Psychomaintenance of Chronic Physical Illness
Psychomaintenance of Chronic Physical Illness
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慢性躯体疾病的心理维护
DOI：
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发表时间：
1982
期刊：
影响因子：
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通讯作者：
N. Jones
中科院分区：
文献类型：
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作者：
R. Kinsman;J. F. Dirks;N. Jones
心理维持是指身体疾病的心理和行为持续和恶化（Dirks，1978；Jones、Kinsman、Dirks 和 Dahlem，1979）。在这方面，应该指出的是，心理维护并不将疾病的病因作为一个感兴趣的领域，而是关注心理和行为因素如何在疾病发生后维持和增加其感知的严重性和医疗难治性。尽管在大多数其他情况下药物治疗是有效的，但患者为何仍然因疾病而丧失功能？为什么患者似乎需要不成比例的高强度药物治疗？为什么患者住院时间比疾病的客观医学参数所表明的时间更长、更频繁？患者的哪些行为对他或她的医疗反应产生了不利影响？患者没有做什么与疾病相关的事情，这对医疗管理和治疗有什么负面影响？通过这些问题可以分离出心理维持的具体机制。心理维持机制似乎在各种疾病类型中都是普遍存在的，而且常常如此普遍以至于被忽视。
Psychomaintenance refers to the psychologic and behavioral perpetuation and exacerbation of physical illness (Dirks, 1978; Jones, Kinsman, Dirks, & Dahlem, 1979). In this regard, it should be noted that psychomaintenance does not address the etiology of illness as an area of interest but instead focuses on how psychologic and behavioral factors maintain and increase both perceived severity and medical intractability of the illness once it has already developed. How is it that the patient continues to be functionally incapacitated by illness, despite medical treatment that is effective in most other cases? How is it that the patient appears to require a disproportionately intense medication regimen? How is it that the patient continues to be hospitalized longer and more frequently than would be indicated by the objective medical parameters of the illness? What is the patient doing to contribute adversely to his or her medical response? What is the patient not doing in relation to the illness, and what negative effects does that have on medical management and treatment? These are questions whereby the specific mechanisms of psychomaintenance can be isolated. The mechanisms of psychomaintenance appear to be general across illness types and often so commonplace as to be overlooked.