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The percentage of those who had an underlying illness was 7.8 points higher than those who did not.
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|"||HealthIs身体of,精神of,社会It is in perfect condition, not just illness or frailty.||'|
sick(Byouki, English: Disease),disease(Yamai) isA human,Animal OfHeart,bodyHas malfunctioned or inconveniencedStatusThat thing.一般的にTypicallyTraumaEtc. are not included.病気の類似Similarity of illnessconceptAs,syndrome(Syndrome),disease(Suppei),disease(Shikan) will be explained together in this article.Another reading, illness (Yamaike), is a sign that an illness will occur.
Being sick is a sign that something in your physical, mental or social life is unhealthy...If people take this sign, modify their daily lives, and manage and treat their etiology, many illnesses will disappear early and they will be healthier than ever.Everyday lifeCan get..In other words, the experience of getting sick looks back on the physical, mental, and social life of the past, and the way of life of oneself.Values,TimeReview and review how to useopportunityIs (Self-care shortage nursing theory）..病むことは、これまでと違った新しい人生を手に入れ、自己成長を得る切っ掛けとなるのであるBeing sick is an opportunity to get a new life different from the past and to gain self-growth..
sickIs an ambiguous concept,IndividualIt is not something that can be defined in
Attempt to judge by the number of distributions
For one thingnatural ScienceTypicalCustomAs it is, aiming for "quantitative analysis", focusing on the numerical aspect, in other words, "正常 / AnomalyThere is a view that we try to divide by the concept.
Of a certain natureGroupThe idea is to draw a line with the numerical distribution in thenormal distribution OfpopulationIt brings in habits in the analysis of.In fact, there is no definition in statistics as to how much is "normal" and how much is "abnormal", and in formal statistics, the delineated value is arbitrary and can be set in various ways.However, from among such arbitrary values, the setting "2 x D", which is often used for convenience and habit, is adopted (for no good reason, half-forced), and "plus from the standard value". Minus 2 ×SDThe difference between the two is normal, and any deviation beyond that is abnormal (so it is a disease). ”“ Disease is a trait / condition found in less than 5% of the total, and normal is the remaining 95%. ” There is an example of trying to do it.しかしこのように「集団内での数的な分布」を「病気」の定義として流用してしまうと、日本で約1000万人が難儀しているHowever, if the "numerical distribution within the population" is diverted as the definition of "disease" in this way, about XNUMX million people are having difficulty in Japan.Diabetes mellitusAnd bring a lot of complicationsobesityOn the other hand, even those who happen to be tall without any underlying illness and who are living well are classified as "ill". Problems arise.すなわち、異常（統計的に数が少ない状態）であれば病気であるとも言えないし、病気であれば異常である、などとも言い切れず、統計的手法によって病気を定義しようとする試みには無理があるのであるIn other words, if it is abnormal (statistically small number), it cannot be said that it is ill, and if it is ill, it cannot be said that it is abnormal, and it is impossible to try to define the disease by a statistical method. There is[Source required].
Position to define qualitatively
On the contrary, there are attempts and positions to generalize and define diseases with qualitative or qualitative descriptions.
One is the personrecognitiondoingStatusEmphasis is placed on (or the content of the subjective experience of the person), and the definition of illness is "a state in which the person feels inconvenienced physically and mentally and wishes to improve", or "the person or his surroundings".[Annotation 1] Is in a state where he feels inconvenienced physically and mentally and wants to improve. "
When the doctor is illDiagnosisEven if you doLifeupperproblemDo not feelthe reason"I'm not sick. I'm healthy."Disability TheObstacleIt is not (a kind of disease in a broad sense) but individuality. ”It can be said that these are also reasonable in that sense.Also,health care workerEven from this standpoint, if the person or others do not feel the need for treatment, they will not come to the hospital, so even with such a definition, practical problems are unlikely to occur.
However, if you think about this as well, the doctorDependence-Addiction,osteoporosisEven in the case of diagnosing such as, the above-mentioned misunderstanding may occur, and from the standpoint of medical research, it is necessary to be able to define and diagnose the disease regardless of the judgment and values of the person and others. There is a demand for.
Attempt to incorporate the subjectivity of medical personnel
DoctorSome people who are engaged in such activities and earn income from it say, "Illness is a condition that is physically or mentally ill or inconvenient, and improvement by so-called medical treatment is desired." It is not uncommon for the definition to be forcibly included in the definition. (However, since medical treatment cures illness, it is a kind of use of "medical treatment" to define illness.Circulation theoryCan be.In addition, many illnesses can be cured without the need for medical treatment, so this is a very problematic definition (described later).
View in medical anthropology
MedicalWhat is happening in this area, apart from the medical staff and the patient's point of view,objectiveStudy academically and academicallyMedical anthropologyThen, the definition that "sickness is a combination of disease and illness" has also been submitted...The explanation is that disease is "biological" and illness is "subjective experience".If this method of explanation is adopted, for example, in the case of diabetes above, there may be 1000 million people who fit the definition of disease,Chronic illnessIn the early stages when there are few subjective symptoms, it is logical that very few people consider themselves "ill".
As I explained at the beginning, it is not easy to decide what is sick or not, and there are different views, and most of the general public are sick with the feelings they feel. It is routinely done to judge whether or not a person is ill, and the definition of "a state in which the person feels inconvenienced physically and mentally and desires improvement" is applied as it is, but a group of doctors is a group of doctors. From the standpoint of a doctor in a group of people, I try to look at biology-oriented perspectives and statistics.ClinicalDoctors set aside general theory and make judgments for convenience by comparing the individual symptoms of the patient who appeared in front of them with the customary judgment criteria written in medical books, and so on. Is being done.それらの見解は様々に複雑に相互影響しあうTheir views interact in a variety of complex ways[Annotation 2].
reality Of社会So what is your view on the disease?position,contextDifferent from one to another, different views are intricately contested.In fact, in clinical practice, doctors and patients often disagree or conflict.In the above, I gave some examples that the surroundings are judged to be ill but the person does not think that he is ill, but on the contrary, the doctor does not recognize or try to do so even though he feels ill. In some cases.For examplePrincipalOn the bodySevere painDespite feeling an abnormal sensation and instinctively complaining that it is some kind of illness, the doctor sees images such as CT and MRI and combines the examination with the skill of the doctor. Then, based on the fact that I happened to find nothing, I said, "It's not a disease (" objectively "or" biologically "). It's because of my mind." After the fact that it got worse or died, by another doctorMisdiagnosisIn some cases, it is determined that it was.またAlsoSteroid dermatosisAnd variousPollution disease,Sudden infant death syndromeAs can be seen in the example, the existence of the disease itself can be a question not only academically but also politically.
IllnessSortIt is not easy to do, and its classification changes frequently with changes in medicine.In medicine, diseases are generally classified from the following viewpoints.
- Mental illnessOrOrganic diseases(Living tissueClassification by (disease due to its own abnormality) or functional disease (disease due to abnormal working style of living tissue)
- Classification by localization ofliverDisease of心 臓Diseases, etc.)
- Classification by cause (infectionsex,,Autoimmunitysex,Iatrogenic diseaseSuch)
- pathologyClassification from target findings (benign, benign,Malignant,Such)
- Classification by aspect of progress (acute,Chronic, Fulminant, transient,SeizuresGender etc.)
Classification according to the necessity of medical care
In addition, the following classifications may be proposed..
- Category 1: Illnesses that cure with or without a doctor (Natural healing powerAnd those that can be cured by the efforts of the person himself)
- Category 2: Illnesses that can only be cured by the involvement of a doctor
- Category 3: Illnesses that do not cure with or without a doctor
Practitioners and the cityhospital OfDoctorIs everydayMedical treatmentMost of the "illnesses" encountered in the above belong to category 1(That is, even if the doctor / medical staff is not involvedhealingIllness to do).The ratio is 70-90%It is said that it is about.When the author, Dr. Hiroshi Okamoto, actually counted, 95% was in category 1..
(For illnesses in categories 1 and 2) For illnesses, (2) those that the person can cure by himself / herself, and (XNUMX) those that do not have the natural healing power and should be cured in cooperation with medical staff. There are two types.. For diseases that the person in question can cure by himself / herself, High blood pressure[Annotation 3],Diabetes mellitus,Hyperlipidemia,obesitydisease,gout,constipationDisease,insomnia[Annotation 4],Autonomic ataxia... and so on.
Illness and health
The antonym of illness is generallyHealthIs believed to be.
WHO(World Health Organization) defines health as follows.
Physically, mentally and socially in perfect condition, not just illness or weakness
Western medicineOf windthe termBy the way, health isHomeostasisCan be rephrased as being kept healthy...そういう観点からは、病気（疾病）というのは、恒常性が崩れてしまって元に戻らなくなっているか戻りづらくなっている状態だと考えると理解しやすいFrom that point of view, it is easy to understand that a disease (disease) is a state in which homeostasis has collapsed and cannot be restored or is difficult to return..
Furthermore, if we re-understand the concept of homeostasis with the term "non-illness" in traditional Chinese medicine, the concept of illness and health becomes easier to understand..
Traditional chinese medicineThe diagnosis of "not sick" by (Chinese medicine) is that there are no obvious abnormalities and no obvious symptoms on examination, but it is a little sick and there are subtle changes in mind and body before getting sick. pointing..Speaking of Kanbun reading style, it is "still unclear". The following is a classification of physical conditions using "not ill" as a keyword.
- State 1: Homeostasis is maintained healthy ... Healthy
- State 2: Homeostasis is about to collapse ... Not sick
- State 3: A state in which homeostasis has collapsed and cannot be restored as it is ... Illness
There is no clear boundary between them, and there is a continuous transition..ChugokuHas long had the word "Kamikoji not sick" (Kamiko cures not sick).In other words, a good doctor is one who detects and deals with abnormalities at the pre-illness stage, not after the onset of illness... on the other hand,Western medicineThen, I overlooked the non-illness and started treatment only after I got sick...If you compare illness to a fire, Chinese medicine inspects dangerous places that are likely to catch fire in advance, and building materials that are likely to burn are made incombustible in advance to prevent them safely, whereas in Western medicine, a fire occurs. The idea is to deal with it after it has been closed.Certainly, once a fire ignites, it is necessary to suppress the momentum of the burning fire for the time being, but it is also very important to prevent the fire and its recurrence.Western medicineIt is not a good idea to leave it until it becomes ill and then deal with it, as in traditional Chinese medicine. The idea of trying to deal with things early is more appropriate and important..
戦 争byInjuryIn the first half of the 20th century, when a large number of deaths continued, Western medicine made remarkable progress.Antibiotics,vaccineWas developed and succeeded in drastically reducing life-threatening infectious diseases.However, after that, the situation of the disease changed completely, andLifestyle habitAnd due to the living environmentHeart disease,Cerebrovascular disease,Allergiesdisease,metabolic syndrome,Collagen diseaseChronic diseases such as these have increased rapidly and have become a serious issue...これらの慢性疾患は西洋医学的な治療法（その多くがThese chronic diseases are treated by Western medicine (many of which areToad) There is a limit to the cure, and while correcting lifestyle habitsSelf-healing powerSince it is indispensable to raise the illness, it is necessary to consider the mind and body as one, restore the balance and rhythm of the whole, and heal the illness, and stand on the idea of mind and body.Oriental medicineThe way of thinking is essential.
Peripheral word concept
Given the existence of the disease, the characteristics common to the patientPathology(Byotai) orDisease imageIt's called (Byozo).Medical condition(Byojo) often refers to the clinical course of a particular patient.These words are often mixed and used.
Illness and "disease" / "disease"
In medicine, the word "illness" is rarely used and instead more rigorousdisease(Shikan),diseaseI often use (Shippei).病気という語では内因性の疾患しか含まないような印象を受けることがあるためである（事故によるThis is because the word illness may give the impression that it includes only intrinsic illness (due to an accident).fractureIs not generally said to be ill).The term mental illness in psychiatry is "DisorderIt is a concept different from the medical term "disease".
English disease (disease, illness) is a term that indicates the cause of sickness (mild illness) and illness (illness), and is used for specific illnesses with clear disease names and symptoms. Sickness and illness refer to "a state of being ill", and disease means an abnormality in internal function due to infection or the like.Generally, it is not used for life-threatening illnesses such as fever and colds, but is used for serious illnesses such as infectious diseases and cancer, and has life-threatening nuances.
Diseases / Diseases / Diseases and "Syndromes"
syndrome(Shokougun) is a common pathological condition (subjective and objective symptoms), although the cause is unknown.InspectionFindingsimageWhen there are many patients who show findings, etc.), the group of such symptoms is given a name for the time being to make it easier to handle.
There are many names of syndromes that bear a personal name, and when the cause is found, the name may be changed or sometimes integrated with other disease names.On the other hand, there are many "syndromes" that have been used idiomatically for a long time even after the cause has been identified, and on the contrary, there are many diseases of unknown cause that bear the name "~ disease", and in reality, a clear distinction is made. Often not.
In the field of psychiatry, almost all of the diseases we deal with are diseases that should be called syndromes, so we do not call them syndromes because of convenience, but we use the terms XX disease and XX disease.
Diseases / Diseases / Diseases and "Symptoms"
symptom(Symptom) is a variety of individual changes of state or mutations from normal that appear in the patient's mind and body due to illness.Getting sick is called illness, and the appearance of symptoms is called onset or onset of illness.患者本人によって主観的に感じられるものをWhat is subjectively felt by the patientSubjective symptoms(Jikakushojo), what is objectively perceived by the surroundings is called an objective symptom to distinguish it.単に「症状」といった場合、自覚症状のことのみを指す場合があり、この際は他覚症状のことをWhen we simply say "symptoms", we may refer only to subjective symptoms, in which case we refer to objective symptoms.FindingsWe call them (shoken) and signs (chokou) to distinguish them.
Usually, "disease" and "symptom" are considered to be very different concepts.In other words, the disease comes first, and the "symptoms" occur in response to it.However, in daily practice, even if a symptom is confirmed, the cause of the symptom is often unknown, and in this case, the boundary between the symptom name and the disease name becomes ambiguous, as in the case of "syndrome". Sometimes.
For example,DehydrationAlthough there is no name for the disease, if dehydration is observed, treatment may be performed under the diagnosis of dehydration, aside from the underlying disease.myopiaIs used both as a symptom name and as a disease name.Essential hypertensionThe name of the disease is unknown, except for those who have another underlying disease and have secondary hypertension.High blood pressureIt is a "disease name" to include all the things that cause the "symptom".
Whether a clinical picture is one of the symptoms of the underlying disease or another independent disease that has emerged as a complication is not only a problem when writing medical textbooks, but also insurance.Medical feeIt is a problem that cannot be ignored because it is related to statistics and statistics.
In a field of medicine that studies symptoms,SymptomatologyThere is.
Illness and annual events
JapanThen in the old days, illnessDemonBecause ofFox Of魂 A humanIt was thought that it was to stay in.Therefore, when a sick person comes out, in order to cure the illnessshamanCallHaraeI was asked to do it.
- ^ "Person or others" saidMental illnessThis is because, for some mild illnesses, the person does not feel any inconvenience in life, but the people around him may feel the need for treatment because they interfere with his or her life.This is a confusion between illness and similar concepts. Mental illness,Illness # Illness and "disease" / "disease"See also.
- ^ The general public may listen to a doctor's explanation and adopt it as their own idea.On the other hand, doctors may also recognize something as a "disease" only after hearing a report from a patient, and such fragmentary information may be gradually aggregated at academic societies, etc., and large-scale statistics may be collected again. ..What doctors say in the media also affects people's view of illness.
- ^ Due to genetic background and lifestyleEssential hypertensionIs 80-90% of hypertension, and the remaining 10-20% is secondary hypertension with a clear underlying disorder of hypertension.Early detection and early treatment of underlying diseases are important for secondary hypertension.
- ^ Insomnia may actually have hidden causes such as periodic limb movement disorder, restless legs syndrome, circadian rhythm sleep disorder, and depression, so differential diagnosis is important..
- ^ a b c d Kazuya Yoshimatsu; Noriaki Koizumi; Masashi Kawano "Psychiatric Nursing I" (6th edition) Nouvelle Hirokawa, 2010, p. 71.ISBN 978-4-86174-064-0.
- ^ "The Anthropologies of Illness and Sickness". Annual Review of Anthropology (June 1982). two:10.1146 / annurev.an.11.100182.001353. 2009th of February 12Browse.
- ^ a b c d e f g h "Introduction-Chapter 1" "9% of illnesses can be cured by yourself"Chukei Publishing, 2009, pp.1 --46.
- ^ "Today's Treatment Guidelines 2011 Edition"Medical school, 2011, pp.339.
- ^ "Today's Diagnostic Guidelines 6th Edition" Igaku-Shoin, 2010, pp.339.
- ^ a b c d e f g h i j k l m Yutaka Okamoto "Chapter 3" "9% of illnesses can be cured by oneself" Chukei Publishing, 2009, pp.121 --138.
- "9% of illnesses can be cured by yourself" Chukei Publishing, 2009 (Heisei 21),ISBN 4-8061-3277-2, ISBN-13: 978-4-8061-3277-6
- List of disease aliases
- International statistical classification of diseases and related health problems
- Medical,health care worker
- Medical sociology
- Medical science/Dentistry