Подпись Лечебного Врача.
ЭПИКРИЗ
Дата поступления больного в клинику, диагноз лечебного учреждения, основные жалобы при поступлении в лечебное учреждении (конкретно). История патологического процесса (настоящая время).
Состояние больного при поступлении в больницу. Краткое и понятное описание патологии. Изменений внутренний органов и центральное нервное система. Выявить результаты дополнительных обследований, особенно патологические изменение. Подробное описание лечение при клиническому диагнозе. Дать показание амбулаторного лечение при домашних условиях. Чтобы не повторился патологический процесс дать показание о профилактике факторах и лечения в санаториях, курортах. Необходимо дать показания ВТЭК о состоянии больного, о течении патологического процесса и степень и потеря здоровья.
bu Bakr Ar-Roziy (865-925), who lived in Bagdad, Hurosan, Bukhara
and other cities of middle east, wrote more than 700 Case Histories and
is the founder of modern Case Histories.
M.Ya.Mudrov (1776-1831) for the first time in Russia put into practice
clinical investigatins and Case History
Professor S.Yu.Tursunov (2010 year) suggested to change the words
“Case History” into the words “Health Diary”
Introduction
It is known, in our country the attention focuses on the development of health care system, health promotion and increasing the medical culture.
Most of men, who are in medical establishments, have depression. The task of medical workers is to instill confidence of their recovery.
We know that inscriptions, slogans, the catchwords written in medical establishments have a large effect on the psyche of the patient.
It is considered from history, that Avicenna didn’t call a building for treatment of patients “hospital”, but a “retreat” as, the name “hospital” has an adverse effect on patients.
Addressing to persons treated in hospitals, we often call them “patient” and we do not pay attention as far as hard this word is tolerated by patient.
We offer instead of the word “patient”, such words, as father, sister, uncle, etc.
Besides, it is necessary to exclude the word “patient” from “case history” and call it «Diary of health». It will promote early recovery of patients.
Sometimes to persons come on preventive inspection, the case history is also opened, and this in turn leads to an artificial overestimation of disease.
Therefore we to all healthy persons, and also newborns suggest to open «Diary of health » and to write down in it all medical data.
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