1. TREATMENT / HOSPITALIZATION AND ITS EFFECT FOR PATIENT
dr. Moetrarsi S, Sp.KJ
Hospitalization and its Effect for Patient
International Programme
FACULTY OF MEDICINE
TREATMENT / HOSPITALIZATION AND ITS EFFECT FOR PATIENT
dr. Mutrarsi S, Sp.KJ Bioethics & Medical Humanities
Block VI, June 9, 2005 Week 4 (International Programme)

2. Introduction
Being ill is considered a burden for someone’s life. To go to the hospital to get diagnosis and treatment for the illness or moreover being hospitalized can be a stressor for certain people. The stressor can appear in many kinds of manifestations. The effects of treatment for patients in the hospital are influenced by many factors, for example type of illness, severity of illness, onset of illness, the previous experience to the illness, age, sex, occupation, socio-culture-economy condition and patient’s perception towards performance and behavior of the health provider.

3. Objectives
To know the factors which influence the effects of treatment.
Understand patient’s images on medical personnel and others in the therapeutic team.
Understand that as hospital staff must be able to empathies with the patient and help them to come to term with the reality on their situation.
To grow awareness of the importance to study the related factors i.e. perception, image, personality, defense mechanism, communication, and professionalism.

4. Objectives (Cont)
To excite self awareness in finding experience through many kinds of media i.e. books, journals, field studies including self experiences.
To grow awareness of the importance of humanizing the patients.
To promote their self to learn about patient defense mechanism.

5. HOSPITAL-HOSPITALIZATION
ILLNESS/DISEASE * *
HOSPITAL-HOSPITALIZATION *
TREATMENT * *
EXAMINATION
THERAPY * * *
Instrument (-) Anamneses Inspection Palpation Auscultation
DIAGNOSE
WITHOUT INSTRUMEN *
PROGNOSE
FARMACO PSYCHO* *
INSTRUMEN * *
INSTRUMEN
ELECTRIC * * * * * *
SMEAR
NEEDLE
SCISSOR
ELECTRIC ECT & RO
NEEDLE
ECG/EEG/ USG SCAN RO FOTO *
PUNCTURE
* = Stressor

6. hospitalization patient
The placing of a patient in a hospital for treatment
The term of confinement in a hospital
patient
A person who is undergoing treatment for disease

7. Effect of Hospitalization
Positive: - Recover
- Remission
- Satisfied
- Residue
- Improve health care
Negative: - Complication - Death
- Worsen - Get stigma
- Deteriorate
- Unsatisfied

8. Treatment Hospitalization and its effect for patient
EXTERNAL
EFFECT
INTERNAL
EFFECT

9. Psychological
Sociological culture
Treatment
Hospitalization and
its effect for patient
Physiolo-
gical age
Value/
perception
His / her
Experience
Financial

10. What / which
Why
Treatment
Hospitalization and
its effect for patient
How
Where
When
Who / Whom

11. HOW : Doctor Patient interaction
Doctor-nurse-patient-relationship
Other member – inter relationship
Does he comply
Frequent
WHERE : Surgical ward
Psychiatric ward
Government Hospital
IMAGE : Educational Hospital
Emergency Case

12. Doctor
Nurse
Staff
Worker
e.t.c
Professional
Attitude
Approach

13. What kind of treatment Surgical treatment  “Lost”  Depression
Medical treatment  Side effect Anxiety
Palliative treatment  image of treatment

14. What kind of Disease Case Illness Acute Chronic Terminal Fatal
Reversible
Irreversible
Physic – Organ
Psyches – psychotic/ non psychotic
Emergency
Pain

15. - Doctor Nurse Personality Staff Perception Worker Environment
Who - The patient :
- infancy : birth – 2 year
- Pre school period – 2 – 3 - years
- School age period : 6 – onset of puberty
- Adolescence
- Old
- Status : Married / unmarried
Who – Patient
- Doctor
Nurse
Staff
Worker
Personality
Perception
Environment

16. appendix
STRESS is the physiological and behavioral response of on individual seeking to adapt and adjust to both internal and external pressures.
STRESSOR is on event, a situation, a person or on object which is perceived as a stressful element and induces the stress reaction as a result.
Stressor can very widely in nature ranking from psychosocial and behaviors sources suck as frustration, anxiety and overload to bio-ecological and physical sources including noise, palliation temperature, and reaction. Appropriate for hospitalization is judged on two grounds
Severity of illness and intensity of service. In other words, the patient has to be sick enough to must being in the acute care hospital setting, and the services the patient needs can only be provided in the hospital setting.

17. There are three areas of adaptations to be faced by patient:
The separation - the family – loss – rejection punishment.
To be separated from work.
To be separated from society or community.

18. Psychological reaction to physical illness:
Factor in the illness it self
The severity of symptoms – pain
The degree of disability and the perceived threat of life.
The duration of the illness
The organ

19. Factor in the patient
Age
Sex
Body image
Pre-morbid personality
3. Situational Factor
Family – work – social environment
Relationship with doctors – nurses and others in the therapeutic team

20. Body image is made up of a person’s perceptions, thoughts and feelings about his own body.
Head – is concerned with intellectual capacity and control.
Hearth – with life it self
Sexual organs – with masculinity or femininity

21. Personality
The characteristic and source extend predictable, behavior – response patterns that each person involves, both consciously and unconsciously as his style of life.
The paranoid person tends to be suspicious and jealous of other patient.
The schizoid personality – may find the closeness of being cared for and nursed somewhat threatening.
The explosive personality incapacitated by illness may react with hostility.
The anankastic (obsessive – compulsive) personality, perfectionist and needing to remain in control of situation.
The hysterical personality – may react to illness in an attention – seeking, exhibitionistic fashion.

22. There are three categories of coping strategies:
Retreat from the threat
Conservation the energy
Involves the defense mechanism of repression.

23. dr. Moetrarsi S, Sp.KJ
Hospitalization and its Effect for Patient
Defense mechanisms
Suppression the set of consciously inhibiting on impulse, effect or idea as in the deliberate attempt to forget something and think no more about it. Denial – Refused to admit the reality of. Rationalization – making a thing appear reasonable etc.
Block VI, June 9, 2005 Week 4 (International Programme)

24. Reference
Sadock, BJ, Sadock, VA. Kaplan & Sadock’s Synopsis of Psychiatry 9th ed Lippincott Williams & Wilkins. Philadelphia, USA.
Helman, CG. Culture, Health and Illness 4th ed Oxford University Press, New York, USA.
M.J. Sains Bury, Key to Psychiatry a tex book for students., general Hospital psychiatry. Chapter 22. Australia-New Zealand Book Co. PT YLTD
M. AW. Brouwer, Anna Alisyahbana. Myra Sidharta Rumah Sakit dalam Cahaya Ilmu Jiwa. PT Grafidion Jaya.
Benyamin Sumenta Pasien Citra …. Dan perilaku – Tinjauan Fenpmena social. Penerbit Kanisius
Instrument for example
Preparing for your childs Hospital liration
Psychiatric hospital liration
Minal Michal Stress- sign sources, symptoms & solution, Rache
Harold /Koplan MD, alfild M Freedmon MD, Benjamin/ Sadock, MD. Comprehension textbook of Psychiatry III, William Wilkins