100 KB24 KB199420252005Ivetić, Vojislavštevilka:2letnik:44str. 189-194ISSN:0025-8121COBISSID:20159449URN:URN:NBN:SI:doc-1KGHW1YGslMedicinski razglediMedicinski razglediDružinska medicinaFamily Practicemedicinsko nepojasnjena stanjaPhysician-Patient RelationsSomatoform DisordersSomatoformne motnjezdravjeZdravnik-bolnik, odnosiMedicinsko nepojasnjena stanja| Medically unexplained symptoms|Almost 20% of patients who consult their family physicians, present with physically unexplained symptoms. Diagnostic clues include multiple unexplainedsymptoms, usually in different organic systems, unclear symptoms, high health care utilization patterns and normal results from physical examination and diagnostic tests. Articles were found through a MEDLINE search. The search was performed utilizing the MeSH terms "medically unexplained symptom", "somatization", "somatoform disorders", "family medicine". Only papers in English were selected. Patients with medicaly unexplained symptoms are found in the following groups of patients: problematic patients, frequent visitors of family physicians office, patients with functional problems, anxious and/or depressive patients, patients with somatisation and somatoform disorders. Common symptoms that induce suspicion of medicaly unexplained symptoms are: fatigue, dizzines, headache, dispnea, syncopa, vomiting, dispepsy, insomnia, chest pain, aritmy, gastrointestinal problems (opstipation, diarrea), chronic pain... Family physicians are often feeling frustrated and responsable for patients discontent with their threatment in cases of medicaly unexplained symptoms. It is generaly believed that family physicians are not sufficiantly theoreticaly and practically educated to threat patients with medicaly unexplained symptoms. The process oftreating these patients is challenging, complex and poorly understood. In spite various strategies to treat such patients have been tried, effective management guidelines are still lacking. Difficulties in treating these patients represent a challenge for searching and developing new methods that would reduce expenses of diagnosis and treatment and lower the frequency of these patients visits to the family physician and their unnecessary direction to the specialistsSkoraj 20% bolnikov, ki obiskujejo ambulanto družinske medicine, toži za telesnimi simptomi, za katere se po številnih preiskavah ne najde konkretnega organskega vzroka. Diagnostični napotki pri obravnavi takšnih bolnikov vključejejo številne simptome, pogosto v različnih organskih sistemih, nejasnosimptomatologijo, kronični potek težav ter številne diagnostične/laboratorijske preiskave. Analizirani so članki, dostopni v bazi podatkov "MEDLINE", od januarja do maja 2005. Uporabljeni so MeSH-izrazi medically unexplained symptom, somatization, somatoform disorders, family medicine. Kot iskalni pogoj sem določil le prispevke v angleškem jeziku. Bolnike z medicinsko nepojasnjenimi stanji opažamo v naslednjih skupinah bolnikov: težavni bolniki, pogosti obiskovalci ambulant, bolniki s funkcionalnimi motnjami (njihovi simptomi se razlagako s funkcionalno motnjo, brez same bolezni), anksiozni in/ali depresivni bolniki, bolniki s somatizacijskimi motnjami in bolniki s samatoformno motnjo. Najbolj pogosti simptomi, ki lahko inducirajo sum na medicinsko nepojasnjeno stanje, so: utrujenost, vrtoglavica, glavobol, dispneja, omedlevica, slabost, bruhanje, dispepsija, nespečnost, bolečina v prsih, občutek nepravilnega bitja srca, prebavne težave (zaprtost, driske), kronična bolečina itd. Zdravniki družinskemedicine se pogosto počutimo odgovorni in kronično frustrirani zaradinezadovoljstva bolnikov z našo obravnavnavo bolnikov z medicinsko nepojasnjenimi stanji. Obstajajo resne objektivne težave, s katerimi se zdravniki srečujemo v odnosu do teh bolnikov in v obravnavi bolnikov z medicinsko nepojasnjenimi stanji. Ne glede na številne poskuse ustreznega zdravljenja in različnih tehnik pristopa zaenkrat še ne obstajajo točne smernice in napotki glede obravnave takšnih bolnikov. (Izvleček prekinjen pri 2000 znakih)TEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaDruštvo Medicinski razgledi