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       Uncooperative Patients Need Psychological Therapy

　　By refusing to take essential medication after a kidney transplant, a 49-year-old woman drives her doctors and nurses to distraction—to no avail, because the organ has in the end to be removed____(1)_____ Patients refusing to cooperate with medical professionals cause damage not only to themselves but also impose substantial costs on the community. The pharmaceutical company Glaxo Welcome estimates the costs to the German taxpayers of this kind of negative behaviour at around five billion dollars a year.

　　A recent conference of medical professionals, health insurers, the pharmaceutical industry and patient representatives revealed a wide range of factors behind non-compliance. Not all defiant behaviour in a patient can be characterized as non-compliance. Greater stress should be placed on psychology during medical training, delegates said.____(2)_____ Psychologist Sibylle Storkebaum told of an eight-year-old boy who ran amok in a hospital before undergoing a heart transplant, threatening to rip out his drip tubes.____(3)_____“Doctors and nurses failed to see that they had downgraded a boy already conscious of his own responsibilities into a small child,” Storkebaum said, explaining that the boy merely wanted to be taken seriously and to be involved in his own treatment. “Once this was acknowledged, the anger attacks subsided.____(4)_____” Jan-Torsten Tews of Glaxo Welcome highlighted the problem of excessive medication, with patients having to take a wide range of medicines at short intervals. Educating patients and self-management were the key to treating patients with chronic conditions, he said.

　　Health insurers also expressed interests in better cooperation between doctor and patient. “The fact that non-compliance exists is a result of patient dissatisfaction with their treatment,” Walter Bockemuehl, a senior executive in the statutory medical insurance scheme. said. According to one study, half of all patients did not want medication, but had drugs prescribed nevertheless.____(5)_____

　　词汇：

　　medication 药物治疗，药剂 kidney 肾 transplant 移植

　　distraciton 心烦意乱 avail 用处 non-compliance 不顺从，固执

　　professional 专业人员 impose把……强加给……

　　pharmaceutical 制药的，药学的 characterize表示……的性格特征

　　insurer 承保人，保险公司 defiant 反抗的，无礼的

　　therapy 治疗，疗法 insecure 缺乏安全感的

　　amok 狂怒的，狂暴的 fit 发作 rage 盛怒，狂怒

　　assert 主张，坚持，维护 downgrade 贬低，小看

　　noticeably 明显地 highlight 使显著，强调，把注意力集中于……

　　dissatisfaction 不满意 statutory 法定的额

　　注释：

　　1.to no avail：徒劳无功

　　2.be characterized：被描绘成……

　　3.run amok：变得勃然大怒。run在这里是系动词，有“变”的意思。

　　4.to rip out his drop tubes：把他的点滴管扯下 rip out 扯掉，扯出

　　drip：水滴，点滴

　　练习：

　　A. However, there are still some medical professionals who don't believe in psychological therapy.

　　B. He became noticeably quieter and turned into a good patient.

　　C. “In these cases we should not be surprised if the advice is ignored,” he said.

　　D. This case of medical non-compliance is not an isolated example.

　　E. There was evidence that psychological therapy for insecure patients could improve cooperation between doctors and patients, they added.

　　F. His fits of rage were subsequently seen as an attempt to assert his rights as a patient.

　　答案与题解：

　　1.D 空白处的前一句举了一位46岁妇女在肾移植手术以后拒服必要的药物的例子。空白处的后一句说拒绝与医务人员合作的病人会给自己、给社会带来什么害处。我们必须注意到后一句的病人是泛指的，当然应该包括这位49岁的妇女在内，因此将D(像这样不合作的事情并非仅此一例)填入空白处可以将上下文更完美地连接起来。

　　2.E 空白处的前一句说道应该更多地强调心理学在药物治疗中的作用。E说有证据表明，对缺乏安全感的病人进行心理治疗可增加医患之间的合作。前后两句话是连贯的，而且they added 还在一定程度上起到了提示作用，故E为最佳选项。

　　3.F 空白处的前一句讲了一个小男孩在做心脏移植手术前脾气非常暴躁的故事。空白处的后偶棉几句叙述了如何解决这个小男孩的心理障碍问题，F说“后来这种愤怒被人物是他要正确作为一个病人的权利”，正好起着承上启下的作用。由于医务人员有这种认识才有后面的好结果。

小编：二月