Читать книгу Neurology - Charles H. Clarke - Страница 102

Gordon Holmes wrote in 1946: ‘More can often be learned of a patient’s disabilities by observing his ordinary actions, as dressing and undressing, walking when apparently unobserved, than by specific tests’. We rely on this approach intuitively – it is the way we form impressions and gauge people. Refine these skills. Think about:

 Greeting, manner, orientation, attention, mental state, mood, personal hygiene, dress

 Cognitive clues – turning to a companion before answering implies uncertainty

 Speech, language, facial appearance

 Gait, stance, clumsiness, weakness, involuntary movements, sensory symptoms

 Risk factors, lifestyle, tobacco, alcohol, drugs, religion, illness beliefs, fears

 Disability, aids, state benefits, aspects of daily living, driving, employment, sports

 Endocrine or other clues – hypothyroidism, hypopituitarism, bruises

 Relations with GP, hospital staff, attitudes towards treatment, expectations.