Tutorial Report Mrs.

Belagaks case By Group B1

Tutor Moderator Members

: : Tinton Ardiyan : 1. Agustria Heny p. 2. Veni Rosita Dewi 3. Fika Minata Putri Wathan 4. Delia 5. Ratri Wulandari Susilaningrum 6. Lesti Marliana 7. Farid 8. Syaifuldin bin suhaimee 9. Azri 10.Siti Fatimah azzahra 11. Fathan Satria Samudra

Medical Faculty of Sriwijaya University 2007

Case :
There is lady,Mrs Belagak who is about 62 years old.She has a condition called exfoliative dermatitis or erythoderma. Before,Mrs Belagak was being looked after by the previous head of the department and he retired.Mrs Belagak was coming and guing in the Out patient Departement ( OPD ).Recently she sought my advise.last week I admitted her in the ward and we started with the treatment.Now,she has improved about 30-40% while test are being done.With this condition Mrs Belagak can go home and treated as OPDs patient.But she wants to stay in the ward until she is completely well.That may take a few months or even longer.She does not want to go home.She says that it will be difficult to come back to the hospital in the OPD.There is an implication that her family members may not bring her to the hospital,if she is discharged.Beside,she can not threat her skin especially for topical application of drug. STEP I TERM CLASIFICATION Exfoliative dermatitis or Erythoderma ODP Retired Implication Treatment Discharged Hospital Topical application of drug : is the abnormal reddening flaking and thickering of the skin effecting wide of body : Rawat jalan : Stop doing your job : Possible effect of an action or decision : Way of treating a person think : Allow the leave : Place where people treated for illness : Obat-obat local

STEP II PROBLEM INDENTIFICATION She wants to stay in the ward until she is completely well Her family members may not bring her to the hospital She cannot treat her skin

STEP III ANALYSIS THE PROBLEM (i) (ii) (iii) Why she wants to stay in the ward until she is completelly well ? a) Why is her family members may not bring her to the hospital ? b) What is the respond from Mrs Belagak towards the family decision? a) How the physician and farmacist collaborated with her to treat her skin problem ? b) Why she cannot treath the skin ? STEP IV HYPHOTESIS She wants to stay in hospital because of the obstacle from her family members. STEP V LEARNING ISSUES

The doctor patient relationship

The doctor patient relationship is central to this exchange of information between doctor and patiets. Advise reassurance and support from the doctor can have a significant effect on recovery. The traditinaal doctor-patient relationship doctor takes on role of parent patient submissive,shift toward mutuality. Characteristic ideal patient : Give up some activities and responsibility regarded as being in need of care its means the patient must give information that clear to a doctor,in order that the doctor can responsibilities about patients problem. Must want to get better quickly seek help from and cooperate with a doctor,its means the patient want get quickly help from a doctor if the patient have health problem and then the patient must cooperate to a doctor ,in order that good relationship between doctor and patient. Characteristic ideal doctor : Apply a high degree of skill and knowledge,its means become a good doctor we have high skill and knowledge. Act for the good of the patient its means good doctor must act according the competency. Remain objective and emotionally detached Respect the position of privilege

The doctors consultation style : Less authoritarian-encourage patien to their own feelings and concerns Open guestioning interested in psychosocial aspect of illness. Paternalistic doctor is the expert and patient expected to cooperate Tightly controlled interviewing style aimed at reaching an organic diagnosis

How the doctor-patient relationship can solve the Mrs belagaks case ? According to the Mrs Belagak case,she does not want to go home because her family members may not bring her to the hospital. The doctor should give some information about her disease because according the doctor her disease improved about 30-40%,so she back go home and the family members should help Mrs Belagak to consultation to the doctor once month,in order that Mrs Belagak can know development the diseases. Therefore doctor-patient relationship to consultation very important in finishing the problem health patient especially Mrs Belagak diseases.