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SGD B8

LEARNING TASK 16

Case:

A 25 years old woman came to Sehat family medicine clinic, complaining that she had been

coughing for 1 month. She also experienced fever particularly at night and loosing weight.

The patient had worked as a waitress in a caf and also as a commercial sex worker since 5

years ago. One of her client was suffering from HIV-AIDS and died several days before.

Assignment:

As a family doctor you are required giving appropriate service.

1. What will you do to apply patient-center care with attention to doctor-patient relationship?

2. How do you do the holistic approach to this patient?

3. How do you do the preventive medicine to this problem? Who is the target of preventive

medicine? Explain your reason!

4. What do you do to solve the undifferentiated/unclear case above?

5. With whom the coordinative and collaborative cares should be done?

6. What approach should you take for the medical team, family and community to solve this

problem?

Answer:

1. Family medicine is preferred to emphasize the family as the sociological unit providing

support to the individual as well as to reiterate the importance of the family in the cause and

effect of health and disease in the individual. For knowing the status health (sick or not), the

patient should share their feel and their expectation to the doctor and then the patient can be

easy to change their behavior in case to solve the disease and the doctor can know the cause

of the disease. This efforts is influenced by doing good patient-doctor relationship.

2. Holistic approach to the patient and his problems that recognizes contribution to ill-health and

well-being come from not only physical disease but equally if not more from social and

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psycological dimensions in the patient as well as from the family and her community. Its also

mean the medical practitioner must take into the whole person, their psyche as well as their

body systems and must not treat just the signs and symptoms. So the family medicine in this

case have to know about the social environment of the patient so can know the psycological

status and not only examine about her symptoms (fever and coughing).

3. Preventive care must take the forefront of family medicines care. Preventive care is better to

do to create better life quality of the community. From this case, the preventive care is done

into 3 stage that is primary, secondary, and tertiary prevention with targets are the patient

herself, patients client, and the other who have risk to be infected. This is done by not doing

unsafe sex, not sharing needle for drug user, and giving the other health education that relate

to HIV/AIDS.

4. Doing complete and comprehensive anamnesis to the patient based on sacred seven and basic

four method. Beside that from this case, also have to be done the laboratory test about the

symptoms. Because of her job as commercial sex worker, also be done the screening test to

know immunity status of the patient as the indication to suffer HIV/AIDS and cure the

oppurtunistic disease.

5. We should do coordinative care to the specialist doctor when we cant solve the patients

problem. In this case, we have to give the information of the patient to the specialist whom we

will refer the patient to. While the collaborative care should be done in corporate in medical

team, health care provider and delegate the patient to whom she has to be.In this case, the

collaborative care should be done with the nurses, and specialist doctor.

6. We take collaborative and comprehensive approach which mean we have do promotive,

preventive, curative, rehabilitative and palliative care in collaborative approach with medical

team, family and community to increase the health status of this patient.