı zor olarak nitelendirilen bu hastaların memnuniyetsizliğinden kaynaklanabilmektedir. İlerletilmiş iyi bir terapötik ilişki, bu zor hastalarda daha az semptom ve daha az girişimi-yatışı sağlar. Hem etiyolojisini hem de çözümünü daha iyi anlayabilmek için hasta-hekim ilişkisine ilişkin daha fazla sistematik araştırma yapılmalıdır.

Aim: Some of the patient-physician encounters are considered "difficult" by the relevant physicians. Somatic symptoms, substance abuse, aggression, hostility, and lack of co-operation are the most common features related to difficult patients. That is, the risk of encountering difficult patients in psychiatric practice is high. The difficult relationship may be related to the patient as well as to the physician. We aimed to investigate the difficult patient characteristics associated with the patient in this study.

Material and Methods: Difficult relationship is defined as "situations in which the psychiatrist-patient relationship is perceived as problematic”. The cases were defined as difficult relationship with at least two of the psychiatrists who were studying. Controls consisted of patients without difficult relationships. 45 cases and 90 controls were included in the study.

Results: There was no significant difference in terms of age, sex, marital status, education status, and working status between the two groups. The number of hospitalization, drugs used, psychotherapy, and social intervention was higher in the case group than in the control group. Personality disorders was significantly higher in the case group.

Conclusion: The use of more medicines, more social interventions, more hospital admissions have been attributed to the dissatisfaction of these patients. The improved good therapeutic relationship can lead to less symptoms and fewer applications in these difficult patients. Further systematic research should be conducted with respect to patient-physician relationship to provide a greater understanding of both its etiology and solution.

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Primary Language en
Subjects Health Care Sciences and Services
Journal Section Araştırma/Research
Authors

Orcid: 0000-0003-2981-8036
Author: Murat Eren Ozen
Institution: Private Adana Hospital, Psychiatry Clinic, Adana, Turkey
Country: Turkey


Orcid: 0000-0002-4154-0738
Author: Mehmet Hamdi Orum (Primary Author)
Institution: Adiyaman University Faculty of Medicine, Department of Psychiatry, Adiyaman, Turkey
Country: Turkey


Orcid: 0000-0002-8216-8610
Author: Aysun Kalenderoglu
Institution: Adiyaman University Faculty of Medicine, Department of Psychiatry, Adiyaman, Turkey
Country: Turkey


Dates

Publication Date: December 15, 2018

Bibtex @research article { adiyamansaglik458680, journal = {Adıyaman Üniversitesi Sağlık Bilimleri Dergisi}, issn = {}, eissn = {2458-9179}, address = {Adıyaman University}, year = {2018}, volume = {4}, pages = {1064 - 1073}, doi = {10.30569/adiyamansaglik.458680}, title = {Difficult Patient in Psychiatry Practice: A Case-Control Study}, key = {cite}, author = {Ozen, Murat Eren and Orum, Mehmet Hamdi and Kalenderoglu, Aysun} }
APA Ozen, M , Orum, M , Kalenderoglu, A . (2018). Difficult Patient in Psychiatry Practice: A Case-Control Study. Adıyaman Üniversitesi Sağlık Bilimleri Dergisi, 4 (3), 1064-1073. DOI: 10.30569/adiyamansaglik.458680
MLA Ozen, M , Orum, M , Kalenderoglu, A . "Difficult Patient in Psychiatry Practice: A Case-Control Study". Adıyaman Üniversitesi Sağlık Bilimleri Dergisi 4 (2018): 1064-1073 <http://dergipark.org.tr/adiyamansaglik/issue/40184/458680>
Chicago Ozen, M , Orum, M , Kalenderoglu, A . "Difficult Patient in Psychiatry Practice: A Case-Control Study". Adıyaman Üniversitesi Sağlık Bilimleri Dergisi 4 (2018): 1064-1073
RIS TY - JOUR T1 - Difficult Patient in Psychiatry Practice: A Case-Control Study AU - Murat Eren Ozen , Mehmet Hamdi Orum , Aysun Kalenderoglu Y1 - 2018 PY - 2018 N1 - doi: 10.30569/adiyamansaglik.458680 DO - 10.30569/adiyamansaglik.458680 T2 - Adıyaman Üniversitesi Sağlık Bilimleri Dergisi JF - Journal JO - JOR SP - 1064 EP - 1073 VL - 4 IS - 3 SN - -2458-9179 M3 - doi: 10.30569/adiyamansaglik.458680 UR - https://doi.org/10.30569/adiyamansaglik.458680 Y2 - 2018 ER -
EndNote %0 Health Sciences Journal of Adıyaman University Difficult Patient in Psychiatry Practice: A Case-Control Study %A Murat Eren Ozen , Mehmet Hamdi Orum , Aysun Kalenderoglu %T Difficult Patient in Psychiatry Practice: A Case-Control Study %D 2018 %J Adıyaman Üniversitesi Sağlık Bilimleri Dergisi %P -2458-9179 %V 4 %N 3 %R doi: 10.30569/adiyamansaglik.458680 %U 10.30569/adiyamansaglik.458680
ISNAD Ozen, Murat Eren , Orum, Mehmet Hamdi , Kalenderoglu, Aysun . "Difficult Patient in Psychiatry Practice: A Case-Control Study". Adıyaman Üniversitesi Sağlık Bilimleri Dergisi 4 / 3 (December 2018): 1064-1073. https://doi.org/10.30569/adiyamansaglik.458680
AMA Ozen M , Orum M , Kalenderoglu A . Difficult Patient in Psychiatry Practice: A Case-Control Study. Adıyaman Üniversitesi Sağlık Bilimleri Dergisi. 2018; 4(3): 1064-1073.
Vancouver Ozen M , Orum M , Kalenderoglu A . Difficult Patient in Psychiatry Practice: A Case-Control Study. Adıyaman Üniversitesi Sağlık Bilimleri Dergisi. 2018; 4(3): 1073-1064.