Vol 26, No 3 (2022)

Knowledge and skills in the field of professional communication are necessary for the doctor to form a trusting relationship with the patient. The right approach to counseling based on this knowledge is important to ensure quality medical care. The consultation has two main tasks: to find out the essence of the problem that led the patient to the doctor, and to find possible solutions to this problem. At the same time, a combination of openness and structuring of the process is important.

The lecture examines the Calgary-Cambridge model of counseling, its structure and features of each stage. The structure of the consultation in accordance with this model includes five stages – the beginning of the consultation, the collection of information, inspection, explanation and planning, and the completion of the reception. Each stage has certain tasks, starting with establishing contact at the beginning of the consultation, and ending with summing up at the end of the reception.

The principles and conditions of effective counseling include the availability of sufficient time; availability of consultation; respect for the personality of each patient and goodwill; confidentiality; provision of information in a language understandable to the patient; respect for the patient’s ability to make decisions.

Communication with a patient in the conditions of primary health care is a long and multifaceted process, but the result of such communication often depends on the successful conduct of counseling by a doctor.

The present article describes a clinical case as an example of compiled treatment of a geriatric comorbid patient with aortic stenosis. The case mentioned in this article enhances and underlines the meaning of multidisciplinary approach in the treatment of such patients according to the contemporary and actual standpoints of geriatrics. Elderly patients are often reported to have comorbidities including valvular heart diseases which might be regarded as one of the most significant reasons for functional activity decrease and lower quality of life of an elderly patient. Meanwhile, it is necessary to admit that functional resources of some patients are very high. It must be taken into consideration when choosing the disease management.

To date, giardiasis remains an urgent disease in the practice of family doctors, internists and pediatricians. Family cases of giardiasis are quite common. If one case of giardiasis is detected in the family, it is necessary to examine all family members. Currently, giardiasis remains relevant, especially in pediatrics. The difficulty of detecting giardiasis in children is primarily due to the fact that its manifestations are often disguised as various clinical variants of gastroenterological pathology (functional disorders of the gastrointestinal tract, syndrome of excessive growth of microflora in the small intestine, malabsorption syndrome) and often occur with the clinic of allergic diseases — recurrent urticaria, atopic dermatitis, gastrointestinal forms of food allergies and others forms.

The article presents a clinical case of familial giardiasis, in which the primary diagnosis of the disease in a child caused the greatest difficulty due to its allergic manifestations by the type of severe urticaria in the presence of possible allergens at home, which led to a long diagnosis and two emergency hospitalizations in children’s hospitals, where despite the examination and treatment, the correct diagnosis was not suspected timely. Differential diagnosis at the first stages of patient management was carried out between allergic urticaria, infectious mononucleosis and streptococcal infection, the possibility of giardiasis was not considered. Difficulties in diagnosis led to the appointment of systemic glucocorticosteroids and unjustified antibacterial therapy. Indirectly, prolonged diagnosis and untimely start of treatment led to a decrease in motivation for examination and treatment of the patient’s parents due to distrust of doctors.