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Transcript of diagnóstico centrado en la persona - mezzich y kastrup
8/8/2019 diagnóstico centrado en la persona - mezzich y kastrup
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Evaluation Procedures forExperience of Illness and Health in
Person-centered Integrative Diagnosis
Evaluation Procedures forEvaluation Procedures forExperience of Illness and HealthExperience of Illness and Health inin
PersonPerson--centered Integrative Diagnosiscentered Integrative Diagnosis
Juan E. Mezzich (New York)
Marianne Kastrup (Copenhagen)
Juan E. Mezzich (New York)
Marianne Kastrup (Copenhagen)
April 2010April 2010
8/8/2019 diagnóstico centrado en la persona - mezzich y kastrup
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AgendaAgenda
Designing Person-centered Integrative
Diagnosis (PID)
Apprasing experience of illness
Appraising experience of positive health
Designing PersonDesigning Person--centered Integrativecentered Integrative
Diagnosis (PID)Diagnosis (PID)
Apprasing experience of illnessApprasing experience of illness
Appraising experience of positive healthAppraising experience of positive health
8/8/2019 diagnóstico centrado en la persona - mezzich y kastrup
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8/8/2019 diagnóstico centrado en la persona - mezzich y kastrup
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Bio-Psycho-Social Framework of HealthBio-Psycho-Social Framework of Health
Engel’s Perspective
Clinical Complexity
Ill- and Positive-Health
Ecological Epidemiology
Engel’s Perspective
Clinical Complexity
Ill- and Positive-Health
Ecological Epidemiology
8/8/2019 diagnóstico centrado en la persona - mezzich y kastrup
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Engagement,
Respect, and Empowerment
Engagement,
Respect, and Empowerment
Engagement
Respect for human dignity
Respect for human values
Respect for cultural diversity
Empowering for autonomy
Empowering for fulfillment
Engagement
Respect for human dignity
Respect for human values
Respect for cultural diversity
Empowering for autonomy
Empowering for fulfillment
8/8/2019 diagnóstico centrado en la persona - mezzich y kastrup
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Promoting Personhood
and Life Fulfillment
Promoting Personhood
and Life Fulfillment
Self-awareness and personal & cultural identity
Autonomy and sense of controlling own life
Resilience and self-efficacy
Healthy habits (eating, exercise, relaxation, etc.)
Positive emotions (cooperation, solidarity, etc)
Self-trascendence and spirituality
Fulfillment of life project
Self-awareness and personal & cultural identity
Autonomy and sense of controlling own life
Resilience and self-efficacy
Healthy habits (eating, exercise, relaxation, etc.)
Positive emotions (cooperation, solidarity, etc)
Self-trascendence and spirituality
Fulfillment of life project
8/8/2019 diagnóstico centrado en la persona - mezzich y kastrup
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Towards a Person-centeredPsychiatry and Medicine
Towards a Person-centered
Psychiatry and Medicine
of the Person
for the Person
by the Person
with the Person
of the Person
for the Person
by the Person
with the Person
8/8/2019 diagnóstico centrado en la persona - mezzich y kastrup
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The Meanings of DiagnosisThe Meanings of Diagnosis
A fundamental concept for clinical care
A name, a variable, a formulation
A process or activity
A fundamental concept for clinical care
A name, a variable, a formulation
A process or activity
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8/8/2019 diagnóstico centrado en la persona - mezzich y kastrup
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The WPA International Guidelines for Diagnostic
Assessment (IGDA) as a starting point forPerson-centered Integrative Diagnosis (PID)
The WPA International Guidelines for Diagnostic
Assessment (IGDA) as a starting point forPerson-centered Integrative Diagnosis (PID)
A. Standardized Multiaxial Formulation
I. Illness
II. Disabilities/Functioning
III. Contextual Factors
IV. Quality of Life
B. Idiographic Personalized Formulation Jointl made b clinician atient and amil
A. Standardized Multiaxial Formulation
I. Illness
II. Disabilities/Functioning
III. Contextual Factors
IV. Quality of Life
B. Idiographic Personalized Formulation Jointl made b clinician atient and amil
8/8/2019 diagnóstico centrado en la persona - mezzich y kastrup
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Outline of Person-centered
Integrative Diagnosis (PID)
Outline of Person-centered
Integrative Diagnosis (PID)
Diagnosis as a formulation and a process
Broader scope of diagnosis describing ill- and positive-
health
Domain levels to include:
▫Illness & disability to wellbeing
▫Experience of illness and health
▫Contributory factors (risk & protective factors)
Descriptive tools to include standardized (categorical and
dimensional) and narrative approaches
Evaluation process to include a partnership of patient,
family/carers, and clinicians
Diagnosis as a formulation and a process
Broader scope of diagnosis describing ill- and positive-
health
Domain levels to include:
▫Illness & disability to wellbeing
▫Experience of illness and health
▫Contributory factors (risk & protective factors)
Descriptive tools to include standardized (categorical and
dimensional) and narrative approaches
Evaluation process to include a partnership of patient,
family/carers, and clinicians
8/8/2019 diagnóstico centrado en la persona - mezzich y kastrup
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erson-centered Integrative Diagnosis Domainerson-centered Integrative Diagnosis Domain
Levels Ill Health Positive Health
I. Health Status Ill-Being Well Being
a. Disorders a. Recovery
b. Disabilities b. Functioning
II. Experience of Experience of illness Experience of Health positive health
III. Contributory Risk factors Protective factorsFactors (internal & (internal &
external) external)
Levels Ill Health Positive Health
I. Health Status Ill-Being Well Being
a. Disorders a. Recovery
b. Disabilities b. Functioning
II. Experience of Experience of illness Experience of Health positive health
III. Contributory Risk factors Protective factorsFactors (internal & (internal &
external) external)
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Experience of Illness Experience of HealthExperience of Illness Experience of Health
Suffering
Idioms of ill-being
Explanations and
meanings of ill-being
Experience and
preferences on carers
Suffering
Idioms of ill-being
Explanations and
meanings of ill-being
Experience and
preferences on carers
Identity & self-awareness
Self-efficacy & controlling
own life
Self-trascendence
Resilience & positive
emotions
Emotional & instrumental
social supports
Quality of life
Identity & self-awareness
Self-efficacy & controlling
own life
Self-trascendence
Resilience & positive
emotions
Emotional & instrumental
social supportsQuality of life
8/8/2019 diagnóstico centrado en la persona - mezzich y kastrup
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Descriptive Methods for Assessing
Experience of Illness and Health
Descriptive Methods for Assessing
Experience of Illness and Health
Categories, e.g. idioms of ill-being
Dimensions, e.g. quality of life scales
Narratives, e.g. identity and self-awareness
Categories, e.g. idioms of ill-being
Dimensions, e.g. quality of life scales
Narratives, e.g. identity and self-awareness
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Evaluation Process for
Experience of Illness and Health
Evaluation Process for
Experience of Illness and Health
Perspectives of the Patient
Perspectives of the Family and Carers
Perspectives of the Clinicians
Integration of Perspectives
Perspectives of the Patient
Perspectives of the Family and Carers
Perspectives of the Clinicians
Integration of Perspectives
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Towards a
Health Experience Formulation
Towards a
Health Experience Formulation Personal history
Cultural identity
Social stressors and supports
Idioms, causes and meanings of illness
Self-efficacy & controlling own life
Resilience and positive emotions
Coherence and self-trascendenceQuality of life
Clinician-patient relationship
Health restoration /promotion experiences & plans
Personal history
Cultural identity
Social stressors and supports
Idioms, causes and meanings of illness
Self-efficacy & controlling own life
Resilience and positive emotions
Coherence and self-trascendenceQuality of life
Clinician-patient relationship
Health restoration /promotion experiences & plans
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