ID#: UD71637HCL80792
Program: Doctorate Degree in Clinical Psychology
SCHOOL OF SOCIAL & HUMAN STUDIES
Atlantic International University
1st May2021
Table of Contents
Overview of Psychological Concepts and Theoretical Frameworks 4
The Humanistic theoretical Approach 6
The Link between Psychology and Medical Practice 8
Concept of Health, Medicine and the Medical Practice 9
Concept of Psychological Medicine 12
Concepts of Medical Diagnosis 13
Concept of Prescriptions in Medicine and Healthcare 15
The Practice of Psychology in the Medical Sector of the United States 16
The Practice of Psychology in the Medical Sector of Nigeria 18
Introduction
Health and wellbeing are undoubtedly critical to human, corporate, and global development because it is an essential aspect of general health that influences humanity’s physical and psychosocial tendencies to a substantial measure. (Sarter, 2014) However, figures on psychological health and physical health disorders worldwide are alarming and call for great concern. According to international health agencies, especially statistics from the WHO, it can be seen that around 2 billion people across planet Earth are suffering from one ailment or the other, primarily psychological and the rest physiological. (WHO, 2020) It is also believed that nearly 180 million individuals come under the attack of stress-induced depressions and depressive conditions yearly. This situation paints a picture of the relationship between physical medicine in the form of general treatment and the body’s psychological needs in the form of mental health care. The traditional norm of denial, avoidance, and indifference practiced by contemporary medical practitioners, who only see health as physical fitness and the absence of disease, intensifies this trend.
The fact that psychology evolved from the concepts and ideas of philosophical frameworks does not overlook its high relevance in medical and health as a scientific field of study. This evolution is because the concepts and theories of human psychology have been enhanced over the years to interpolate with medical procedures, especially those dealing with the diagnosis of illness and prescriptions of treatment either in the form of drugs or vaccines. In the same vein, the complex nature of psychological fields of study, which has fluctuated between the behavioral health aspect of the human mind and the social, environmental factors affecting the human mind with the human body. According to influential physiologist Wilhelm Wundt, the average human being comprises both mental and physical states of life. These two distinct sections need a form of equilibrium for individuals and communities to survive usually. (Newman, 2017) In a global study released in 2015, the American Psychological Association (APA) emphasized the importance of linking people’s physical and mental health in a way that promotes wellness. All these points to the underlying truth that the magnanimous evolution of psychological concepts from prehistoric times till the common era has primarily influenced medical practice. This dynamism makes the medical application of psychological knowledge a crucial element in analyzing the recovery process for several physical and biological ailments, including neurological disorders and cardiovascular diseases. This paper, therefore, examines in clear and elaborate terms how psychology and medical practice interrelates as well as the processes involved in diagnosis and prescriptions used in psychological medicine. The researcher will carry out a comparative discussion of the rule of medical psychology and psychological therapy in the United States. Nigeria will also be carried out to bolster the real-life implications of this research study.
Justification
The synergy between the mind and the human body comes into purview as illnesses that affect the biological and physiological human body functions have a reverberating impact on the mental environment of individuals and vice versa. This situation, therefore, creates the need for infusing psychologists into the medical practice, a procedure that some highly developed countries have started applying for their national healthcare programs. Therefore, the study creates the practical application and implementation of psychological medicine and medical psychology into the medical practice of diagnosing and prescribing treatment instructions to patients, especially those fascinated with mental health disorders and neurological and cardiovascular ailments. The primary beneficiaries of this study would be health sector stakeholders such as health ministries, healthcare agencies, public health providers, private and public medical facilities, mental health treatment centers, and public health and community rehabilitation centers.
General Analysis
Overview of Psychological Concepts and Theoretical Frameworks
Humanity’s quest for wisdom and enlightenment has led him to explore a wide range of disciplines, including abstract studies, academic fields of research, and technological design disciplines. One of these new insights in psychology is a long and fascinating history mirrored in today’s psychological research (Smith, 2007). Therefore, it is essential to recognize that modern psychology, which is essentially the study of the mind and mental faculties, has evolved from an earlier iteration of primitive practice.
Psychology can be described as studying the human mind in terms of behavioral patterns shown by individuals in a specific environment. Psychology is a discipline due to the implementation and application of experimental procedures, experiments, and observation methods. In the mid-nineteenth century, Wilhelm Wundt, a German physiologist, founded psychology as a body of scientific knowledge. According to Kendra (2018), he conducted such investigations using scientific research methodologies, which resulted in a convergence of human thoughts, behaviors, and physiology science. In the German city of Leipzig, the Wilhelm Wundt psychological laboratory was founded.
Social psychology, positive psychology, political psychology, growth psychology, organizational psychology, and educational psychology are only a few of the disciplines that have developed and matured as a science right from prehistoric times till contemporary times. The idea of psychology has evolved into various sectors apart from the healthcare industry. Employers of labor and educationists have also keyed into the statements emanating from psychological concepts to design psychology branches in industrial psychology and educational psychology.
Researchers can use theoretical frameworks to analyze the connection between psychological concepts and medical practice, starting from the earlier science of psychology until the concurrent psychological age of multi-disciplinary adoption and application into diverse sectors. From the earlier days of psychology’s development as a field of study in the sciences, there has been huge debates and controversy as to whether it should be given full consideration as a critical and friendly aspect of medical science or not. Starting from the period of structural psychology as developed by physiologist Wilhelm Wundt, psychology has been considered a hard science since it dealt with the study of the mind, which is located in the structural component of the human physical brain. Some other earlier science psychologists, such as Edward Titchener, aligned with the structural theory propounded by Wilhelm Wundt with the premise that the mental capacity of the mind was the sole controller of all other physiological functions of the human body, both internally and external organs and systems. This condition creates the picture of an existing connecting force between psychology and medical practice. Some other theoretical approaches that explain this phenomenon include the systems theory, humanistic theory, and assessment theory.
Systems Theory
The inter-relationship between elements and social constructs in the universe has been expounded and analyzed starting from the 1940 theoretical proposition by biologist Ludwig van Bertalanfly who conceptualized that living organism’s function in a complex and interactive way and also elucidates that a system operates in an environment with the order, inter-dependency, goal-driven nature, and result-oriented situation. This theoretical proposition was further developed into the General systems theory, which then considered that connections exist between people in society that required a great deal of observation and introspection (Hammond, 2010). Hence, the general systems theory approach further expounds on Bertalanfly’s earlier submission and expands his work from the biological focal point to a broader perspective, which can now be applied to analyze the connection between medical procedures and the usage of psychological concepts.
The Humanistic theoretical Approach
While previous psychological thought patterns focused on abnormal behavior, the humanistic approach focused on assisting individuals in realizing their full potential. In response to behaviorism and psychoanalysis, the humanist approach encourages and supports free will, mental growth, and personal fulfillment. The humanist approach has influenced the development of different forms of psychology, such as positive psychology, which was designed to guide people through being satisfied in their lives. Abraham Maslow and Carl Rogers are two of the most well-known humanist thinkers today whose works vilified the counseling process of psychology from the scientific point of view. This has made a significant contribution to establishing a connecting force between the practice of medicine and psychological concepts since the process of mind-body interaction is considered a continuous one, according to Carl Rogers. (Secor&Drabenstot, 2020)
Assessment Theory
This is another theoretical approach that can create a connector between medical practice and psychological concepts. According to (insert citation), psychology finds growing and development opportunities in assessments and diagnosis. Analyzing psychology in parallel to psychiatry, it can be seen that there is a breakaway from the personality element. Psychology, on its standpoint, tends to view personality and behavioral tendencies as it influences the mental health of individuals. At the same time, the study of psychiatry deals with the psychodynamic operation of the human body. Hence, Highhouse (2002) and Sattler (2018) have helped understand the neurological interpolation between medical practice and psychology since psychiatry is now fully considered medical practice.
Furthermore, another perspective thinking into the interrelationship between psychology and medical practice is Finkehlor’s (1978) study, as cited by (insert citation), which looked at the influence of psychology on human biology and anatomy psychological impacts of sexual abuse on individuals. In contemporary times, however, it has been noted that this impact can also go in the opposite direction as there is a substantial network that exists between traumatic situations and adverse health conditions.
The Link between Psychology and Medical Practice
The medical practice has also benefited from the conceptual framework and ideas of psychology. These concepts have been applied in diagnosing, prescribing, and treating mental health disorders and some other diseases that affect the vital organs. These branches of psychology that can be linked to the medical practice of diagnosis and prescription of drugs include the following:
- Clinical Psychology: This branch of psychological study focuses on applying psychological concepts, expertise, and skills, as well as study and intervention methods, to health and disease, especially in the context of mental health. According to American Psychological Association (2009), this branch of psychology can be described as “a clinical specialty that includes the provision of diagnosis, evaluation, care plan, treatment, preventive, and consultative services to patients of emergency rooms, inpatient units, and hospital clinics,.” The Canadian Psychological Association defines it as “a wide area of practice and study within the discipline of psychology that applies psychological concepts to the evaluation, prevention, and amelioration of psychological disorders.”Clinical psychological study as an aspect of mind science combines research, philosophy, and experience to understand better, anticipate. It treats maladjustment, disorders, and discomfort and encourages human adaptation, change, and personal growth. As a result, it concentrates on the cognitive, mental, physiological, mental, societal, and interpersonal aspects of human function across ideologies and social classes. (Seshia et al., 2014)
- Health psychology: this branch of psychological study deals with applying the knowledge of psychology into the public health domain by designing policies that help promote high-quality health practices and institutions of positive health behaviors in individuals and societies. In essence, health psychologists are generally concerned about biological and social elements on disease contracting, spreading, and infections. (Slovik& Peters, 2006)
Other branches of psychology connected to medical practice are clinical neuropsychology, counseling psychology, pediatric psychology, and community psychology, amongst others.
Concept of Health, Medicine and the Medical Practice
The World Health Organization (WHO), being the authoritative global agency of the United Nations armed with the determination of health policies and medically related activities across the world, has been able to come up with an all-encompassing description of health which can be seen as a condition of total body, mind and environmental wellbeing of individuals, rather than just simply the absence of disease or infirmity in an individual or a society (WHO, 2016). This aligns with the stable view of the psychosocial school of medical thought, which proposes that the wellness and susceptibility of disease infections by people are determined by specific social, psychological, or physiological factors, following the quantum of experiences draw from patients. This approach is much different from the conventional medical postulation, which requires a high level of medically induced testing and clinical evaluation.
As a result of developments in psychological, medical, and physiological research, a new paradigm of thought process has arisen concerning medical operations and the health of individuals in society. The biological and psychosocial model, which considers health and disease as the product of a complex interaction of physical (e.g., genetic susceptibility), behavioral (e.g., diet, stress, and health habits), and social factors (e.g., cultural factors, family relations, and social support), considers health and disease as the product of a complicated interplay of physical, behavioral (e.g., diet, stress, and health habits), and social factors. This approach to health and disease has numerous theoretical and practical benefits. The ability to reduce one’s risk of contracting major medical problems, obtain more effective treatment, and rehabilitate oneself is gaining popularity. (Reeves et al., 2010; Rich, 2006)
It’s essential to keep in mind that, in the recent past, coping with health and disease was based on the biomedical model, in which scientists and practitioners focused primarily on biological aspects. The absence of illnesses and accidents was regarded as good health, while their appearance was regarded as ill-health. The proper treatment for that model necessitated biological interventions to alleviate the physical harm. As a result, healthcare professionals were split into two groups: doctors who followed biomedical thinking and had complete control over patients, and their assistants, whose job was to carry out the specialists’ orders. Prominent international health organizations have globally accepted this approach of integrating the biological aspect of human health to the psychological and social components. It is now seen as a way of blending psychology with the medical practice of illness diagnosis and drug prescription. (Schiff &Leape, 2012)
Behavioral wellness is becoming the foundation of integrating psychology with the medical diagnosis because behavior plays an essential role in mental and physical health. According to Tombu et al. (2011), behavioral tendencies may positively or negatively impact the human body, and poor behavior is linked to health and disease. This is because how we think of events influences how we react to them to create healthy or negative behaviors and change our habits. Health attitudes influence whether we hear or listen to medical advice, and a person’s personality can predispose the body to specific disorders.
As a study of actions and mental processes, psychology places a premium on education and training in these areas (e.g., human development, learning experiences, motivations, emotions, cognition, social, behavioral traits and attitudes, personality, etc.). It also aims to comprehend how physiological, psychological, and peer relationships affect healthy living and sickness. As medical practitioners, psychologists play a critical role in determining how physiological, psychological, and sociocultural environments affect health and illness. They have the requisite skills, working experience, and training to understand how basic behavioral and cognitive processes (such as cognition, emotion, motivation, growth, personality, and social and cultural interaction) prepare the body to develop dysfunctions. On the other hand, they are taught to recognize how these behavioral and cognitive processes are affected, the causes that lead to these changes, and how these disorders are adequately tested and put on medication. As a result, the need for psychologists in medical facilities, especially for diagnosis and prescription practices, has skyrocketed. Primary care therapy has emerged amongst the essential fields in medical services.
Concept of Psychological Medicine
In recent times, it has become a clear notion that individuals in public and private domains can improve medical care and general health wellbeing by focusing on the mental and psychological components of medical diagnosis, prescription, and treatment. This form of medical practice is tagged psychological medicine. It is a common form of medical practice utilized by medical practitioners and health care systems to cater to the teeming population of individuals who, one way or the other, are in a dilemma or scourge of depressive conditions and are also being troubled by biological and physiological disorders. According to Kendra (2020), certain factors serve as causal agents for the co-habitation of medical or physical diseases and mental health disorders. These factors include the interference between medical conditions that affect the body and mental health or psychiatric conditions that affect the mind and the central nervous system. It has been reported that cardiovascular disorders related to the cardiac region, in conjunction with neurological diseases such as stroke, paralysis, and PTSD, are directly linked to increased blood pressure and depression among individuals, especially older adults above the age of 50 years.
Therefore, psychological medicine, which is also known as liaison psychiatry, is primarily concerned with the means, methods, and technicalities involved in managing mental health and psychiatric illnesses using psychological processes and the knowledge of psychiatry within the medical environment. Since this field of study is considered part of medicine, the skills needed to carry out psychological treatment draw its source from medical diagnosis, clinical evaluations, and prescriptions in the form of drugs and vaccines.
Concepts of Medical Diagnosis
According to Schwartz et al. (2011), diagnosis is a procedure and a classification system, or a deliberate collection of conventional rules that the professional medical system has decided upon by the professional medical system to assign to a particular illness. Since medical decisions will be customized to a precise and accurate expression of the patient’s health status when the test is reliable and made promptly, a patient will have the most excellent chance for a positive health result. Furthermore, diagnostic knowledge is often used to influence public policy decisions such as payment plans, capital allocation decisions, and study goals. In the same vein, diagnostic testing can include various forms of medical practice ranging from medical imaging, pathological test, laboratory testing procedures, and neuro-cognitive testing.
According to Song et al. (2015), the medical diagnosis method is a dynamic, customer-focused, teamwork activity that includes data collection and clinical judgment to assess a patient’s health issue. This procedure takes place over time and occurs within a broader healthcare work environment that affects the health assessment. The diagnostic process is depicted by the medical board or society using a modification of a judgment call framework for understanding the continuous process of decision-making, collecting knowledge, integrating and interpreting it, and creating a working test procedure. The following is how the method of diagnosing individual works: A patient first develops a health issue. The patient is considered the first to think about his or her symptoms, and he or she will decide to seek medical help at this stage. When a patient requires medical assistance, a sequential process of collecting data, integrating and interpreting the information, and assessing a functioning diagnosis begins. Taking a patient’s medical history and interview, performing a medical assessment, performing diagnostic tests, and referring or communicating with other physicians are ways to gather knowledge that could be useful in understanding a patient’s health issue. A clinical manifestation is a compilation of disorders present, while a functioning diagnosis is a single probable diagnosis. Usually, physicians will suggest several diagnostic hypotheses or possibilities as explanations for a medical problem, and this list will be refined when further knowledge is gathered during the testing phase. The patient should be informed of the working diagnosis, which should provide an overview of the degree of ambiguity involved.
In carrying out medical diagnosis, there is information gathering through clinical history recording and interviewing the patients. This information gathering creates a clear line of action between medical diagnosis and psychology as a scientific field. The interview method is also used in collecting data during psychotherapeutic interventions and counseling sessions. According to NASEM (2015), the interview phase starts with the formulation of appropriate questions to the research issue, the design of motivator questions to motivate interviewees, and creating a convenient atmosphere for the interview session to obtain an optimal answer and exact details for analysis. This is referred to as the preparation process, and it precedes the actual interview, which is followed by the review and contemplation phase. It can be seen that the study method is derived from the human behavioral analysis since it seeks to interpret people’s attitudes and inner dispositions toward a specific topic.
Consultation between a clinician and a patient begins with the healthcare professional compiling a patient’s medical history or confirming that the details of the patient’s history already in the medical database of the facility are correct. The current problem, previous medical histories, family timelines, social history, and other relevant information, such as current medications (prescription and without prescription) and dietary supplements, are all part of a patient’s health history.
Obtaining a patient’s clinical history and administering an interview necessarily requires strong communication and good communication skills to the patient’s desires, values, and preferences.
Concept of Prescriptions in Medicine and Healthcare
Prescription can be seen as a critical interaction between a patient and a medical practitioner during therapeutic interventions. In prescription, it involves a written order by trained and licensed medical personnel, mostly a physician and a pharmacist. This order is a list of drugs or medication to treat an ailment that the practitioner has previously diagnosed. (Kumar et al., 2019) Prescriptions are exclusively meant to be handled by certified and recognized practitioners rather than any professional in the medical practice. In writing a prescription, symbols are used, and hence they must be written so that other medical personnel can interpret and apply the instructions. The practice of medical prescriptions has transcended over the years. Its symbols are from ancient prehistoric civilizations; the colon is the symbol Rx derived from a Latin recipe for treating wounds and ailments.
Prescriptions could be embedded as information and infused into a medical record database system that can then be sent to a pharmaceutical store via the internet. Alternatively, depending on the circumstances, a prescription can be handwritten on pre-designed prescription forms, which have been prepared in a format similar to notepads, then printed onto similar conditions using a printing machine or even a written piece of paper. A prescription may be communicated orally by telephone from a physician to a pharmacist in some cases; however, this procedure could lead to medically generated error as the audibility of the conversation could serve as a negative deterrent. (Manchikanti, 2007)
Discussions
The Practice of Psychology in the Medical Sector of the United States
The United States is a developed nation that has, over the centuries, developed its healthcare system in an innovative manner that accommodates a great deal of occupational, professional functioning in various jurisdictions across her numerous medical facilities all over the 50 States and Washington DC. While psychologists operate in diverse healthcare settings where medical treatments, including psychological medication, are used, they cannot prescribe or administer drugs either in drugs and vaccines. Traditionally, the medical practitioner’s job, either a doctor or a pharmacist, is to issue medical prescriptions. In the same vein, pharmacologists, nurse practitioners, and physician’s assistants are examples of those who can also give medical drugs. (Svensson et al., 1997) However, two States- New Mexico and Louisiana have created legislation that allows psychologists to prescribe to patients, which has now empowered the rights and duties of medical psychology as a vital aspect of the medical practice.
As part of social responsibility and job functions, medical psychologists keep an eye on the side effects of medications, spot complications, and hand in hand with the medical staff of private and public health facilities to ensure that patients recover in record time. Patients should also learn to speak for themselves if their treatment or dosage is no longer reliable. Also, medical psychologists are licensed to institute and organize support groups for recovering patients, especially those with critical life-threatening ailments. These support groups could be combined with therapy sessions by counseling or clinical psychologists.
On the other hand, they may assist the patient and caregiver, such as helping them cope when a shift in functioning prevents them from working or when the meditation cost becomes a problematic situation. This assistance can be provided using contemporary fundraising techniques and platforms, particularly online crowdfunding schemes.
Continuing education services now offer university college classes and programs in psychopharmacology and psychology for medical psychologists in several schools and medical colleges. Books on these issues include a detailed understanding of psychological drugs and adverse effects and internal organ reactions, including when to place patients on a new medication. As shown in a review of related evidence on medical psychologists and substance treatment or psychopharmacology, medical psychologists in collaboration with psychiatrists are involved in certain aspects of prescription administration, but only to the extent that they do not prescribe the treatment to the client. (Cohen, 2014)
Psychology as a discipline is embodied in almost every health service, especially those in the world’s developed nations. As a result, medical practitioners who practice psychology are recognized as offering needed, practical, and cost-effective health services in state and federal systems and many local neighborhoods in the entire United States. These practitioners in the United States, on the other hand, are regarded as full members of the hospital medical staff and enjoy full benefits given to nominal hospital staff. In recent times, specific policies and codes of conduct have been included in the CMT program designed to make mental health treatment available through testing via face-to-face diagnosis.
The Practice of Psychology in the Medical Sector of Nigeria
The advent of psychology into the medical and healthcare sector of the Nigerian economy can be seen as rather too late than the growth and development of psychology in the Western world. This has led to low benefits for the Nigerian populace as mental health illnesses continue to ravage the nation and other developing countries in Sub-Saharan Africa. It is, therefore, not able to indicate that the Nigerian health care sector is still highly handicapped regarding the practice of clinical and medical psychology. However, there are prospects for futuristic growth. Certain private institutions and government-based facilities are gaining interest in psychological studies and how they can be infused into the medical practice. (Ogueji& Constantine-Simms, 2019)
Even though psychology is thought to have promising national prospects, research shows that it has not attained a considerable level of development in Nigeria. The required growth needed to elevate psychology and its subfields to a high professional level has not yet been reached. In Nigeria, for example, Zamani (2019) found in a survey study that, despite participants’ good knowledge of psychological science and their belief that psychology is necessary for national growth, psychology and its subfields are still behind in development. Similarly, existing research studies suggest that the growth of psychology in Nigeria may be constrained by Nigerians’ attitudes toward this field of research and other subfields emanating from it.
Methods
We gathered knowledge in secondary data about general health challenges across the health sector, particularly health ailments related to cardiovascular and neurological body functioning, for this research study from academic articles, journals, and newspapers. The motive of the data collection process was to analytically evaluate the use of medical psychology in diagnosing and prescriptions of treatment of these health challenges. This is to access the level of implementation of psychological concepts and theories into medical practice by government and privately owned medical facilities, as well as compare the pattern of Although the reports presented here represent the general situation of both the United States and Nigeria at the moment, their interpretation deserves caution since the data was gathered from newspapers and scholarly journals and was mainly limited to physical health challenges reported in the medical facilities within the public domain of the Nigerian and United States healthcare sector.
Results
This research study showed that the practice of psychology in the medical procedures of diagnosis and prescriptions was significantly implemented in the health sector of the United States and was poorly implemented in the Nigerian health sector.
Actualization
The primary beneficiaries of this research study would be health sector stakeholders such as health ministries, healthcare agencies, public health providers, private and public medical facilities, mental health treatment centers, and public health and community rehabilitation centers. This study benefits counseling psychologists and occupational psychologists as it would create opportunities for innovation in the healthcare sector of developing economies that are still struggling to implement psychological concepts into their medical practice programs at the local, state, and national government level. Future researchers’ findings could be used to minimize the prevalence of general health disorders, diagnoses, outcomes, and intervention programs. It will guide how to handle health emergencies, including health problems affecting vital body organs and the brain.
Conclusion
From psychology as a scientific field of study, its relevance and requisite importance to medical practice have been for clinical evaluation and patient assessment during the recovery stage for specific illnesses. However, things began to change midway into the 20th century when the tentacles of psychology and psychological concepts were expanded fully into medical diagnosis and treatment prescriptions. This resulted from new studies suggesting that illnesses of the mind affect the human body and vice versa. It is on this premise that psychological concepts are infused into the treatment of medical conditions related to the neurological and cardiovascular functioning of the human body. Medical diagnosis and prescriptions can now be carried out alongside psychological evaluations as medical psychology and psychological medicine has been developed to bridge the gap. This research study focused on analyzing psychology and its connection with medical practice, emphasizing medical diagnosis and treatment prescriptions. From the study results, it is noticeable that there is a full implementation of psychological concepts into the medical practice of the United States and the opposite in the Nigerian healthcare sector.
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