心身医学
Online ISSN : 2189-5996
Print ISSN : 0385-0307
ISSN-L : 0385-0307
17 巻, 2 号
選択された号の論文の26件中1~26を表示しています
  • 原稿種別: 表紙
    1977 年 17 巻 2 号 p. Cover1-
    発行日: 1977/04/01
    公開日: 2017/08/01
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  • 原稿種別: 表紙
    1977 年 17 巻 2 号 p. Cover2-
    発行日: 1977/04/01
    公開日: 2017/08/01
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  • 池見 酉次郎
    原稿種別: 本文
    1977 年 17 巻 2 号 p. 74-
    発行日: 1977/04/01
    公開日: 2017/08/01
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  • 金子 仁郎
    原稿種別: 本文
    1977 年 17 巻 2 号 p. 75-
    発行日: 1977/04/01
    公開日: 2017/08/01
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  • 石川 中
    原稿種別: 本文
    1977 年 17 巻 2 号 p. 76-82
    発行日: 1977/04/01
    公開日: 2017/08/01
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    The results of a questionnaire survey made by the Education Committee of the Japanese Sociaty of Psychosomatic Medicine in February, 1975,are reported.The questionnaires were sent to 76 medical departments throughout the country, and answers were received from 32 of them. Among teh 32 departments, these were 29 where the lectures were given and bedside teachings conducted on psychosomatic medicine.As a common trend, insufficient teaching hours and shortage of teaching staff were emphasized in the contents of the answers.These answers were classed according to the kind of department into three groups, that is, 10 psychiatric, 12 internal medicine and 9 other departments.Comparison among them indicated that at non-psychiatric departments, especially at the departmetns of psychosomatic medicine, lectures on psychosomatic medicine were being given according to the teaching to the teaching curricula which were quite different from those given at psychiatric departmetns where psycholomatic medicine is considered only as a part of psyshiatry.As psychosomatic medicine is in a transitional stage, various psychiatric techniques are currently used in teh departments of psychosomatic medicine. No doubt the day will come in the future when the departments of psychosomatic medicine use their independent techniques which are different from those orthodox ones traditionally used in psychiatry.
  • 圷 千代子
    原稿種別: 本文
    1977 年 17 巻 2 号 p. 83-86
    発行日: 1977/04/01
    公開日: 2017/08/01
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    The forfeiture of humanity and the estrangement of human being have been the subject of discussion today. The rise and development of psychosomatic medicine may be said to be a natural sequence because the object of medicine cannnot be thought of without human beings.Nursing, which plays a part in the total medical care system, has also changed the quality of its activity in conformity with the expanded concept of medical care. It is evident that underneath this change is the philosophy of psychosomatic medicine.Psychosomatic medicine urges us to recognize again that the object of medical care is "the human being" and not "material things". It has replaced the existing "dehumanized medicine" with "medicine of the whole person has psychological pains as well as deseased organs." This means that psychosomatic medicine deals with the human being who is an integrated whole of subjective, independent, creative and social existence.This trend also has percolated into the nursing field, and resulted in the practice of integrated nursing. To be concrete, patient-centered nursing, continuous nursing, and nursing may be cited.These activities take different forms but their aim remains the same, that is, to extensively accept man as a whole being, and look at the problems of health not only from the physical point of view, but also from the psycosocial as well, and furthermore in their mutual relations.Assistance and care can be given in a most suitable manner on the basis of this holistic approach.In realizing such activities, it must be considered that necessary assistance should be extended without spoiling the potentiality of the patients, but rather to fully develop and facilitate their possibilities autonomy, so that they may plan to develop and use their abilities to deal with their future problems.This is the so-caled "person-centered nursing, " and true nursing can be found in the process of putting this philosophy into daily practice.Can't this be called "creative nursing"?
  • 深沢 道子
    原稿種別: 本文
    1977 年 17 巻 2 号 p. 87-92
    発行日: 1977/04/01
    公開日: 2017/08/01
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    With the ever-expanding knowledge and increased use of technology in the field of medicine, medical care has become multi-faceted and highly specialised . This development creates an environment of alienation for the hospital patient who cannnot grasp what is happening around him. Instead of helping the patient, the various services offred him might, at times, make him feel more confused and disorganized. The problem is that the "whole person" is being ignored, while "parts" of him are being treated. He may be identified as a bed number or by his diagnosis, not as a person. This creates additional anxiety in the patient whose existence as a human being is negated.Society as a whole is also moving in the direction of depaersonalization. Over-abundance of information, urbanization, multiple and diverse value systems reinforce the individuals sense of alienation and helplessness. This phenomenon is also apparent in the hospital setting where medical services and tratment modalities vary, leaving the patient feeling lost and with the impression that "no one person" is coordinating services upon which his life depends.It is impossible to carry out effective medical services without dealing with patients' anxiety.Handiling the patients' feelings, however, is not valued highly in the current educational and training systems for para-medicals. It is even viewed as a "waste of time" to sit and listen to a patient.As a social worker with many years of experience, I propose the following to implement the training program for staff to deal more effectively with patients. Ideally, this approach would be most effective when started in school. but a hospital setting would be an excellent alternative through an in-service training aimed toward producing "counseling-minded, patient-oriented" para-medicals.1. Team approach and standardization of terms.2. Establishment of personnel's communication system.3. Understanding of patients and their families.4. Understanding of patients' psychology.5. Understanding of group dynamics.6.Self-understanding of personnel.7.Establishment and implementation of hospital philosophy.8. Development of a supportive hospital milieu.9.Understanding and use of patients' dependency.10. Relating to the "layman's view point".11. Learning through experience-seeing through patients' eye.12. Effective use of authority figure.
  • 杉田 峰康
    原稿種別: 本文
    1977 年 17 巻 2 号 p. 93-96
    発行日: 1977/04/01
    公開日: 2017/08/01
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    We Organized our first citizens' group for studying an maintaining health in September, 1970,which now has developed into 13 branches all over Japan. The aims of these self-help groups include : 1) Integration of excessive and unorganized medical knowledge from the holistic, psychosomatic standpoint, 2) most appropriate application of medical knowledge to individuals on the basis of their dispositions, personalities and environmental factors, and, 3) Facilitation of self-management of health by educating the general public.Three cases were presented to demonstrate how the self-help groups were working. We find our approach useful and effective because it can make the best of potentials hidden in these healthy groups, facilitate self-reflection by individuals' participating in the groupw an help them realize their responsibility for the fellow citizens. Since 1976 the Ministry of Education has starte rendering aid to our activities. Similar groups are carried out by psychosomaticians in Australia and Germany. A symposium on this topic will be held at the Congress of the International College of Psychosomatic Medicine in Kyoto, September 5-9,1977.
  • 筒井 末春
    原稿種別: 本文
    1977 年 17 巻 2 号 p. 96-
    発行日: 1977/04/01
    公開日: 2017/08/01
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  • 池見 酉次郎
    原稿種別: 本文
    1977 年 17 巻 2 号 p. 97-100
    発行日: 1977/04/01
    公開日: 2017/08/01
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    In our daily practice of psychosomatic treatment, the therapist's personality ('therapeutic self') Plays an essential role. The patient's mind is to be reflected in the mirror of the therapist's mind. The therapist is requested to modify his mind according to a variety of different therapeutic goals.Non-conditional positive regard and empathetic understanding are considered to be the foundation for every kind of psychotherapeutic approach. In practice, however, such an ideal basis for the 'therapeutic self' is rarely achieved. We, therefore, have initiated the following basic training programme for all trainees in our psychosomatic department, for the purpose of developing their 'therapeutic selves'.a) Practice in roleplaying of listening.Simple listening and sincere interest in the patient's problem is most important in initiating real communication with the patient.b) It has been reported that the practice of autogenic training, Zazen and other related methods of altering consciousness, may considerably facilitate the therapist's empathetic understanding and cultivation of a relaxed and accepting attitude.c) In our experience, transactional analysis, a colloquial form of psychoanalysis originated by Eric Berne, which is easily understood by our paramedical staff and even our patients, has been very helpful not only for treatment, but also for the therapist's self-analysis. The therapist's insight into his own personality problems may prevent him from having a distorted understanding of the patient.d)Training in behaviour therapy based on leaning theory (such as systematic densensitization and operant conditioning) may develop the therapist's ability to help the patient change his distorted behaviour patterns.e) The optimal psychotherapeutic doctor-patient relationship shouls not be modelled after the teacher-pupil relationship. Rather, there should be interactive relationship in which the doctor may change along with the patient.f) The therapist guided to develop a general holistic understanding of the human being, in addition to a knowledge of psychotherapeutic psychology.
  • 藤井 高明
    原稿種別: 本文
    1977 年 17 巻 2 号 p. 101-107
    発行日: 1977/04/01
    公開日: 2017/08/01
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    Changes of digital plethysmographic patterns following the administration of vitamin E, γ-oryzanol, sex hormone or tranquilizer for 2 to 4 months were investigated in 94 female cases of non-specific complaints ranging in age from 16 to 54. The results are summarized as follows : 1. In 29 cases whose complaints were induced by psychogenic caused, 16 cases (55.2%) of peripheral plateau wave, 5 cases (17.2%) of spastic wave, 3 cases (10.3%) of monophasic wave, 2 cases (6.9%) of bisferiens wave, 2 cases (6.9%) of dilatd wave and 1 case (3.4%) of anacrotic wave were observed before the therapy. In 65 cases whose complaints were induced by humoral imbalance due to the change of gonadial environment, 35 cases (53.8%) of peripheral plateau wave, 10 cases (15.4%) of bisferiens wave, 8 cases (12.3%) of spastic wave, 6 cases (9.2%) of dilated wave, 4 cases (6.2%) of monophasic wave and 2 cases (3.1%) of anacrotic wave were observed before the therapy.2. A normalization of digital plethysmographic patterns and a remarkable decrease of nonspecific complaints were not observed in almost all of the cases whose complaints were induced by psychogenic causes following the therapy. However, in cases whose complaints were induced by humoral imbalance, 18 cases of peripheral plateau wave, 4 cases of spastic wave, 4 cases of bisferiens wave, 4 cases of dilated wave and 1 case of anacrotic wave showed the normalization of digital plethysmographic patterns following the therapy. In addition, nonspecific complaints fairly disappeared concomitantly with an improvent of the digital plethysmographic patterns following the therapy in those cases.3. Clinical findings of 6 representative cases in which a close relationship between nonspecific complaints and digital plethysmographic patterns was shown in the course of the therapy are repreted.
  • 上西 創造
    原稿種別: 本文
    1977 年 17 巻 2 号 p. 108-114
    発行日: 1977/04/01
    公開日: 2017/08/01
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    The principal factors of adolescent school phobia are often attributed to interpersonal anxiety.The present case was also in the state of maladjustment due to interpersonal anxiety.The author treated a case of adolescent school phobia by using asssertive training and systematic desensitization produres with marked success.Impressions were summarized as follows : 1) Behavior therapy was effective in this patient with adolescent school phobia.2) The sysmptom of this disorder would spontaneously be removed if (a) noxious stimuli and the anxiety reaction were precisely grasped, (b) abnormal reactions to those noxious stimuli were released and (c) a new adaptive behavior was leaned.
  • 筒井 末春
    原稿種別: 本文
    1977 年 17 巻 2 号 p. 114-
    発行日: 1977/04/01
    公開日: 2017/08/01
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  • 荒木 登茂子, 庵原 トモ子, 高橋 宣生, 吾郷 晋浩, 杉田 峰康
    原稿種別: 本文
    1977 年 17 巻 2 号 p. 115-120
    発行日: 1977/04/01
    公開日: 2017/08/01
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    This research was conducted to study some psychological aspects of corticosteroid dependent asthmatics. Our subjects consisted of teh following 4 large groupe : 1. Group M……31 asthmatics who are presently seen by physicians and who were further divided into 2 types : 10 corticosteroid dependent patients (Type S) and 21 non-corticosteroid dependent patients (Type n-S).2. Group LT…13 tubeculosis patients who had been long hospitalized. 3. Group ST…13 tuberculosis patients who had been hospitalized for a short period of time.4. Group K…28 asthmatics who are presently seen at the Department of Psychosomatic Medicine, Kyushu University School of Medicine.As the psychological tests, Cornell Medical Index(CMI), Yatabe-Guilford Personalit Test(YG) and Picture Frustration Study (PF) were used. The results of our study were summarized as follows : 1. Type S was more neurotic, submissive and repressive than Type n-S.2. Compared with Group ST, Group LT was characterized by repression of dependency and aggressive needs, and showed a more neurotic tendency.3. Asthmatics were more neurotic than tuberculosis patients;however, both Type S and Group LT showed repressive tendencies.4. No significant difference was found between Group M and Group K.From these date, it is suggested that, in an attempt to terminate the use of steroid hormone, we need to take into consideration its psychological as well as endocrinological aspects, and that many of the asthmatics who are treated in general hospitals, partculaly those who are dependent on steroid hormone, need a psychological approach in addition to physical treatment.
  • 西園 昌久
    原稿種別: 本文
    1977 年 17 巻 2 号 p. 120-
    発行日: 1977/04/01
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  • 原稿種別: 付録等
    1977 年 17 巻 2 号 p. App1-
    発行日: 1977/04/01
    公開日: 2017/08/01
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  • 津田 彰, 平井 久
    原稿種別: 本文
    1977 年 17 巻 2 号 p. 121-129
    発行日: 1977/04/01
    公開日: 2017/08/01
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    It is well known that stress-induced physiological changes, such as gatrointestinal ulcers or essential hypertension, are innate reactions to chronic fear. But from the point of view of organic adaptation, any learning of the abersive situation that affects the strength or duration of the fear elicited may be expected to influence the physiological simptoms of stress. A psychological factor of this type of learning depends on whether or not the animal can "think" of a way to cope with the stress when the stressor arrives.The present study was conducted to determine the effects of coping response on chronic stress in the rat in a free-operant avoidance situation(R-S interval, 200 sec., S-S interval, 0.4 sec., shock intensity, 2.25 ma. mean) when measured by stomach lesions. The matched quartet design was employed. Each quartet consisted of an experimental animal (N=11) which could avoid or escape shocks by its flapper-pushing rsponse, a yoked animal (N=11) which received the same intensity and duration of shocks as the expeimental animal but which could not avoid or escape shocks, a nonshock control animal (N=11) which was never shocked throughout the experiment, and a home-cage control animal (N=11) which remained in his individual cage in the rat colony room. Avoidance-escape stress sessions lasting 23 hrs. followed by 1 hr. feeding-rest periods were repeated for 7 days. Flapper-pushing rate, body weight, and food and water intake were recorded daily. Gastric incidence was noted at the termination of the eight experimental day. Results of teh present study showed that the yoked group developed more severe gastric lesions than experimental, nonshock, or home-cage control group and also confirmed findings of previous acute stress experiments by indicating that subjects which could not control shock were more stressed than subjects which could. Through the ezperimental and yoked groups did not differ in body weight loss during the chronic stress session, both the nonshock and home-cage control groups differed significantly from the other two shocked grouls. The experimental group ate and drank somewhat more than the yoked group. The home-cage control group showed the most food an water intake, All experimental group subjects made more flapper pushes than in all matched yoked or nonshock subjects, as would be expected. Response rates were similar either eleven triplets.These results were predicted by Weiss' ulcer-prediction model which related ulceration to certain psychological (or behavioral) variables. Also an explanation for the atypical "exective" monkey pehnomenon was attained.
  • 菊池 長徳, 石川 中, 森堂 忠夫, 工村 房二, 紅露 恒男
    原稿種別: 本文
    1977 年 17 巻 2 号 p. 130-133
    発行日: 1977/04/01
    公開日: 2017/08/01
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    A 21-year-old girl complained of frequent vomitting and loss of weight. She had repeated overeating and vomitting since she was 17 years old, and had reduced weight from 52 kg to 32 kg.When she was adminitted to our hospital for the first time, the diagnosis of anorexia nervosa was given without much suspicion.On psychological examination, she wa found to be a hysterical character(dissociation reaction type).She improved in less than 3 months without any special therapy.Soon after discharge, however, her symptom developed again so that she was admitted for the second time and an abdominal X-ray examination confirmed an acute gastric dilatation just before her vomitting took place.Brief psychotherapy with major tranquilizer proved a satisfactory management at this time.
  • 長谷川 和夫
    原稿種別: 本文
    1977 年 17 巻 2 号 p. 134-
    発行日: 1977/04/01
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  • 原稿種別: 付録等
    1977 年 17 巻 2 号 p. 134-
    発行日: 1977/04/01
    公開日: 2017/08/01
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  • 原稿種別: 付録等
    1977 年 17 巻 2 号 p. 135-
    発行日: 1977/04/01
    公開日: 2017/08/01
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  • 篠田 知璋
    原稿種別: 本文
    1977 年 17 巻 2 号 p. 136-137
    発行日: 1977/04/01
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  • 原稿種別: 付録等
    1977 年 17 巻 2 号 p. 138-
    発行日: 1977/04/01
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  • 原稿種別: 付録等
    1977 年 17 巻 2 号 p. 138-
    発行日: 1977/04/01
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  • 原稿種別: 付録等
    1977 年 17 巻 2 号 p. 140-
    発行日: 1977/04/01
    公開日: 2017/08/01
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  • 原稿種別: 表紙
    1977 年 17 巻 2 号 p. Cover3-
    発行日: 1977/04/01
    公開日: 2017/08/01
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