虚血性心疾患患者の行動パターンへの理解と全人的医療(指定発言)(内科領域における全人的医療)(第31回日本心身医学会総会)

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Holistic medicine means undertaking biopsychosocioethical medical approaches and giving supports to patients. Type A behavior pattern is a well known risk factor for coronary heart disease (CHD), consisting of components such as time-urgency, harddrivingness, competitiveness and hostility. By understanding the behavior pattern of patients, several benefits can be obtained by holistic approaches and supports to CHD patients. 1) The first of all, to know the behavior pattern of patients is to gain new information about risk factors for CHD. Many evidences have been shown clinically and experimentally which prove the relationship between CHD and the type A behavior pattern. 2) Secondly, to know the behavior pattern is to have a keyword which tells psychosomatically the whole state of patient. The behavior pattern is associated with and constructed of many personal (constitutional hereditary disposition and personality) and environmental (psychosocial stress, occupational position, social demand and nationality) factors. So understanding the behavior pattern is very useful for understanding whole characteristics of patient. 3) Thirdly, understanding behavior pattern helps to have a standpoint which points out social pathogenecity for CHD. This social pathogenecity induces the type A behavior pattern which is believed as the way to make economic success or to become an excellent administrator. Clinically type A patients seemed to have many harmful tendencies for CHD in their daily lives. For example, they make a vicious circle between excessive involvement in job and emotional stress due to job, then they become tired and exhausted. They often have wrong overconfidence, lack of self-awareness of being ill, and of proper self-control to prevent heart attack. Concerning these harmful characteristics of type A, a case of recurrent MI was demostrated. This administrator, 53 years of age, fell with acute myocardial infarction and was admitted to hospital and came back to job. Thereafter he could not modify his typical type A behavior pattern. He was involved more and more in his job, until he fell due to his recurrent attack. Type A modification is apparently necessary to prevent recurrent MI. So both beharioral couselling to patient and social education to his environmental surroudings are necessary to modify patient's type A behavior pattern. These efforts may be considered as a final approach of holistic medicine to CHD patient.
日本心身医学会の論文
1991-03-01

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前田聡
名古屋第二赤十字病院循環器内科

虚血性心疾患患者の行動パターンへの理解と全人的医療(指定発言)(内科領域における全人的医療)(第31回日本心身医学会総会)

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