精神医学实践和日常生活中的行为契约:心理学和精神病学的观点

IF 1.2 Q4 PSYCHIATRY Psychiatry international Pub Date : 2023-01-03 DOI:10.3390/psychiatryint4010002
H. Ino, E. Nakazawa, A. Akabayashi
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引用次数: 0

摘要

近年来,“疑难”患者受到关注,行为契约被引入临床实践。这是因为一些患者对医疗保健提供者的行为不恰当,行为合同要求患者避免这种行为。然而,有人强调,行为合同存在伦理问题。我们从精神实践和患者心理学的角度对行为契约进行了伦理分析。我们分析了为什么患者对医生来说变得“困难”,并解释了为什么必须考虑患者的心理方面和精神疾病的负担。行为合同是不合适的,因为它们没有考虑到个别患者的心理或精神状况,并且是统一适用的。此外,行为契约假设的行为模式在今天的精神病学中是不合理的。此外,在这篇文章中,我们展示了行为契约如何促进精神疾病的污名化。出于这些原因,我们认为在临床实践中使用行为契约在道德上是不合理的。然而,我们补充说,在任何情况下都不应容忍针对医疗保健提供者的身体暴力。
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Behavior Contracts in Psychiatric Practice and Everyday Situations: A Psychological and Psychiatric Viewpoint
In recent years, “difficult” patients have gained attention, and behavior contracts have been introduced into clinical practice. This is because some patients behave inappropriately toward healthcare providers, and behavior contracts require patients to refrain from such behavior. However, it has been highlighted that behavior contracts have ethical problems. We present an ethical analysis of behavior contracts from the viewpoint of psychiatric practice and patient psychology. We analyze why patients become “difficult” for medical practitioners and explain why consideration must be given to the psychological aspects of the patient and the burden of mental illness. Behavior contracts are inappropriate because they do not consider individual patients’ psychological or psychiatric conditions and are applied uniformly. Moreover, the behavioral model that behavior contracts assume is not justified by today’s psychiatry. Furthermore, in this article, we show how behavior contracts promote the stigmatization of mental illness. For these reasons, we argue that the use of behavior contracts in clinical practice is not ethically justified. However, we add that physical violence against healthcare providers should not be tolerated under any circumstances.
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来源期刊
CiteScore
1.90
自引率
0.00%
发文量
0
审稿时长
11 weeks
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