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Abnormal illness behaviour: the nursing contribution.

J Wilson-Barnett, M Trimble

    International Journal of Nursing Studies
    |January 1, 1984
    PubMed
    Summary
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    Patients with unexplained physical symptoms often experience psychological distress, including anxiety and depression. Healthcare professionals, especially nurses, play a crucial role in identifying and supporting these individuals.

    Area of Science:

    • Psychiatry
    • Psychosomatic Medicine
    • Clinical Psychology

    Background:

    • Patients presenting with physical symptoms lacking clear organic pathology frequently receive suboptimal care in general hospital settings.
    • Existing terminology for these patients is often pejorative, highlighting a need for more sensitive and systematic approaches.
    • A lack of appropriate assessment and treatment strategies contributes to patient distress and healthcare system inefficiencies.

    Purpose of the Study:

    • To differentiate patients with 'hysterical' complaints (excluding pain) from those in psychiatric and neurological settings.
    • To identify psychological characteristics, including mood and personality disturbances, in patients with unexplained physical symptoms.
    • To explore the role of healthcare professionals, particularly nurses, in managing these complex patient needs.

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    Main Methods:

    • Interviewed a sample of 79 patients with non-pain 'hysterical' complaints.
    • Administered psychological instruments to assess personality and mood disturbances.
    • Compared findings with two control groups from psychiatric (N=34) and neurological (N=36) clinics.

    Main Results:

    • The primary study group exhibited significant affective disturbances, characterized by moderate anxiety and depression.
    • Patients recognized the potential psychological origins of their symptoms but demonstrated unrealistic self-perceptions regarding coping and life challenges.
    • Key differences were identified between the patient groups, validating the study's primary objective.

    Conclusions:

    • Patients with unexplained physical symptoms frequently experience co-occurring anxiety and depression.
    • Effective identification and management of these patients require enhanced assessment and treatment protocols.
    • Nurses in both general and psychiatric settings are pivotal in providing essential guidance and care to this patient population.