Management

Abstract

When it has been decided, as a result of examination and investigation, that a considerable part of the total clinical picture is due to anxiety or other emotionally determined factors, the medical and nursing professions have at their means several alternatives and combinations of treatment to use. As the terms of reference of this book are psychosomatic disease, it is not proposed to go into detail regarding moderate or major psychiatric illnesses such as severe depression and schizophrenia. The very fact that a patient is in hospital is frequently therapeutic in itself as it means that society, relatives and friends have acknowledged the person’s right to receive care and help, and that he is ‘worthy’ for this to take place. Naturally such a formulation is never spelt out but is implicit in the total situation of hospital admission or even out-patient care. In the majority of conditions where a specific event needs to be altered or cured, for example pneumonia, appendicitis, childbirth, there will be in most cases no need for any further considerations towards the patient’s mental state other than perhaps a mild sedative at night. When, however, it has been decided that stress or unresolved anxiety is playing a part in the maintenance of the symptoms, then notwithstanding a specific measure such as gastrectomy or administration of anti-hypertensive drugs, those caring for the patient may wish to use other measures, which can be divided into specific and non-specific.

(1) Specific to the disease itself, for example Hypotensive drugs—anti-spasmodics for asthma, ergot for migraine, etc.

(2) Non-specific measures.

(3) The special role and opportunities for the nurse, and other ‘caring’ professionals:—TRANSFERENCE