Iatrogenic diseases: causes, classification

We live at a time when various diseases can occur not only against the background of malfunctioning of the body, but also result from the direct or indirect effects of medical workers. Turning to the doctors, we sometimes do not suspect that we can still earn problems in addition to the existing sores. As it is possible and what are the iatrogenic diseases, we will try to understand.

The concept of iatrogeny

Everyone knows perfectly well that the basic precept of any doctor is "Do no harm!". Most doctors try to do it, but even the most devoted of their profession there are mistakes, and what to say about those who simply do not take their place and are not engaged in their own business.

The concept of iatrogenic diseases Includes those conditions and diseases that were provoked by medical intervention or influence. It can be both physical problems, and psychological.

In medicine, there are two definitions of this concept:

1. The role of iatrogenia is a variety of secondary diseases that are associated with:

• Wrong treatment.
• Diagnostic tests.
• Incorrect behavior of medical personnel.

2. Iatrogenic diseases are those that manifested as complications of the underlying disease, they were caused by incorrect or erroneous actions of the doctor and nurses.

What's interesting is that iatrogenia includes all diseases and injuries that can occur not only in patients, but also in medical personnel during the provision of medical care.

Speaking of iatrogenia, you immediately remember the saying that you can kill a person with a word, so doctors should feel at a subconscious level which patient you can tell the whole truth about his illness, and in what situation it is better to discuss this with relatives.

But, unfortunately, not all doctors in our medicine are good psychologists and think about the consequences of said words or actions. Despite the fact that many argue that there is not as such a problem - a medical error, iatrogenic diseases They say the opposite.

In some impressionable patients, even simple carelessness of the doctor, his indifferent look and coldness are already causing mental anxiety.

In modern society, we often have to face the callousness and impudence of our doctors.

Varieties of iatrogenia

Until now, there has never appeared one generally accepted approach to the classification of iatrogenic, so several options are used:

1. On the etiology of the disease.
2. According to the ICD.
3. According to Kalitievsky.
4. According to Rykov.

If we consider the classification by the nature of the onset of the disease, then there are several classes of iatrogenia:

1. Iatrogenia associated with disease prevention.
2. Associated with the diagnosis.
3. Provoked with medicines.
4. Iatrogenia, which caused radiation diagnosis or therapy.
5. Using medical equipment and tools.
6. Complications after a blood transfusion.
7. Lethal outcome as a result of an incorrect dose of anesthesia.
8. Iatrogenia as a result of surgical operations.

According to the International Classification of Diseases (IBC) , iatrogenic diseases are divided in their own way. Classification Can be the following:

1. Iatrogenia, which occurred after surgery or as a result of surgical disease.
2. Iatrogenia, provoked by drug treatment.
3. Diseases resulting from improper diagnosis.
4. Death from anesthesia.

Classification by Kalitievsky differs in that each class of the disease is further subdivided into subclasses.

1. Iatrogenia associated with treatment.

• Medical iatrogenia.
• Surgical.
• Physical.

2. Iatrogenia caused by diagnostic measures.

• Diseases that are caused by the risk of using the method or diagnostic tools.
• Diseases resulting from improper diagnosis.

3. Iatrogenia associated with preventive measures.

• For example, the risk of side effect of the method (inoculation).
• Diseases caused by erroneous prevention.

4. Informational iatrogenic disorders are most often associated with self-medication, that is, the patient does not use the medications prescribed by the doctor.

5. Pseudo-diseases, i.e. those of iatrogenia, which have arisen as a result of misdiagnosis.

Rykov's classification is based on the application of economic sanctions when iatrogenium occurs. There are several groups:

• Iatrogenii, arising at the initial stage of treatment.
• Diseases provoked by an unexpected reaction of the body to drugs and other therapies.
• Iatrogenia caused by erroneous diagnosis and treatment.
• Iatrogenia, which in the pathogenesis of the disease are superimposed on the underlying disease or concomitant.
• Problems arising from self-treatment. In this case, there is no question of any sanctions against the medical institution.

Here is a multi-faceted classification, which just shows that the problem of iatrogenic diseases is not weakening, but, on the contrary, every year becomes more acute.

Traits of iatrogenia

If you analyze the iatrogenic pathology, then you can distinguish the following features:

1. Medico-biological. This means that the development of iatrogenesis always depends on the individual characteristics of the patient, its stress-resistance, susceptibility, tolerability of drugs. These same features include the doctor's misconceptions, which are not made specifically, but are caused by his insufficient qualification.
2. Medico-social traits. The development of iatrogeny can be caused by diagnostic errors associated with outdated equipment.
3. Legal features. Concerning compensation of the person of the harm put by its health as a result of medical intervention.

It should be borne in mind that the complications or diseases that arose as a result of refusal to provide assistance, do not apply to iatrogenia.

Causes of iatrogenia

Iatrogenic diseases can be triggered by the following factors:

1. Careless or deliberate exposure to the patient's words or non-verbal means of expression, for example, facial expressions, gestures.
2. Hastening to inform the patient about the diagnosis and its prognosis. Worst of all, when it turns out that this information was wrong.
3. A pronounced inattentive attitude of medical personnel or in general inaction.
4. Non-compliance with the rules for storage of medical records.

Recently, new concepts have appeared:

• "Sestrogenia" - mental disorders in a patient, triggered by careless statements or actions of a nurse.
• "Ego" - the patient's influence on himself through autosuggestion.
• "Egrotogenia" is when patients directly or indirectly influence the state of each other.

As practice shows, the most susceptible patients are iatrogenic, who show emotional instability, they easily give in to suggestion and strongly depend on someone else's opinion.

Symptoms of iatrogenesis

Iatrogenic diseases do not have strict and pronounced certain signs. This is due to the variety of reasons that cause them.

If this is iatrogenia of a psychological nature, then it may manifest as a complete refusal of treatment by a given doctor or by these methods. In some cases, the patient, on the contrary, begins to intensively heal, walks constantly from one doctor to another, does not bypass the healers, psychics and fortune-tellers.

If iatrogenic manifestations of infectious diseases, they have their typical symptoms, but are more often difficult to treat.

It is also worth remembering that there are cases when medical workers are not at all to blame for the occurrence of iatrogenia (if you recall self-hypnosis, the influence of patients on each other).

The factors that can provoke the development of iatrogenium are a great many, and therefore there are many manifestations. Most often, the causes are subjective, and therefore the course of diseases depends on the state of the psyche and the whole organism as a whole.

Oddly enough, the medical personnel themselves can suffer from this pathology - everyone knows the "burnout syndrome".

Diagnosis of iatrogenesis

For some iatrogenic it is not difficult to diagnose correctly, for example, if a patient, when going through a course of treatment in a hospital for gastritis, suddenly catches up with an infectious disease, it becomes less clear that this was due to the presence of this infection in hospital walls.

If the patient makes claims to the doctor about the incorrect attitude, wrong treatment, as a result of which he got the disease, then it will be necessary to prove it further to sue. Maybe the patient already had these illnesses, but did not suspect them.

Treatment of iatrogenesis

Iatrogenic diseases are most often treated with psychotherapy if it is associated with mental problems. To eliminate this condition, tranquilizers, antidepressants and other psychotropic drugs are prescribed.

If, as a result of medical intervention, misdiagnosis and therapy, the patient receives another disease, the treatment is reduced to eliminating the symptoms of the disease.

When prescribing treatment for iatrogenic diseases, the physician must take into account the psychological characteristics of the patient's body, his social environment. In some difficult situations, you may need the help of a psychiatrist or a psychotherapist.

Prognosis of iatrogenic treatment

In most cases, the treatment of iatrogenic diseases ends favorably. Depending on the type of disease, the duration of therapy can take from several weeks to several months.

The earlier iatrogenic disease is recognized, the more effective the therapy. There are prerequisites for an increase in the number of mental illnesses among older patients and children. In connection with this, every medical worker must more closely monitor all his words, gestures that concern the patient. Care should be chosen methods and methods of treatment, drug therapy.

There are several unspoken rules for medical staff:

1. Think about who to talk to.
2. Well think about how to talk.
3. Think what you will say.

If at least these rules are observed, then it will be already possible to talk about reducing the number of iatrogen.

Prevention of iatrogeny

Considering the versatile nature of iatrogen, one can talk about a variety of ways to prevent them.

1. To prevent drug iatrogenic, the doctor should know the effect of the drug on the body, the possibility of complications. Carry out individual selection of dosage in each case.
2. Prevention of physical iatrogeny should consist in the reasonable use of diagnostic methods and indications for surgical intervention.
3. During surgical intervention, only proven techniques should be used that allow the treatment of the patient's organs and tissues as carefully as possible.

A common measure of prevention can be called compliance by medical professionals with medical ethics and showing compassion for their patients. If doctors become a little psychologists and will treat not a disease, but a person, prevention of iatrogenic diseases will not be required.