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HOLISTIC DIAGNOSIS

HOLISTIC DIAGNOSIS

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HOLISTIC DIAGNOSIS

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  1. HOLISTIC DIAGNOSIS Nita Arisanti

  2. Type

  3. RUJUKAN YANKES PERORANGAN RUJUKAN YANKES MASYARAKAT RS UMUM/KHUSUS PUSAT/PROPINSI DINKES PROPINSI , DEPKES RI STRATA 3 STRATA 3 RS UMUM/KHUSUS KAB/KOTA, BP4, BKMM, BKOM, BKTK , KLINIK SPESIALIS, SPESIALIS DINKES KAB/KOTA , BP4, BKMM, BKOM, BKTK ,BPOM STRATA 2 STRATA 2 PRAKTEK DOKTER,PUSKESMAS, BP, BKIA , PRAKTEK BIDAN PUSKESMAS STRATA 1 STRATA 1 POSYANDU, POLINDES MASYARAKAT MASYARAKAT PERORANGAN/KELUARGA PERORANGAN/KELUARGA UPAYA KES KEL MANDIRI KADER UPAYA KES KEL MANDIRI STRATIFIKASI PELAYANAN KESEHATAN POSYANDU, POLINDES ,UKBM

  4. The health enhancement continuum Before man is involved The course of the disease in man DEATH Interrelation of the various: - AGENT - HOST - ENVIRONMENT factors (known & unknown) which bring AGENT & HOST together, or produce a disease-provoking STIMULUS Chronic state Defect Disability Illness Signs & symptoms Tissue & physiologic changes Immunity & resistance STIMULUS & AGENT becomes established & increases by multiplication or increment RECOVERY Interaction of HOST & STIMULUS in the human HOST HOST reaction Advanced disease Discernable early lesions Early pathogenesis Convalescence Pre-pathogenesis Pathogenesis Early detection & prompt treatment Disability Th/ & Rehabilitation Health promotion & Spesific protection PROMOTIVE CURATIVE PREVENTIVE PROMOTIVE REHABILITATIVE PREVENTIVE CURATIVE REHABILITATIVE

  5. INTEGRATED CONTINUING follow up Consultation and referral Acute, chronic, palliative care Organization

  6. Focus Not organ oriented Patient and Family oriented

  7. Approach HOLISTIC Biopsychosocial

  8. Selama ini pendidikan kedokteran berpusat pada pengenalan anatomi, fisiologi, patologi, farmakologi dari suatu penyakit, tetapi ada hal yang penting yang membantu memahami proses suatu penyakit yaitu individu sebagai pasien

  9. Exploring both the Disease & illness experience Understanding the whole person Finding Common ground Physical, history, lab Disease CONTEXT PROBLEMS PERSON Mutual Decision GOALS Illness Illness Disease Ideas, expectations Feelings, effect on functions ROLES Enhancing Patient-doctor relationship Incorporating Prevention and Health promotion Being realistic Patient Presents cues The Patient Centered Clinical Method

  10. BIOPSYCHOSOCIAL • biopsychosocial  union of body, mind, soul, and social

  11. THINK SYSTEMS!

  12. PERSON Organ system tissues cells molecules BIOMEDICAL atoms Subatomic particles

  13. GLOBAL SOCIETY & NATION COMMUNITY FAMILY COUPLE PSYCHOSOCIAL PERSON

  14. Biosphere  Society nation  Culture – subculture  Community  Family  Two person  Personal (experience & behavior)  System  Organs  Tissues  Cells  Organelles  Molecules  Atoms  subatomic Biopsychosocial

  15. Continuum of natural system

  16. Holistic Diagnosis • Personal aspect • Clinical aspect • Internal risk aspect • Expernal risk aspect

  17. History • Basic information • Chief complain • Present illness • Past medical history • Past surgical history • Medication • Allergies history • Immunization history • Screening history • Dietary assessment • Genogram and family history • Social history and occupational • Risk factors • Physical examination • Differential diagnosis • Laboratory assessment depends on the circumstances

  18. Diagnosis holistic • Personal aspect • Clinical aspect • Internal risk aspect • Psychosocial aspect • Management • Preventive and promotion plan • Screening • Immunization (if needed) • Counseling/ patient education • Chemoprophylaxis (if needed) • Curative • Rehabilitative • Follow up • Prognosis

  19. PUSTAKA • Rakel RE. Textbook of Family Practice. Sixth Edition. WB Saunders Co. Philadelphia. 2002 • Paulman PM, Susman JL, Harrison JD, Paulman AA, Finkelstein KM, Zatechka RB. Family Medicine Clerkship Guide. Elsevier Mosby. Philadelphia. 2005. • Yu-Maglonzo EI. The Filipino Physician Today. A Practical Guide to Holistic Medicine. UST Publishing House. 2003. • Dionisio, A. Counseling Skills for Caring Physicians: Individual Intervention. Department of Family and Community Medicine, University of the Philippines Manila. 2005