同濟(jì)醫(yī)學(xué)院診斷學(xué)ppt課件

1、DIAGNOSISCASE HISTORY AND INQUIRYWU SHUMING MDImportance of InquiryGaining clinical information and collecting case history based on systemic inquiry Base of clinical practice6080% diagnosis could be induced from interview between patient and physicianNew form：consultation by phone, in internet Succ

2、essful treatment is reinforced by a confidently established and maintained doctor-patient relationship benefits to patients compliance benefits to improve doctors clinical skill and confidence世界醫(yī)學(xué)教育結(jié)合組織愛丁堡宣言1988 每個病人都有權(quán)益希望醫(yī)生被訓(xùn)練成為留意力集中的傾聽者、仔細(xì)的察看者、感情細(xì)膩的交談?wù)吆透咝У呐R床醫(yī)生。OBJECTIVE OF INQUIRY The medical inte

3、rview serves three functions: to collect information, to respond to the patients emotional state, to educate the patient and influence patient behavior. 發(fā) 熱頭痛關(guān)節(jié)痛 咽喉痛皮疹 腰背痛咳嗽小便腹痛熱輻射氣急咳痰前傾惡心嘔吐眩暈認(rèn)識病毒感染發(fā)疹性疾病尿感腎盂腎炎中暑急腹疹肺炎支氣管炎關(guān)節(jié)痛病毒感染腦膜炎腦炎腹瀉胃腸炎wsm:METHODS &SKILLSkill of communicationSuitable environmen

4、tGreeting patientActive listenerLanguage & termNon-language communicationEnding talkrespectSkill of collectionEmphasis chief complainOpening & closing questioningSimple to complicateAvoiding med. termAvoiding irritable termSkillful induce sensitive topicKind & carefulGuiding PrinciplesEt

5、hical principles that guide the successful approach to diagnosis and treatment are honesty, beneficence, justice, avoidance of conflict of interest, and the pledge to do no harm. Increasingly, Western medicine involves patients in important decisions about medical care, including how far to proceed

6、with treatment of patients with terminal illnessesThe importance of the empathic clinician in helping patients and their families bear the burden of serious illness and death cannot be overemphasized. To cure sometimes, to relieve often, and to comfort always The secret of the care of the patient is in caring for the patient. Discussing psychosocial issues and forgoing clinician domination of the encounter increase patient satisfaction. Any diagnostic procedures ordered at this time should be chosen after consideration of the test characteristics