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Pojęcia holizmu i chaosu w medycynie rodzinnej

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Czachowski S.

Prakseologia

2007

nr 147

31-49

In this review I am starting a discussion on the subject of the notion „holism”, which was brought by the European Academy of Teachers of Family Medicine into the definition of a family doctor. This notion characterizes one of six axial skills of a family doctor. The holism is known in medical science mainly in field for the human physiology and it shows that a human organism as a whole is something more than just the sum of one’s parts. Feedbacks between the gigantic number of molecules are creating new in terms of quality correctness which may act in complicated and unpredictable way. Other disciplines like psychology and sociology adapted the holism to theories explaining public behaviors. The „holism” is waking big controversies up because of its negative associations with alternative and complementary medicine, with New Age moves and the shamanism. In the new medical discipline – value of the communication with the patient is being underlined in family medicine but medical consultation still has a central meaning. Theories of the chaos and complexities can explain a lot of phenomena in this context, which have the influence of functioning of the entire system of the health care. Correct understanding new medicine notions can prevent appropriating these notions for the needs of charismatic healers.

Psychospołeczne determinanty chorób. Implikacje medyczne w podstawowej opiece zdrowotnej

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Czachowski S.

nr 4

The social determinants of diseases within the primary care settingThe article highlights the social determinants of diseases within the primary care setting. Since the introduction of the new paradigm of the bio-psycho-social model into medicine, the social impact on illness has gained recognition. This article discusses the new approach to patients, as well as the impact that socio-economic status, emotional factors and stress have on health. Furthermore, factors such as the stages of patients’ lives and their ethnic and cultural identity (as well as approaches, such as the general theory of systems) are taken into consideration. New problems in primary care, including multimorbidity, patient frailty and medically unexplained symptoms, which have recently come under intense scrutiny, are also presented. Finally, clinical aspects of frail patients and the economic cost of the treatment of patients who suffer from unexplained symptoms are pointed out.