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[Patients with functional symptoms--what should be done?]
1Departement Innere Medizin, Kantonsspital Basel.
Schweizerische Medizinische Wochenschrift
|March 28, 1992
Summary
Managing patients with unspecific complaints requires a shift from solely ruling out organic causes. Integrating psychosocial history, specific questioning, and validating patient experiences improves care and reduces frustration for both doctors and patients.
Area of Science:
- General Practice
- Psychosomatic Medicine
- Patient Communication
Context:
- Unspecific complaints are a frequent reason for medical consultations.
- Current management often focuses on excluding organic causes, leading to patient and doctor dissatisfaction.
- Effective strategies for managing these patients are underexplored.
Purpose:
- To provide guidelines for improved management of patients with unspecific complaints.
- To enhance doctor-patient communication and therapeutic alliance.
- To reduce unnecessary diagnostic procedures and "doctor shopping."
Summary:
- Obtain psychosocial history early, not just after excluding organic causes.
- Ask specific questions about symptom triggers and alleviating factors.
- Validate patient symptoms, avoiding dismissive phrases.
- Explore the patient's understanding of their symptoms (lay theory).
- Collaborate on working hypotheses, aligning with patient beliefs.
- Establish trust to set realistic therapeutic goals.
- Utilize brief psychotherapeutic techniques, such as supportive approaches and relaxation exercises.
Impact:
- Improved patient-doctor relationships and trust.
- Reduced patient frustration and "doctor shopping."
- Potential for long-term patient benefit through validated experiences and targeted interventions.