著者
木村 浩子
出版者
Japanese Society of Psychosomatic Dentistry
雑誌
日本歯科心身医学会雑誌 (ISSN:09136681)
巻号頁・発行日
vol.22, no.2, pp.73-83, 2007-12-25 (Released:2011-09-20)
参考文献数
42

Excessive clenching of the teeth due to physical or psychological tension or stress can result in excessive air swallowing.This study sought to investigate and evaluate the characteristics of such patients in terms of both their physical condition in the head and neck region and relevant psychological and social factors.The subjects consisted of 187 patients (57males and130females) having chief complaints of aerophagia symptoms who visited the psychosomatic medicine clinic at the head and neck department of the Tokyo Medical and Dental University.52.4%were in their twenties and thirties and 69.5%were female.The principal psychological and social stress factors tended to be study and work related among younger patients, and family problems among female patients.Most of the patients exhibited depression, anxiety, neurosis and a tendency towards autonomic imbalance, and also tended to complain of neck or shoulder pain, headache, oral or pharynx paresthesia and symptoms of quasi-temporomandibular arthrosis in the head and neck region.The degree of improvement of aerophagia symptoms and a tendency to change doctors too frequently in order to find more appropriate treatment were both considered to be related to depression.The explanation of habitual teeth clenching, the existence of psychological and social stress factors, the mechanism of air swallowing, and ways to control clenching was useful in helping patients to reduce their aerophagia symptoms.
著者
木村 浩子
出版者
日本歯科心身医学会
雑誌
日本歯科心身医学会雑誌 (ISSN:09136681)
巻号頁・発行日
vol.22, no.2, pp.73-83, 2007

Excessive clenching of the teeth due to physical or psychological tension or stress can result in excessive air swallowing.This study sought to investigate and evaluate the characteristics of such patients in terms of both their physical condition in the head and neck region and relevant psychological and social factors.<BR>The subjects consisted of 187 patients (57males and130females) having chief complaints of aerophagia symptoms who visited the psychosomatic medicine clinic at the head and neck department of the Tokyo Medical and Dental University.52.4%were in their twenties and thirties and 69.5%were female.<BR>The principal psychological and social stress factors tended to be study and work related among younger patients, and family problems among female patients.Most of the patients exhibited depression, anxiety, neurosis and a tendency towards autonomic imbalance, and also tended to complain of neck or shoulder pain, headache, oral or pharynx paresthesia and symptoms of quasi-temporomandibular arthrosis in the head and neck region.<BR>The degree of improvement of aerophagia symptoms and a tendency to change doctors too frequently in order to find more appropriate treatment were both considered to be related to depression.<BR>The explanation of habitual teeth clenching, the existence of psychological and social stress factors, the mechanism of air swallowing, and ways to control clenching was useful in helping patients to reduce their aerophagia symptoms.
著者
西岡 直子 中川 真次 木村 浩子 森本 遥 中野 貴文 山﨑 佳歩 小谷 廣信
出版者
日本赤十字社和歌山医療センター
雑誌
日本赤十字社和歌山医療センター医学雑誌 = Medical journal of Japanese Red Cross Wakayama Medical Center (ISSN:13419927)
巻号頁・発行日
vol.34, pp.67-72, 2017-03-31

平成26年4月の特定共同指導において「再指導」という結果を受けたことから、特定共同指導ワーキング(以下、WGという)を立ち上げ、指摘事項について協議を行った。医療情報管理課は、カルテ監査及び医学管理料(以下、管理料という)の監査を担当した。診療報酬点数表より管理料の算定要件を精査し、医師による管理料算定の徹底を院内に周知した。管理料オーダの中で、算定要件を満たしているものを「適正」、満たしていないものを「不適正」とし、不適正オーダについて日々督促を行い、毎月開催されたWGで適正率ならびに不適正オーダに対する督促数、不適正オーダの修正数等を報告した。その結果、平成27年2月の個別指導では、「経過観察」となった。管理料の監査については、個別指導後も日々行っており、平成28年5月の管理料の適正率は98%であった。個別指導後も、高い適正率は保っているものの不適正オーダの未修正オーダも残存しているので、再督促の徹底が急務である。