In the article we will talk about what the TOBOL technique is. We will consider this issue in detail and try to understand it thoroughly. Let's start with where this concept came from and how it is applied in the modern world.
Method Description
TOBOL is a clinical technique that is used as a test to determine and diagnose how a person feels about an illness.
The main distinguishing feature of this technique is that it is necessary to select questions from a list. The structure of the TOBOL methodology consists of several lists and affirmative beliefs. The respondent needs to choose only one of the available options that best suits his desire.
It is also possible to choose your degree of agreement or disagreement with a particular belief.
Basics
Attitude towards the disease TOBOL was created on the basis of the typology of clinical and psychological variants of a person's attitude towards the disease. The technique was proposed by the researchers A. Lichko and N. Ivanov. It happened in 1980. As a result, 12 types of reactions to diseases that are diagnosed in patients were identified.
Main types of reactions:
- Alarming.
- Sensitive.
- Neurasthenic.
- Paranoid.
- Anosognosic.
- Dysphoric.
- Ergopathic.
- Harmonic.
- Egocentric.
- Apathetic.
- Melancholic.
- Hypochondriacal.
Conventionally, these reactions were divided into 3 types, namely: conditionally adaptive, intrapsychically maladaptive and interpsychically maladaptive.
The TOBOL questionnaire was compiled after a selection of the author, who identified the 12 most important areas of life, which fully and to the largest extent reflect the system of relations in society and at the personal level. This allows you to determine the patient's attitude to the disease, to the process, the complexity and duration of the treatment process, to the doctors and staff of the medical institution, to relatives and friends, to others and the outside world, to the loneliness that may arise due to the disease. The level of a person’s appetite, a change in his mood, activity and quality of sleep, a person’s self-esteem, and his level of well-being are also assessed.
Important difference
Another distinguishing feature is the data processing in the TOBOL method. The fact is that the validation of patients does not take into account the type of response to the disease, as is done in most tests and questionnaires, but taking into account the opinion of a group of experts who are specially selected. They must correspond to one or another type of response. Further, these experts fill out the questionnaire not as experts, but as patients. It's necessaryfor more accurate and reliable results. It also allows you to evaluate the results from the outside.
The reason for such a confusing version of the study is unclear. This is a distinctive feature of the TOBOL technique, which distinguishes it from others.
How was the methodology created?
This method was invented and designed by a number of experts who worked as a team to create an effective diagnostic technique. The technique was created by L. Wasserman, A. Vuks, B. Iovlev, E. Karpova. The work was carried out in 1987 at the Research Institute. Bekhterev. Initially, this technique was positioned as a model for the study of thinking, intended for the purposes and work of a neuropsychiatrist or clinical psychologist. It allows you to make up for the lack of experience among specialists who work with personal diagnostics. Thus, the technique allows interns to work more efficiently. Also, in many clinics and hospitals that have a somatic focus, it is convenient to use the TOBOL technique, since it is simple, effective and does not require special knowledge to work.
Interestingly, this technique was originally called LOBI and it was deciphered as a personality questionnaire of the Bekhterev Institute.
Steps
At the first stage, about 32 different doctors and specialists were involved in filling out the questionnaire on behalf of the patient. As we said above, the specialists were selected in such a way that they represented different types of response. Thereafter, researchers whoconducted an experiment, weeded out certain answers and judgments that were used very rarely. They were considered diagnostically insignificant. As a result, it was possible to form the most capacious and complete system of response types that are inherent in man.
At the second and last stage, the other 28 experts were engaged in assessing the importance and significance of this or that statement. All this ultimately made it possible to compose the most complete picture.
Each statement or answer option was assigned a certain number of points, which were adjusted using previously obtained statistical data. This was necessary in order to minimize the overestimated or underestimated answers of one or another specialist.
Carrying out
Diagnosis began with the fact that a person was given a form of the TOBOL method. It contains 12 groups of different statements. In one group there could be from 10 to 16 any statements. What was the patient supposed to do? His task was to select one or maximum 2 answer options in each group that best suit him or describe his condition in a comprehensive manner. If the patient was sure that none of the statements presented in the questionnaire suited him, he had to choose the last option. It was that none of the answers satisfied the patient.
Record
The person wrote down all his answers on a special form, while the time for filling it out was not limited by any framework. Researchwere carried out not only individually, but also in groups, which made it possible to obtain more information at a time. At the same time, patients were strictly forbidden to consult with each other. The answers had to be purely individual. Then the answers were recorded on a separate document, which was a table for convenient summary of the results.
Subtleties of conducting
The questionnaire for diagnosing types of attitudes towards TOBOL has specific principles for calculating results. So, for the analysis, a form with the results of the study is used. For each answer given by a person, a coefficient is determined for the convenience of calculations. After that, the coefficients that belong to the same group of indicators are summed up, the resulting amount is entered in a special column. Also, the results can be viewed not only in digital form, but also in graphical form. To do this, the received data is displayed graphically for quick presentation of information and its easy interpretation.
Interpretation of results
If a person is diagnosed with a type of attitude towards the disease, according to which the patient fully corresponds to one or another group, then his type is called pure. However, patients with a pure type of attitude towards the disease are quite rare. This is due to the fact that each person is a mix of certain points of view and there is no clear line between concepts.
Clinical and psychological description of the patient allows you to understand his type, in order to further use for better and fastertreatment.
If a person is diagnosed with a mixed type of attitude towards the disease, then his description is based on a complex of descriptions. So, if a person has 3 types, then the description will consist of three different structures. At the same time, one must understand that in the patient they will not be fully implemented, but only partially. It is also recommended to pay attention to the ratio of certain types of reactions in order to get the most complete clinical picture of the condition of a sick person.
Diagnosis of types of attitude to the disease according to the TOBOL method lies in the fact that it is necessary to take into account and carefully analyze the answers that the patient has chosen. It is not enough just to compare them and assign the patient to one or another group. It is necessary to find contradictions, critical and incomprehensible points that will clarify the picture. It is very important to have a multidimensional attitude towards the patient's personality and perceive him as a set of some prejudices, thoughts and feelings, which mainly concern his attitude to the treatment process.
The significance of the TOBOL technique
Recently, medicine has developed very rapidly, especially in countries that can afford to spend large sums of money on important research and draw relevant conclusions.
Today, we can say that medicine as a whole is moving away from the paternalistic system. The relationship between doctor and patient is undergoing dramatic changes. The TOBOL method describes the attitude towards the disease as something very important for the effectiveness of thetreatment. Incredibly, scientists have indeed identified a relationship between these factors. Much depends on how a person treats his doctor, how he reacts to treatment.
Description of types
We already know how to process the results obtained during the test using the TOBOL method. But now let's dwell on exactly what the features of this or that type are.
TOBOL method describes the type of attitude to the disease very specifically and clearly. Consider the main types that exist in this technique.
The harmonious type is typical for people who are realistic and balanced about their disease. They do not exaggerate its significance, but they do not underestimate the possible consequences. Such people are set to work with a doctor, help in treatment. They want to recover, but adequately assess their strength. When a he alth condition limits their activities, they turn their attention to those areas in which they can be active.
Interpretation of the TOBOL technique also suggests an ergopathic type, which is characterized by the fact that it is very important for a person to work. He goes headlong into work, trying to escape from his illness, to overshadow bad thoughts. Most often, the zeal for work increases as the disease progresses.
Anosognosic type, or euphoric, is characterized by the fact that a person denies the presence of a disease and does not want to recognize the possible consequences at all. He believes that everything will pass by itself. Does not like to talk about the disease, the treatment process.
Anxious type is manifested in the fact that the patient is too worried about his condition, pumps. He constantly thinks about the consequences, exaggerates them, invents various complications and thinks out a negative outcome.
Complex traits
The hypochondriacal type focuses too much on their negative experiences and sensations. His mood and self-awareness are completely dependent on this. He exaggerates his suffering and puts it at the center of his life.
The neurasthenic type can be described in one word "irritability". Such a person gets very angry if something goes wrong during the treatment process, it is necessary to change therapy, etc. He communicates irritably with loved ones and is constantly in suspense. Very impatient, aggressive. But then he realizes his guilt and apologizes for rash words.
Melancholic type is characterized by a pessimistic attitude towards the disease. Such a patient often expresses negative thoughts and expectations, he may clearly manifest suicidal tendencies. He is very doubtful that the treatment will be successful and will bring him relief.
Apathetic attitude to the disease is characterized by complete indifference to the course of treatment. The patient is sluggish and inactive. He loses interest not only in himself, but also in the whole world around him. Constantly set to negative.
The sensitive type is too vulnerable and vulnerable, clings to words, believes in rumors and is afraid of everything. Hypersensitivity is evident.
The egocentric type accepts his illness, but at the same time seeks the benefits that it can bring him. He flaunts and greatly exaggerates his suffering, inspires feelings of guilt in his loved ones so that they treat him more loyally.
The paranoid type is convinced that someone is to blame for his illness. He is very suspicious of doctors, of the drugs they prescribe. He sees a conspiracy in everything, does not trust others and even close people, because he wants to see a catch in everything.
Separate aggressive type
The dysphoric type of attitude towards the disease is also called aggressive. The TOBOL technique describes such a patient as an embittered, gloomy and gloomy person. He is constantly dissatisfied with something, finds fault with others and enjoys when he spoils their mood. There is a tendency to blame other people for all your troubles. He wants to be pleased in everything, he is despotic towards his relatives.
