摘要
时间性是叙事医学的核心特征之一,对精神疾病患者病史采集具有独特的实践价值。时间性有两层涵义,即物理时间和症状时间,其中,症状时间体验又包含主观时间和时空混乱两种体验。通过三个典型临床案例,逐一对应物理时间、主观时间和时空混乱,系统阐述精神科医生运用与时间性相关的叙事沟通技巧和方法,进行病史采集的过程。依据这些方法,能深入挖掘患者疾病经历、心理状态与社会背景,识别疾病的各种表现与变化,确认疾病本质,进而为构建诊疗关系、制定治疗计划打下坚实基础。
Temporality is one of the core characteristics of narrative medicine,holding unique practical value in the collection of medical histories for patients with mental illnesses.Temporality encompasses two layers of meaning:physical time and symptom time,with the experience of symptom time further including subjective time and spatiotemporal confusion.Through three specific clinical cases,this paper sequentially addresses physical time,subjective time,and spatiotemporal confusion,detailing the process by which psychiatrists employ narrative communication techniques and methods related to temporality for medical history collection.These methods enable a deep exploration of the patient's disease experience,psychological state,and social background,identifying various manifestations and changes of the disease,and confirming the nature of the disease.Furthermore,it lays a solid foundation for building diagnostic and therapeutic relationship and formulating a treatment plan.
作者
陈妍
邵静
杨甫德
袁曦
CHEN Yan;SHAO Jing;YANG Fude;YUAN Xi(Research and Intervention Center for Psychological Crisis,Beijing Huilongguan Hospital,Beijing 100096,China;College of Marxism Department of Humanities and Social Sciences,Hainan Medical University,Haikou 571199,China)
出处
《医学与哲学》
北大核心
2025年第15期66-71,共6页
Medicine and Philosophy
基金
2023年北京市卫生健康委高层次公共卫生技术人才建设项目培养计划(学科骨干-02-08)
2022年海南省人文医学研究基地重点课题(QRYZH202205[ZD])。
关键词
叙事医学
时间性
症状时间体验
精神疾病
病史采集
narrative medicine
temporality
symptom time experience
mental illness
medical history taking
