دانلود کتاب بررسی علائم – رویکرد مبتنی بر شواهد به تاریخچه بیمار

Patients present with symptoms not diseases. They rely on healthcare professionals to accurately interpret these symptoms. A patient who attends their doctor is saying: ‘I’ve noticed my anatomy and physiology are changing’. Can you tell me: is this normal change as I get older? Or am I developing a disease? If it is a disease: will it get better, and will I return to normal? Or will it continue and change my health and level of function? Will it shorten my life? Answering these questions requires good communication but also accurate interpretation of the patient’s description based on understanding of what is being described. Exploring Symptoms describes the connection between the underlying science of symptoms and the words used by patients to describe them. Though many patients may have a particular disease, each person’s experience and description of it is unique to them. Nonetheless, connecting science, patients words, and studies of how symptoms are presented in disease facilitates clinical reasoning and diagnostic accuracy. It is safer for patients and more professionally satisfying for clinicians. Importantly, it may lead to more judicious use of finite resources with more appropriate choice of limited diagnostic technologies. Despite technological advances in medicine and particularly in diagnostics, the patient history remains responsible for approximately 80% of diagnoses. Even where examination, blood tests and imaging are undertaken, they can only be accurately interpreted by reference to the patient’s symptoms. Rightly, we emphasise the evidence-base to establish new investigations and treatments not least on the grounds of patient safety. However, the history, our most important tool, remains without a firmly established and widely known evidence-base so far as its content is concerned. Understanding the patient’s symptoms is crucial to modern medicine for diagnostic accuracy, patient safety, and satisfaction and for good resource management in finite health services. I have tried to ensure this work is representative of those who too often feel excluded from heath care and who suffer discrimination from services through no fault of their own. I could not include everything about all groups or individuals, but this book is dedicated to everyone. I hope it will contribute to improving care for all of us. I thank Dr. Anna Frain for her reading and re-reading of the chapters which has helped to refine and clarify the text and for all the support she has given over the past year I have been writing this book. Dr. Jo Butler of www.medical-artist. com has provided some wonderful anatomical illustrations to help connect the science to the patient experience. Thank you also to Fozia Mushtaq, Prathishta Gnanaratnasingham, Isabel and Leo Ashford, Leonardo Jackson and Dr. Magdy Abdalla all from the University of Nottingham, UK for their contribution to Chapters 1, 5 and 15.