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
The TOBOL technique is a clinical technique that is used as a test to determine and diagnose how a person relates to the disease.
The main distinguishing feature of this technique is that it is necessary to select questions from the 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 conviction.
The basics
Attitude to the disease TOBOL created on the basis of a typology of clinical and psychological options for the relationship of the person to the disease. The methodology was proposed by researchers A. Lichko and N. Ivanov. It happened in 1980. As a result, 12 types of reactions to diseases that were diagnosed in patients were identified.
The main types of reactions:
- Alarming.
- Sensitive
- Neurotic.
- Paranoid.
- Anosognosic.
- Dysphoric.
- Ergopathic.
- Harmonious.
- Self-centered.
- Apathetic.
- Melancholic.
- Hypochondriac.
Conventionally, these reactions were divided into 3 types, namely: conditionally adaptive, intrapsychic-maladaptive and interpsychic-maladaptive.
The TOBOL questionnaire was compiled after a sample of the author, who identified 12 of the most important areas of life that fully and most fully reflect the system of relations in society and on a 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 doctors and staff of a medical institution, to relatives and friends, to those around and the outside world, to loneliness that may arise due to illness. It also assesses 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.
Important difference
Another distinguishing feature is the processing of data in the TOBOL methodology. 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 opinions 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. This is necessary to obtain more accurate and reliable results. It also allows you to evaluate the results from the outside.
The reason for this confusing research option is not clear. This is a distinctive feature of the TOBOL methodology, which distinguishes it from others.
How was the technique created?
This method was invented and framed by a number of experts who worked as a single 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. Ankylosing spondylitis. 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 fill the lack of experience among specialists who work with personality diagnostics. So, the technique allows interns to work better. Also, in many clinics and hospitals that have a somatic focus, it is convenient to use the TOBOL method, 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.
Stages
At the first stage, about 32 different doctors and specialists were involved, who were engaged in the fact that they completely filled out the questionnaire on behalf of the patient. As we said above, specialists were selected in such a way that they represented different types of response. After that, the researchers who conducted the experiment sifted out certain answers and judgments that were used very rarely. They were recognized as diagnostically insignificant. As a result, it was possible to form the most capacious and complete system of types of response that are inherent in man.
At the second and last stage, the other 28 experts were engaged in assessing the importance and significance of a statement. All this ultimately made it possible to compose the most complete picture.
Each statement or answer was given a certain number of points, which were adjusted using previously obtained statistics. This was necessary in order to minimize the overestimated or underestimated answers of one or another specialist.
Carrying out
Diagnostics began with the fact that a person was given a blank TOBOL methodology. It contains 12 groups of various 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 in each group one or a maximum of 2 answer options that most suit him or comprehensively describe his condition. If the patient was sure that none of the statements presented in the questionnaire was suitable for him, he had to choose the latest option. It consisted in the fact that none of the answers satisfied the patient.
Record
A person wrote down all his answers on a special form, while the time for filling it out was not limited by any framework. Studies were 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 should have been purely individual. Then the answers were recorded on a separate document, which was a table for convenient summarization of the results.
The subtleties of conducting
The questionnaire for diagnosing types of attitude to the TOBOL disease has specific principles for calculating the results. So, for analysis, a form with the results of the study is used. For each answer that a person gave, a coefficient is determined for the convenience of calculations. After that, the coefficients that belong to the same group of indicators are summarized, the resulting amount is entered in a special column. Also, the results can be viewed not only digitally, but also in graphical form. For this, the received data is displayed graphically for quick provision of information and its simple interpretation.
Interpretation of Results
If a person is diagnosed with a type of attitude to the disease, according to which the patient is fully consistent with one or another group, then his type is called pure. However, patients with a pure type of attitude toward the disease are quite rare. This is because each person is a mix of certain points of view and there is no clear boundary between the concepts.
The clinical and psychological description of the patient allows us to understand its type, so that in the future it can be used for better and faster treatment.
If a person is diagnosed with a mixed type of attitude toward 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. It should be understood that they will not be fully implemented in the patient, but only partially. It is also recommended to pay attention to the ratio of various types of reactions in order to get the most complete clinical picture of the condition of a sick person.
Diagnosis of the types of attitude to the disease according to the TOBOL method consists 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 refer the patient to one or another group. It is necessary to find contradictions, critical and incomprehensible moments that will clarify the picture. A multidimensional attitude to the patient’s personality and its perception as a combination of some prejudices, thoughts and feelings, which mainly concern his attitude to the treatment process, are very important.
The significance of the TOBOL methodology
Recently, medicine has developed very rapidly, especially in countries that can afford to spend large sums of money on important research and draw appropriate conclusions.
Today we can say that medicine as a whole is moving away from the paternalistic system. Strong changes undergo the relationship between the doctor and the patient. The TOBOL technique describes the attitude to the disease as something very important for the effectiveness of the treatment itself. Incredibly, scientists have indeed revealed a relationship between these factors. Much depends on how a person treats his doctor, how he reacts to treatment.
Type Description
We already know how to process the results obtained during the test using the TOBOL method. But now let us dwell on exactly what the features of this or that type are.
The TOBOL methodology describes the type of attitude towards the disease very concretely and clearly. Consider the main types that exist in this technique.
The harmonious type is typical for people who are real and balanced about their disease. They do not exaggerate its significance, but also do not underestimate the possible consequences. Such people are determined to work with a doctor, help in treatment. They want to recover, but adequately assess their strength. If health conditions limit their activity, they turn their attention to those areas in which they can be active.
The interpretation of the TOBOL methodology also implies an ergopathic type, which is characterized by the fact that it is very important for a person to work. He headlong goes into labor, trying to escape from his illness, overshadowing bad thoughts. Most often, the desire 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. He believes that everything will pass by itself. He does not like to talk about the disease, the treatment process.
An alarming type is manifested in the fact that the patient is too worried about his condition, and is pumping. He constantly thinks about the consequences, exaggerates them, comes up with various complications and thinks over a negative outcome.
Complex types
The hypochondriacal type focuses too much on its negative experiences and feelings. His mood and sense of self are completely dependent on this. He exaggerates his sufferings and puts them at the forefront of his life.
The neurasthenic type can be described in one word “irritability”. Such a person is very angry, if something goes wrong during the treatment, it is necessary to change the therapy, etc. He irritably communicates with relatives and is constantly in tension. Very impatient, aggressive. But then she realizes her guilt and apologizes for rash words.
The 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 very much doubts that the treatment will be successful and will be able to bring him relief.
The apathetic attitude towards 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 in the entire 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 to him. He flaunts and greatly exaggerates his suffering, inspires relatives with a sense of guilt 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, the drugs they prescribe. He sees a conspiracy in everything, does not trust others and even close people, because he wants to see a trick in everything.
Separate aggressive type
The dysphoric type of attitude towards the disease is also called aggressive. The TOBOL methodology 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 their troubles. He wants to be pleased with everything, is autocratic in relation to his native people.