rRuoNo DAI Hgc Y HA Ngr .\ W B0 ruOru rAm rHAN o2 s I tl i, DIEU DUOilIG , T - ^lr ,l SUC IffiOE TAM THAilI (Sdch dung cho cfr nhdn di6u dudng) ? NHA xuAr BAN Y Hec TRUONG ?4I HQC Y HA NQI Be vtox rAu rHAN crAo rnixn orEu oUONG suc xnOe rAu rnAru (Sfch dilng cho cfr nhfln tli6u duftrg) l NHAXUAT BAN Y HgC HA Nol -2020 ffi&Wditr# Chfi bi6n: PGS. Nguy6n V[n Tu6n TS. Le Thi Thu He TS. Eric Hahn TS.
Tp Thi Minh Tdm Tham gia bi0n so?n: PGS. Nguy6n V[n Tu6n TS. Le Thi Thu He ThS. LC COng ThiEn TS.
Eric Hahn TS.TV Thi Minh Tdm : ThS. Dodn Thi Hue ThS. Nguy6n Hodng Yisn ThS. Nguy6n VIn Phi ThS.
Phpm Thenh Ludn ThS. D6 Tuyi5t Mai ThS. Nguy6n Thi Hoa ThS. TrAn Thi Thu He ThS.
Nguy6n Thenh Long ThS. Phpm Thi Thu Hucrng Thu ky: ThS. Nguy6n V[n Phi ThS. Pham Thenh Ludn ThS.
LOI NOI DAU ROi loan tdm thAn vd c6c vAn dd srlc kh6e tdm thdn gpp v6i tj' lQ cao trong cQng tl6ng, inh hu&ng tli chdt lugng cuQc si5ng ye kle n[ng lao ttQng cria gguOi bQnh O nhiAu mric t10 kh6c nhau. Ngoii ra nhtng v6n dA ndy cdn 6nh hu&ng ttSn c6c gia <linh vd xd hQi. C[n nguy6n ctra r5i logn tem than h cilcv6n Cd Amly,b0.nh co qh6, nQi sinh, chlit t6c tlQng t6m thdn.; th6ng qua nhiOu co ch6 nhuc tap vd iluo,c thric dAy boi nhtng y6u tO thuan lqi vC mflt di truydn, nhdn c6ch, hia tu6i, gi6i tffi, th6 trang. CLc r6i lopn t6m tnan Ui6u hiQn bing nhfmg d6u hiQu thucmg gflp trong tldi s5ng nhu r5i loan gi6c ngri, k*r6ng thich img duo.
c sau sang ch6n lfrml{,lo 6u, trdm cim. d6 nhAm 6n vcri c6c bii5u hiQn cria bQnh co thiS n6n nguoi benh thucmg tti khrim b cfuc chuy6n khoa kh6c vd dugc chAn dorin, diAu tri chua dring ldm anh huong dtSn ti6n lugmg bQnh, giam khe n[ng h6i phgc cria nguoi bQnh. Di6u du0ng sric kh6e t0m thdn ld mQt m6n khoa hgc.DiAu du0ng tdm th0n c0n hqc nhfrrig ki6n thrlc vd nguy6n nhen, yiSu t6 thuQn lgi, cfucbiiSu hiQn, nguy6n tiic tti6u tri vd c6ch chdm s6c ngucri bQnh. Cu5n nGitio Trinh Diiu Drhng Sftc Khde TAm Thdn'dugc bi6n soan d6 Aap img giang d4y cho c6c tti6u dud,rg chuydn nganh Tem than - nhtng ngudi nhfn nhiQm vuita-i6c nguoi benh tem thdn vn ph6t triiSn nganh tti6u duong tem then cfing nhu c6c dQc gii quan tdm.
Cilc t6c gie 3 MUC LUC Ldi n6i dAu.{G TAM THAN HOCOOO"'O"O"'O'. MOt sO kh6i niQm trong t0m thAn hgc. Nguy6n nh0n vd phOn lopt cdc r6i lopn t6m thAn. Cicy6u t5 anh hu6mg di5n sric kh6e t6m th4n.Yartrd cira t1i6u duOng trong chfun s6c srtc kh6e tdm thAn.
19 trAr 2, n6r cANn cnArvr s6c sffc xnOB rAvr rnAN r+r vrpr NAM. fam quan trgng cira ch[m s6c sric kh6e t6m tnan tai viQt nam .HQttr5ng chdm s6c sric k*r6e tdm tlan Ai viQt nam. MOt sO vhndA ve dao dric vd ngh6 nghigp. oANn clt vA cnAN ooAN cAc n6r r,o4N rAu rnAN.
Vai trd cria xdy fimg m6i quan hQ v<vi bQnh nhen vd ngucri nhe. Nguy6n tficxl'y d1mg m5i quan hQ voi bQnh nh6n vi nguoi nhe. Nhirng k! nlng can *riiSt d6 xiy dlmg mi5i quan hQ voi bQnh nhfln vd ngUdi nha. 32 Cic triQu chrfrng vir hQi chfng thudmg gip.
TriQu chrrng 6m tfnh vd ducmg tinh. ROi 1o4n cim gtitc trt gtitc. ROi lopn tu duy. ROi lopn tri nh6.
ROi lopn y thuc 47 , 8. ROi lopn tri fuQ. 51 Cic phutrng phip d6nh gi6 tri$u cht'i'ng tflm thAn. MUc ti€u cira d6nh gL6.
Cdcphucrng ph6p d6nh grilbQnh nhdn tdm thAn. X6t nghiQm dich ndo tuy. Xet nghi-6m mfiu, nudc ti6u. ChAn do6n hinh enh so n6o.
Ttic nghiem tdm l!,:. erry rniNn orEu orldxc vA rrtu cnuAN rRoNG cnAvr s6c srrc rcr6n rAvr rnAn. a a a a a a a a a a a o a o a a a a a a a a a a a a oa a a aaa a oa a a a a a a o a a a. 57 3 62 4 f0t qua mong dqi.
aa a a a aaaaoa aaaaa a aaaaaaa aoaa aa aa a a a a a a a aa a a a a a 63 5 LAp ti5 hoach chdm s6c. Thgc hiQn kiS hoAch. CAC ROI LOAN LO AU. Benh nguy€n - benh sinh.
DAc dii5m l6m sdng. Chdrn s6c di6u du0ng. CAC ROI IOAN DANG CO TIIE 77 1. Benh nguy0n, bQnh sinh.
DAc ditim l6m sdng. ChEm s6c di6u du0rrg. cAc n6r LoAN r,r0N euAN oEN srrogNc cnAr. Dpi cuong circ rOi lopn li6n quan sri dpng ch6t aa a a a aaaa a a a aaaaa aaaaaao a a aaoa a a aaa a aaaaaa a a a a 89 92 3.
Cfucri5i loa, tdm th6n <16ng di6n thuong gflp 6 nguoi sri ftrng ch6t. Cn6n doin cdc r6i loqn li6n quan str dgng ch6t. DiAu tri cilcr6i lopn 1i6n quan su dpn g chdt. Chdm sdc diAu du0rrg.
rAu rnAN pnAN Lrpr vA n6I LoAN pn6 pnAN r,rpr. Benh nguyen - benh sinh. DAc dii5m 16m sdng. ChAn do6n a a aaaa a a a a a a a a aaaa a aaaa a 116 5.
ChIm s6c di6u du0ng. Benh nguyen, benh sinh t2s 3. DEc tti6m 16m sang (kh6ch quan vi chri quan). Ch[m s6c di6u du0ng.
ROi lopn cim xirc lutrrrg cgc. DAc di6m 16m sing (chu quan ve kh6chquan). Ch[m s6c di6u du0rrg. SA SUT TRf TUE 1s5 2.
Benh nguy6n, bQnh sinh .EAc di6m lOm sdng. a a a a oo aa a a oa a a oo a a a aaoaaaaaoa a aa 179 6. Chdm s6c diOu du0ng. n6r r,o4N rANc oglvc cr,lna cn[r f.
BQnh nguyen, bQnh sinh. DAc dii5m 10m sdng. ChAn do in:. ChSm s6c di6u du0ng.
DEc di6m 16m sdng. Di6u tri tg s6t. Chdm s6c di€u du0rrg. lg5 Kich tlQng.
Benh sinh kich t10ng. DAc diOm 16m sdng. Ch[m s6c tli6u du6'ng. KhAi niQm vd ph0n lopi c{rc nh6m thu6c hucrng thAn.
Circ nh6m thu6c hu6mg thdn chinh sri {rng trong l0m sdng. MOt s0 ligu phap tdm \i'. Vai trd ctra tti6u duOng trong can thiQp tam 1)?.Iortc pnAp rfcn rrricn NAo. Kich thich ddy thAn kinh ph6 vi.
Kich thich ndo sdu. Phuong ph6p kich thich n6o kh6c.237 9 Bii 1 DAI CI./ONG TAM THAN HgG PG^S. IYguyEn Vdn Tufrn, ThS. IYguydn fhi Hoa, ThS.
L0 COng ThiQn MUC fftU: Sau khi hgc xong biri niry sinh vi6n didu dudnrg c6 khfl ning: 1. Trinh bay du. c m\t sii khdi ni€m co bdn: tdm thin kpc, b€nh tdm thin, sthc khde tdm thdn. Trinh bay du.oc cdc nguyhn nhdn vd phdn loqi bQnh tAm thdn.
Trinh bqt duqc cdc ydu 6 anh hudng d€n srbc khde tdm thin. Trinh bay du.oc vai trd ctia diiu dudng trong chdm s6c silrc khde tdm thdn. MQr S6 rnAr N|EM rRoNG rAn,l rnAN H9C 1. Khai niQm t0m thin hgc T0m thSn hqc li mQt b0 m6n trong y hQc, c6 nhiQm vq nghiCn cr?u c6c bi6u hi-6n 16m sdmg, bQnh nguy6n, benh sinh cua t64 th6n: nghiOn cr?u chan dorln, diCu "ir.rOilo4n fi, citcUiOnpnap aU phdng c6c ri5i lopn niy.
Tdm thdn ho.c ttugc chia ldrn hai phdn lcrn ld: Tdm thArhqc dpi cuong vi Tdm thdn hqc chuy6n biQt.Khei niQm r5i lqn tdm thin (mental disorder, mental illness) - Theo T6 chric Y td Th6 gi6i - WHO, r5i 1o4n tdm thdn duqc dinh nghLali "sq kdt ho.p aia nhibng biit thudng trong suy nghi, quon niQm, cdm nitc, hdnh vi vd m:6i quan h€ vdi ngrdi khdc-. - UiQp hQi tim thdrr hqc M! (American Psychiatrie Association, APA 2000) dA itinh nghia-"h€n* tdm thin edi bqV tdm thdn) ld m\t h$i chilmg vi hdnh vi h2dc vi tdm $, xd hQi ddng k€ tAn ldm sdng xuiit hi€n ffAn mQt cd nhdn, cd hAn quan toi nhfrng cdng ilrdng hien tit (vi du triQu chthng dau don) hodc.liAn quan toi rii loqn chtc ndng h.iQn tqi (ii &t: gidm khd ndng trong m\t hodc nhiAu l\nh wc quan trqng a)a cuQc s6ng) hodc hAn qian toi viQc tdng ddng ke cdc nguy co t*vong, dau ddn, logn hoqt ndng hortc *dt su fig do". - Ti0u chu6n chung trong chan tloan ckc r(;iloan tdrn thdn bao 969 sy lfi6ng thoi m6n voi circ dic tinh cta Uan-inan; s1r phd vO cilc m5i quan hQ, co ctri5 AOi ph6 k*r6ng hiQu qui vor circ sg kiQn trong cuQc s5ng, thii5u sU ph6t tri6n c6 nh6ri. Hcrn nta, nhtng henh vi cria ngudi t16 phai kh6ng pht hqp vC mflt vIn h6a.
WrdnWrdigfu 11 Cq nhfl'ng bQnh tam thin nflng (c6c.bQnh logn th6n), qu6 trinh phan rffi thpc t4i .- - yi tQ+ trdm tro.ng, henh vi,tirc phong bi rOi lo4n nhi6u.Xt*g cflng cO nhiAu bQnh t6m ,!to frg (c6c bQnh tdm c5n, nhdn-c6ch benh), qu6 trinh phrem 6nh ttg" tpi cfing nhu hanh vitfuc phong r6i loqn it,vdnc6 thii sinh hopt, hb d6ng, hqc tflp ttuqc, tuy c6 gla-,lit. Vi tt vfy danh "di6n" B"*g tlugc dtng di5 chi si5 it ntrimg ngudi bi bQnh i-am tnan.rit n[ng, d giai do4n cudi .t g,96 ngdn ngfr vi kic phong ky di" 16 l5ng, phi x6 hQi, hiQn nay kh6ng cdn thich hqp d6 chi rla s6 Upnfr nhen tem thin nta, nn6t n nirtng benh nhan nhg. Ngodi ra, danh tt "di6n" cdn bao hu-y nghia kfiinh miQt ngucri b-Onhlcho n6n tu 16u n6 dA bi loai tni ra 1*r6i ng6n ngfi trim thdn hqc nu6c ta. Khei niQm srlc kh6e t6m thin (mentat heatth) - Dinh nghia vd sric ft*r6e cria T6 chric y t6 Th6 gi6i (WHO):,,Suc kh6e kh6ng ihi ld,trqng thdt kh6ng bQnh,,kh6ng cd tfit chilrng md cdnTd t qng thtii hodn todn thodi mdt v€ cdc mrtt co th€, tdm thtin vd xd hAi-.
_: - Tt dinh nghia vA sric kh6e n6i trOn c6 *6 tacAra tlinh nghia vdi slic kh6e tffm thAn: "Silrc khde tdm thin ld trqng thdi kh6ng chi kh6ng c6 cdc'r6i loqn vd di til fim thdn md cdn ld trqng thdi tdm tltainoan ndn thodi mdi,,. - Nhtng nguoi kho6 mpnh.vA mflt r6m th6n nghia ld h9 c6 cuQc s5ng tlQc lfp vi c6 tloh t.o quy6t, c6 cdi nhin thgc tC vd t<na n6ng vi nhimg thi6u s6t, i<truytiidibm cria ban ,lto.r1ng nhu cria rgudi kh6c. Nhtng hdnh vi, c6m xric vd gi6 fi cria h9 pht hqp vd duo. c chdp nhfn trong ndn vln ho6 cria tqng qu5c gia vd ttuqc coi li th6ng nhdi voi nhirng vi6n -kh6c trong ctng cQng ddng.
MOt s6 it{c trrmg cria con ,!ooi moe therh manh v0 mflt tem than du_o. c n6u ra trong Bang l.thlrc t€, c9;6t kh6e tdm. it Sigf ry-.""- il6 rung cho reng minh bang c6 v6n d6 v6 sric nhdt mOt thcri EiiSm nao d5 rong. O6 eO, nguoi ta cho F:" tdm tW tf:- kh6e lui thdn vn bQnh tQm thdn nim trCn clng mQt mi6n li6n fuc iluqc ggi li mi6n li6n fuc sric ft*r6e tdm than - benh tem thAn (mental health-mental illness continuum) (Hinh 1.
Nh0ng dac trung c0a con ngucri kho6 manh v6 mAt tdm thdn 7:lroat-AOng .ndng mQt c6ch dQc tQp vd c6 tinh t1r quy6t: Hq t6n trsng nhii,ng quan ??