TY - JOUR T1 - Difficult Patient in Psychiatry Practice: A Case-Control Study TT - Psikiyatri Pratiğinde Zor Hasta: Bir Vaka-Kontrol Çalışması AU - Orum, Mehmet Hamdi AU - Ozen, Murat Eren AU - Kalenderoglu, Aysun PY - 2018 DA - December Y2 - 2018 DO - 10.30569/adiyamansaglik.458680 JF - Adıyaman Üniversitesi Sağlık Bilimleri Dergisi JO - ADYÜ Sağlık Bilimleri Derg PB - Adıyaman University WT - DergiPark SN - 2458-9179 SP - 1064 EP - 1073 VL - 4 IS - 3 LA - en AB - Aim: Some of the patient-physicianencounters are considered "difficult" by the relevant physicians. Somaticsymptoms, substance abuse, aggression, hostility, and lack of co-operation arethe most common features related to difficult patients. That is, the risk ofencountering difficult patients in psychiatric practice is high. The difficultrelationship may be related to the patient as well as to the physician. Weaimed to investigate the difficult patient characteristics associated with thepatient in this study. Material and Methods: Difficult relationship is definedas "situations in which the psychiatrist-patient relationship is perceivedas problematic”. The cases were defined as difficult relationship with at leasttwo of the psychiatrists who were studying. Controls consisted of patientswithout difficult relationships. 45 cases and 90 controls were included in thestudy. Results: There was nosignificant difference in terms of age, sex, marital status, education status,and working status between the two groups. The number of hospitalization, drugsused, psychotherapy, and social intervention was higher in the case group thanin the control group. Personality disorders was significantly higher in thecase group. Conclusion: Theuse of more medicines, more social interventions, more hospital admissions havebeen attributed to the dissatisfaction of these patients.The improved goodtherapeutic relationship can lead to less symptoms and fewer applications inthese difficult patients. Further systematic research should be conducted withrespect to patient-physician relationship to provide a greater understanding ofboth its etiology and solution. KW - Case-Control Study KW - Difficult Patient KW - Physician-Patient Relation KW - Relationship N2 - Amaç: Bazı hasta-hekim karşılaşmalarıilgili hekimler tarafından "zor" olarak kabul edilir. Somatikbelirtiler, madde kötüye kullanımı, saldırganlık, düşmanlık ve işbirliğieksikliği, zor hastalarla ilgili en sık görülen özelliklerdir. Yani, psikiyatripratiğinde zor hastalarla karşılaşma riski yüksektir. Zor ilişki hastaya olduğukadar hekime de bağlı olabilir. Biz bu çalışmada hasta ile ilgili zor hastaözelliklerini araştırmayı amaçladık.Gereç ve Yöntem: Zor ilişki “psikiyatrist-hastailişkisinin sorunlu olarak algılandığı durumlar” olarak tanımlanmaktadır. Olgular,çalışmakta olan psikiyatristlerin en az iki tanesi tarafından zor ilişki olaraktanımlandı. Kontroller bu hekimlere göre zor ilişkileri olmayan hastalardanoluşuyordu. 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 sosyalmüdahale, kontrol grubuna göre daha yüksekti. Olgu grubunda kişilikbozuklukları anlamlı olarak yüksek bulundu.Sonuçlar: Daha fazla ilaç kullanımı, dahafazla sosyal müdahale, daha fazla hastane yatışı zor olarak nitelendirilen buhastaların memnuniyetsizliğinden kaynaklanabilmektedir. İlerletilmiş iyi birterapötik ilişki, bu zor hastalarda daha az semptom ve daha az girişimi-yatışısağlar. Hem etiyolojisini hem de çözümünü daha iyi anlayabilmek içinhasta-hekim ilişkisine ilişkin daha fazla sistematik araştırma yapılmalıdır. CR - 1. Grooves JE. Taking Care of the Hateful Patient. N Engl J Med 1978;298(16):883-7. CR - 2. Varan LR. The clinical interview using DSM-IV, Volume 2: The difficult patient. J Psychiatry Neurosci 1996;21(1):58-9. CR - 3. 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