ConsultationModels-Bradfordvtsbradfordvts协商模型

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1、ConsultationModelsDrDarrenTymens,2003ConsultationModels"Badconsultationsresultfromhavinginsufficientclinicalknowledge,fromfailingtorelatetopatientsorfromfailingtounderstandthepatient'sbehaviour,hisperceptionofhisillnessoritscontext“-JGRHowie(1985)ConsultationModelsDescriptiveNormativeConcept

2、ualPracticalTheBiomedicalModelTakeanaccurateandrelevanthistory(OBSERVATION).Performanaccurateandrelevantexamination(OBSERVATION).Makeaprovisionaldiagnosis(HYPOTHESIS).Orderandinterprettheresultsofappropriateinvestigations(HYPOTHESISTESTING).Makeadefinitivediagnosis(DEDUCTION).MBalint(1957)Th

3、eDoctor,HisPatientandTheIllnessTheApostolicFunctionTheDrugDoctorTheSickRoleTheLongConsultationBerne(1964)GamesPeoplePlay/TransactionalAnalysisGamesParent/Adult/ChildRCGPModel(1972)Physical,PsychologicalandSocial‘TheTriaxialModel’ExtendthinkingbeyondorganicConsiderEmotional,Family,SocialandE

4、nvironmentalfactorsBecker&Maiman(1975)HealthBeliefModelIdeasConcernsExpectationsHeron(1975)TypesofInterventionPrescriptiveInformativeConfrontingCatharticCatalyticSupportiveByrne&Long(1976)6PhasesoftheConsultation1.Thedoctorestablishesarelationshipwiththepatient2.Thedoctordiscoversorattemptst

5、odiscoverthereasonfortheattendance3.Thedoctorconductsaverbaland/orphysicalexamination4.Thedoctor,thedoctorandpatient,orthepatient(inthatorderofprobability)considerthecondition5.Thedoctorandoccasionallythepatientdetailfurthertreatmentorinvestigation6.Theconsultationisterminated,usuallybythedo

6、ctorByrne&Long(1976)ConsultationStylesdoctor-centreddominatestheconsultationasksdirect,closedquestionsrejectsthepatient'sideasevadesthepatient'squestionspatient-centredasksopenquestionsactivelylistenschallengesandreflectsthepatients'wordsandbehaviourtoallowthemtoexpressthemselvesintheirownwa

7、yStott&Davis(1979)AreastoExploreTheidentification&managementofthepresentingproblemModificationofthepatient'shelp-seekingbehaviourThemanagementofcontinuingproblemsOpportunistichealthpromotionHelman(1981)‘FolkModel’-QuestionstobeAnsweredWhathashappen