Making first contact: What to do with all that information! part 2

Last week I described some of the reasons for using a case formulation approach when working through initial assessment information, and today I’m going to describe one approach for organising a formulation. This is the “4 P” formulation, and it’s one that’s often used in mental health (Bolton, 2014). In the 4 P model, there are four questions to ask yourself: Preconditions – Why is this person vulnerable to this problem?Precipitating factors – Why now? This can mean “why is this person having symptoms now?” or “why is this person presenting to this person for treatment right now?”Perpetuating factors – Why is this person still ill?Protective factors – Why is this person not more ill? Remembering that people are whole people, and that pain is always multifactorial, this formulation approach incorporates diagnostic information (disease) alongside a person’s response to disease (illness). The two facets of “being unwell” go together – but not synchronously. We can have a disease and be oblivious to it (think of many forms of cancer, hypertension, Type 2 diabetes, osteoarthritis…and even Covid-19). Once we begin to experience symptoms and decide that this is not “normal” we call it illness. And if symptoms and signs begin to impinge on what we can and can’t do in life, we can call this disability or functional limitations. These in turn (more o...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Assessment Chronic pain Clinical reasoning Pain conditions Professional topics Research Science in practice biopsychosocial case formulation Occupational therapy pain management Therapeutic approaches Source Type: blogs

Related Links:

CONCLUSION: In our sample, percentages of variation in PLR and PD were found to be directly representative of TBI patients’ fentanyl blood concentration. Considering information about blood drug concentration is generally not available at bedside, PLR could be used as a proxy to assess analgesia requirements before a nociceptive procedure in critically ill sedated TBI patients who are vulnerable to stress.
Source: Journal of Neuroscience Nursing - Category: Neuroscience Tags: Articles Source Type: research
This study used data from 2 cross-sectional studies conducted in the neurology departments of 3 hospitals in Guangzhou, China. In total, 110 hypertensive stroke patients were recruited in stage I (2008-2009), and 119 hypertensive stroke patients were recruited in stage II (2018-2019). Patients' stroke knowledge was measured by the Stroke Knowledge Questionnaire. Patients' prestroke health behavior was measured by the Health Behavior Scale for Stroke Patients. RESULTS: The total score of prestroke health behaviors significantly increased over the decade (P
Source: Journal of Neuroscience Nursing - Category: Neuroscience Tags: Articles Source Type: research
Journal of Human Hypertension, Published online: 16 January 2022; doi:10.1038/s41371-021-00649-7Masked hypertension and neonatal outcome in high-risk pregnancies
Source: Journal of Human Hypertension - Category: Cardiology Authors: Source Type: research
ConclusionsPatient experiences related toH. pylori management are predominantly negative. Increasing providers ’ awareness about patients’ values, beliefs, anxieties, and expectations surroundingH. pylori diagnosis/treatment may improve provider-patient communication and, ideally, related outcomes.
Source: Digestive Diseases and Sciences - Category: Gastroenterology Source Type: research
Cell Death &Differentiation, Published online: 16 January 2022; doi:10.1038/s41418-021-00925-6TLR4 downregulation by the RNA-binding protein PUM1 alleviates cellular aging and osteoarthritis
Source: Cell Death and Differentiation - Category: Cytology Authors: Source Type: research
Oncogene, Published online: 16 January 2022; doi:10.1038/s41388-021-02151-3The critical role of STAT3 in biogenesis of tumor-derived exosomes with potency of inducing cancer cachexia in vitro and in vivo
Source: Oncogene - Category: Cancer & Oncology Authors: Source Type: research
Cases seem to be subsiding in states with high vaccination rates, but observers are reluctant to make firm predictionsIn February 2021, Dr Craig Spencer wrote in a Mediumpost that he was as “eager as anyone to see the end of this pandemic. Thankfully, that may be in sight”.“Covid cases and hospitalizations are dropping,” wrote Spencer, director of Global Health in Emergency Medicine at New York-Presbyterian/Columbia University Medical Center. “Vaccines are getting into arms. So, what happens next?”Continue reading...
Source: Guardian Unlimited Science - Category: Science Authors: Tags: Omicron variant Coronavirus Science New York US news North Carolina Source Type: news
Here's how this reaction may be different from an immediate skin reaction.
Source: Forbes.com Healthcare News - Category: Pharmaceuticals Authors: Tags: Healthcare /healthcare Innovation /innovation Science /science business pharma Source Type: news
AS CONCERNS about disease spread, a growing body of experts are investigating which unknown health boosters could pave the way to a longer lifespan. In the pursuit of longevity, one lesser-known herb has been shown to be highly effective.
Source: Daily Express - Health - Category: Consumer Health News Source Type: news
The stunning Covid vaccines manufactured by Pfizer-BioNTech and Moderna drew upon long-buried discoveries made in the hopes of ending past epidemics.
Source: NYT Health - Category: Consumer Health News Authors: Tags: Clinical Trials Coronavirus (2019-nCoV) Vaccination and Immunization National Institutes of Health MERS (Middle East Respiratory Syndrome) Acquired Immune Deficiency Syndrome Graham, Barney S (1953- ) Kariko, Katalin (1955- ) Fauci, Anthon Source Type: news
More News: Anesthesiology | Back Pain | Behavioural Therapy | Brain | Cancer | Cancer & Oncology | Chronic Pain | Cognitive Behavior Therapy | Conferences | COVID-19 | Diabetes | Diabetes Type 2 | Disability | Employment | Endocrinology | Hypertension | Insurance | Men | Neurology | Neuroscience | Neurosurgery | Occupational Health | Occupational Therapy | Osteoarthritis | Pain | Pain Management | Psychiatry | Psychology | Science