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Characteristics in patients with headache in an outpatient clinic in Japan. 日本门诊中头痛患者的特征。
Q1 Medicine Pub Date : 2010-11-18 DOI: 10.1186/1447-056X-9-10
Toshikatsu Okumura, Sachie Tanno, Masumi Ohhira, Satoshi Tanno, Tsukasa Nozu

Background: Little is known about the prevalence of primary and secondary headache in clinics in Japan. The aim of this study is to characterize patients with headache in an outpatient unit where primary care physicians are working in Japan.

Methods: Consecutive outpatients who newly visited the Department of General Medicine, Asahikawa Medical College Hospital, Asahikawa, Japan between April 2005 and March 2009 were analyzed. Each parameter such as age, sex or diagnosis was investigated.

Results: Out of 4693 patients, 418 patients visited to our department because of headache. Primary headache was found in 167 patients (39.9%). The rate of tension-type headache (TTH) (30.8%) was highest, followed by migraine (9.1%). Approximately 3 times higher rate of migraine was observed in female patients when compared with male patients. In female patients, migraine was observed more frequently in younger patients. On the other hands, TTH was observed in almost all aged patients in males and females, and the rate of TTH peaks between the ages of 40 and 49 years in both sex. The present study also demonstrated that 8.4% of patients who chiefly complained of headache had been diagnosed as depression while 1.7% of remained patients had been diagnosed as depression, indicating 5-times higher rate of depression in patients with headache.

Conclusion: All these results suggest that primary headache, especially TTH, is highly observed and depression should be considered in patients with headache in an outpatient clinic where primary care physicians are working in Japan.

背景:人们对日本诊所中原发性和继发性头痛的发病率知之甚少。本研究旨在了解日本初级保健医生工作的门诊部中头痛患者的特征:方法:对 2005 年 4 月至 2009 年 3 月期间新到日本旭川市旭川医学院附属医院全科医学科就诊的连续门诊患者进行分析。对年龄、性别或诊断等各项参数进行了调查:在 4693 名患者中,有 418 名患者因头痛到我科就诊。其中 167 名患者(39.9%)为原发性头痛。紧张型头痛(TTH)的发病率最高(30.8%),其次是偏头痛(9.1%)。与男性患者相比,女性患者的偏头痛发病率高出约 3 倍。在女性患者中,偏头痛多见于年轻患者。另一方面,在几乎所有老年男性和女性患者中都发现了 TTH,男女患者的 TTH 发生率在 40 至 49 岁之间达到高峰。本研究还显示,8.4%主诉头痛的患者被诊断为抑郁症,而 1.7%的残留患者被诊断为抑郁症,这表明头痛患者的抑郁症发病率是其他患者的 5 倍:所有这些结果表明,原发性头痛(尤其是 TTH)的观察率很高,在日本,初级保健医生工作的门诊中,头痛患者应考虑抑郁症。
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引用次数: 0
The usefulness of a clinical 'scorecard' in managing patients with sore throat in general practice. 临床“记分卡”在管理咽喉痛患者中的作用。
Q1 Medicine Pub Date : 2010-07-29 DOI: 10.1186/1447-056X-9-9
Tony Mo Bakare, Peter Schattner

Background:

Objective: To evaluate the usefulness of a clinical scorecard in managing sore throat in general practice.

Design: Validation study of scorecard for sore throat with a throat swab culture used as the 'gold standard'.

Setting: A solo family practice in rural New South Wales, AustraliaParticipants: Patients attending with sore throat.

Methods: Patients from the age of 5 years and above presenting with the main symptom of a sore throat, and who have not had any antibiotic treatment in the previous two weeks, were invited to participate in the study. The doctor completed a scorecard for each patient participating and took a throat swab for culture. Adult patients (> 16 yrs) were asked to complete a patient satisfaction questionnaire, while guardians accompanying children (5 yr to < 16 yrs old) were asked to complete a similar, guardian questionnaire.

Main outcome measures: 1. Ability of a new scorecard to differentiate between bacterial and non-bacterial sore throat.2. Patients' trust in the scorecard.

Results: The scorecard has a sensitivity of 93.33%, a specificity of 63.16%, a positive predictive value of 50% and a negative predictive value of 96%. The sensitivity is better than other sore throat scorecards that have been published but with a slightly lower specificity.There was a high level of patient trust in the scorecard was (85.8% agreement). Patients also trusted their doctor's judgement based on the scorecard (90.6% agreement).

Conclusions: As the scorecard has a high sensitivity but only a moderate specificity, this means that it is more reliable for negative results, i.e. when the result suggests a viral infection. When the result favours a bacterial sore throat, then a high sensitivity can mean that there are a number of false positives. GPs can be confident in withholding antibiotics when the scorecard indicates a viral infection.

背景:目的:评估临床记分卡在一般情况下治疗喉咙痛的有效性。设计:用咽拭子培养作为“金标准”的咽喉痛记分卡的验证研究。背景:澳大利亚新南威尔士州农村的一个单独的家庭实践参与者:患有喉咙痛的患者。方法:邀请5岁及以上以咽喉痛为主要症状,且前两周未接受任何抗生素治疗的患者参加研究。医生完成了每位患者的记分卡,并取了咽拭子进行培养。成年患者(> 16岁)被要求完成一份患者满意度问卷,而陪同儿童(5岁至< 16岁)的监护人被要求完成一份类似的监护人问卷。主要观察指标:1。一种新的记分卡能够区分细菌性和非细菌性喉咙痛。患者对计分卡的信任。结果:该计分卡的敏感性为93.33%,特异性为63.16%,阳性预测值为50%,阴性预测值为96%。敏感性优于其他已发表的喉咙痛记分卡,但特异性略低。患者对计分卡的信任度较高(85.8%)。患者也信任医生基于记分卡的判断(90.6%)。结论:由于记分卡具有较高的敏感性,但只有中等的特异性,这意味着它对阴性结果更可靠,即当结果提示病毒感染时。当结果倾向于细菌性喉咙痛时,那么高灵敏度可能意味着有许多假阳性。当计分卡显示有病毒感染时,全科医生可以放心地不使用抗生素。
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引用次数: 4
Family physicians understanding about Mantoux test: A survey from a high endemic TB country. 家庭医生对Mantoux试验的了解:来自结核病高发国家的调查。
Q1 Medicine Pub Date : 2010-05-31 DOI: 10.1186/1447-056X-9-8
Niloufer Sultan Ali, Kishwar Jamal, Ali Khan Khuwaja

Background: Tuberculosis is a global health emergency and is a big challenge to diagnose and manage it. Family physicians being first contact health persons should be well competent to diagnose and manage the patients with tuberculosis.

Aims: This study was aimed to assess the level of understanding about Mantoux Test amongst Family Physicians in Karachi, Pakistan and to determine the difference of level of understanding by gender and number of tuberculosis patients seen in a month.

Methods: A cross sectional survey was conducted among 200 Family Physicians working in Karachi; the largest city and economic hub of Pakistan. Family Physicians who attended Continuous Medical Education sessions were approached after taking consent. Pre-tested, self administered questionnaire was filled consisting of: basic demographic characteristics, questions regarding knowledge about Mantoux Test, its application and interpretation. Data of 159 questionnaires was analyzed for percentages, as rest were incomplete. Chi square test was used to calculate the difference of understanding levels between various groups.

Results: Almost two thirds of respondents were males and above 35 years of age. Majority of Family Physicians were private practitioners and seeing more than five tuberculosis patients per month. Overall, a big gap was identified about the knowledge of Mantoux Test among study participants. Only 18.8% of Family Physicians secured Excellent (>/= 80% correct responses). This poor level of understanding was almost equally distributed in all comparative groups (Male = 20.8% versus Female = 15.9%; p - 0.69) and (Seen < 5 tuberculosis patients per month = 18.6% versus seen >/= 5 tuberculosis patients per month = 19.3%; p - 0.32). A huge majority of Family Physicians (92%) however, showed keen interest in obtaining further knowledge regarding Mantoux Test and amongst them 72% suggested Continued Medical Education sessions as preferable mode of updating themselves.

Conclusion: Our study revealed an overall major deficit in understanding and interpretation of Mantoux Test amongst Family Physicians which needs to be addressed. Continues Medical Education sessions for Family Physicians should be organized in regular basis for upgrading their knowledge in this regards.

背景:结核病是一种全球性的突发卫生事件,对其进行诊断和管理是一项重大挑战。家庭医生作为第一接触卫生人员,应具备良好的结核病诊断和管理能力。目的:本研究旨在评估巴基斯坦卡拉奇家庭医生对曼图克斯检测的了解程度,并确定性别和每月结核病患者数量对曼图克斯检测的了解程度的差异。方法:对卡拉奇市200名家庭医生进行横断面调查;巴基斯坦最大的城市和经济中心。在征得同意后,与参加持续医学教育课程的家庭医生进行了接触。预先测试,自我管理问卷填写包括:基本人口统计学特征,关于曼图克斯测试的知识问题,其应用和解释。159份问卷的数据进行了百分比分析,其余数据不完整。采用卡方检验计算各组之间的理解水平差异。结果:近三分之二的受访者为男性,年龄在35岁以上。大多数家庭医生是私人医生,每月为超过5名结核病患者看病。总体而言,研究参与者对曼图克斯测试的了解存在很大差距。只有18.8%的家庭医生获得优秀(正确率>/= 80%)。这种低水平的理解在所有比较组中几乎平均分布(男性= 20.8%,女性= 15.9%;p - 0.69)和(每月< 5例肺结核患者= 18.6% vs每月>/= 5例肺结核患者= 19.3%;P - 0.32)。然而,绝大多数家庭医生(92%)对进一步了解Mantoux测试表现出浓厚的兴趣,其中72%的人建议继续医学教育课程是更新自己的最佳模式。结论:我们的研究揭示了家庭医生在理解和解释Mantoux测试方面的总体主要缺陷,这需要解决。应定期为家庭医生举办继续医学教育课程,以提高他们在这方面的知识。
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引用次数: 5
Fourth Wes Fabb Oration Diversity of primary care in Asia Pacific: pathways to convergence. 亚太地区初级保健的多样性:趋同之路。
Q1 Medicine Pub Date : 2010-03-26 DOI: 10.1186/1447-056X-9-7
Zorayda E Leopando

Asia Pacific is one of the 6 regions of the World Organization of Family Doctors (Wonca). It is a region with 16 full and 2 associate members coming from 14 countries. One of the main activities in the region is the regional conference highlighted by the Wes Fabb Oration.This Fourth Wes Fabb Oration has a historical perspective and three main parts: the results of a cross sectional survey done among member organizations and three countries not affiliated yet with Wonca which show Family Medicine as to status, practice, education and research; the regional initiatives and activities which indicate convergence; and, suggested action points which can further promote family medicine development, collaboration, and convergence.

亚太地区是世界家庭医生组织(Wonca)的六个区域之一。该地区有来自14个国家的16个正式成员和2个准成员。该区域的主要活动之一是韦斯·法布致辞所强调的区域会议。第四次韦斯·法布演讲有一个历史的视角和三个主要部分:在成员组织和三个尚未加入Wonca的国家中进行的横断面调查的结果,显示了家庭医学的地位,实践,教育和研究;表明趋同的区域倡议和活动;并提出了进一步促进家庭医学发展、协作与融合的行动点。
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引用次数: 0
Dietary salt reduction in rural patients with albuminurea using family and community support: the Mima study. 在家庭和社区支持下减少农村白蛋白尿素患者的饮食盐:Mima研究
Q1 Medicine Pub Date : 2010-02-25 DOI: 10.1186/1447-056X-9-6
Shinji Fujiwara, Kazuhiko Kotani, Phillip J Brantley, Kokoro Tsuzaki, Yukiyo Matsuoka, Masayuki Domichi, Yoshiko Sano, Eiji Kajii, Naoki Sakane

Background: Residents of rural communities are often more socially connected compared to urban dwellers. Using family and community support to motivate health behavior change may be useful in rural settings. The objective of this study was to pilot a salt reduction (SR) intervention for rural albuminuria patients using support from family and neighborhood residents compared to a usual care condition. The primary outcome was change in urine albumin-creatinine ratio (ACR).

Methods: All consecutive outpatients with an ACR >= 30 mg/gCr were recruited from the Koyadaira Clinic. Patients self-selected their participation in the intervention group (IG) or the control group (CG) because the rural population expressed concern about not being treated at the same time. In the IG, patients and their families were educated in SR for 30 minutes in their home by experienced dieticians. In addition, patients, families and neighborhood residents were also educated in SR for 2 hours at a public town meeting hall, with educational content encouraging reduction in salt intake through interactive activity. The CG received conventional treatment, and ACR and blood pressure (BP) were measured after 3 months.

Results: Of the 37 subjects recruited (20 male, 16 female, mean age; 72.8 +/- 9.2 years), 36 completed the 3-month follow up and were analyzed. In the IG, ACR decreased significantly from baseline (706 +/- 1,081 to 440 +/- 656; t = 2.28, p = 0.04) and was reduced compared to the CG (213 +/- 323 to 164 +/- 162; F = 3.50, p = 0.07), a treatment effect approaching significance. Systolic BP in the IG (145 +/- 14 to 131 +/- 13 mmHg; t = 3.83, p = 0.002) also decreased significantly compared to the CG (135 +/- 13 to 131 +/- 14; F = 4.40, p = 0.04).

Conclusions: Simultaneous education of patients, their families and neighborhood residents may be important in rural areas for treatments and interventions requiring health behavior change.

Trial registration: UMIN000001972.

背景:与城市居民相比,农村社区居民的社会联系往往更紧密。在农村环境中,利用家庭和社区支持来激励健康行为的改变可能是有用的。本研究的目的是在家庭和社区居民的支持下,与常规护理条件相比,对农村蛋白尿患者进行减盐(SR)干预试验。主要结局是尿白蛋白-肌酐比值(ACR)的改变。方法:从Koyadaira诊所招募ACR >= 30 mg/gCr的连续门诊患者。患者自行选择参与干预组(IG)或对照组(CG),因为农村人口表示担心不能同时接受治疗。在IG中,由经验丰富的营养师在家中对患者及其家属进行30分钟的SR教育。此外,还在公共市政厅对患者、家属和社区居民进行了2小时的SR教育,教育内容鼓励通过互动活动减少盐的摄入量。给予常规治疗,3个月后测量ACR和血压(BP)。结果:招募的37例受试者中,男性20例,女性16例,平均年龄;72.8±9.2年),36例完成3个月随访并进行分析。在IG中,ACR从基线(706 +/- 1,081)显著下降到440 +/- 656;t = 2.28, p = 0.04),与CG相比降低(213 +/- 323至164 +/- 162;F = 3.50, p = 0.07),治疗效果接近显著。IG收缩压(145 +/- 14 ~ 131 +/- 13 mmHg);t = 3.83, p = 0.002)与CG相比也显著降低(135 +/- 13至131 +/- 14;F = 4.40, p = 0.04)。结论:在农村地区,对患者、家属和社区居民进行同步教育可能对需要改变健康行为的治疗和干预措施很重要。试验注册号:UMIN000001972。
{"title":"Dietary salt reduction in rural patients with albuminurea using family and community support: the Mima study.","authors":"Shinji Fujiwara,&nbsp;Kazuhiko Kotani,&nbsp;Phillip J Brantley,&nbsp;Kokoro Tsuzaki,&nbsp;Yukiyo Matsuoka,&nbsp;Masayuki Domichi,&nbsp;Yoshiko Sano,&nbsp;Eiji Kajii,&nbsp;Naoki Sakane","doi":"10.1186/1447-056X-9-6","DOIUrl":"https://doi.org/10.1186/1447-056X-9-6","url":null,"abstract":"<p><strong>Background: </strong>Residents of rural communities are often more socially connected compared to urban dwellers. Using family and community support to motivate health behavior change may be useful in rural settings. The objective of this study was to pilot a salt reduction (SR) intervention for rural albuminuria patients using support from family and neighborhood residents compared to a usual care condition. The primary outcome was change in urine albumin-creatinine ratio (ACR).</p><p><strong>Methods: </strong>All consecutive outpatients with an ACR >= 30 mg/gCr were recruited from the Koyadaira Clinic. Patients self-selected their participation in the intervention group (IG) or the control group (CG) because the rural population expressed concern about not being treated at the same time. In the IG, patients and their families were educated in SR for 30 minutes in their home by experienced dieticians. In addition, patients, families and neighborhood residents were also educated in SR for 2 hours at a public town meeting hall, with educational content encouraging reduction in salt intake through interactive activity. The CG received conventional treatment, and ACR and blood pressure (BP) were measured after 3 months.</p><p><strong>Results: </strong>Of the 37 subjects recruited (20 male, 16 female, mean age; 72.8 +/- 9.2 years), 36 completed the 3-month follow up and were analyzed. In the IG, ACR decreased significantly from baseline (706 +/- 1,081 to 440 +/- 656; t = 2.28, p = 0.04) and was reduced compared to the CG (213 +/- 323 to 164 +/- 162; F = 3.50, p = 0.07), a treatment effect approaching significance. Systolic BP in the IG (145 +/- 14 to 131 +/- 13 mmHg; t = 3.83, p = 0.002) also decreased significantly compared to the CG (135 +/- 13 to 131 +/- 14; F = 4.40, p = 0.04).</p><p><strong>Conclusions: </strong>Simultaneous education of patients, their families and neighborhood residents may be important in rural areas for treatments and interventions requiring health behavior change.</p><p><strong>Trial registration: </strong>UMIN000001972.</p>","PeriodicalId":39050,"journal":{"name":"Asia Pacific Family Medicine","volume":"9 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2010-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1447-056X-9-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28737416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Assessment of menopausal symptoms using modified Menopause Rating Scale (MRS) among middle age women in Kuching, Sarawak, Malaysia. 使用改良的更年期评定量表(MRS)评估马来西亚沙捞越州古晋市中年妇女的更年期症状。
Q1 Medicine Pub Date : 2010-02-22 DOI: 10.1186/1447-056X-9-5
Syed Alwi Syed Abdul Rahman, Siti Rubiah Zainudin, Verna Lee Kar Mun

Background: Menopausal symptoms can be assessed by several tools, and can be influenced by various socio-demographic factors.

Objectives: To determine the commonly reported menopausal symptoms among Sarawakian women using a modified Menopause Rating Scale (MRS).

Methods: By using modified MRS questionnaire, 356 Sarawakian women aged 40-65 years were interview to document of 11 symptoms (divided into somatic, psychological and urogenital domain) commonly associated with menopause.

Results: The mean age of menopause was 51.3 years (range 47 - 56 years). The most prevalent symptoms reported were joint and muscular discomfort (80.1%); physical and mental exhaustion (67.1%); and sleeping problems (52.2%). Followed by symptoms of hot flushes and sweating (41.6%); irritability (37.9%); dryness of vagina (37.9%); anxiety (36.5%); depressive mood (32.6%). Other complaints noted were sexual problem (30.9%); bladder problem (13.8%) and heart discomfort (18.3%). Perimenopausal women (n = 141) experienced higher prevalence of somatic and psychological symptoms compared to premenopausal (n = 82) and postmenopausal (n = 133) women. However urogenital symptoms mostly occur in the postmenopausal group of women.

Conclusions: The prevalence of menopausal symptoms using modified MRS in this study correspond to other studies on Asian women however the prevalence of classical menopausal symptoms of hot flushes, sweating was lower compared to studies on Caucasian women.

背景:更年期症状可通过多种工具进行评估,并受各种社会人口因素的影响:更年期症状可通过多种工具进行评估,并受各种社会人口因素的影响:使用改良的更年期评定量表(MRS)确定砂拉越妇女通常报告的更年期症状:方法:使用改良的MRS问卷,对356名年龄在40-65岁之间的砂拉越妇女进行访谈,记录与更年期相关的11种常见症状(分为躯体、心理和泌尿生殖领域):结果:更年期妇女的平均年龄为 51.3 岁(47-56 岁不等)。最常见的症状是关节和肌肉不适(80.1%)、身心疲惫(67.1%)和睡眠问题(52.2%)。其次是潮热和出汗症状(41.6%)、易怒(37.9%)、阴道干涩(37.9%)、焦虑(36.5%)和抑郁情绪(32.6%)。其他主诉包括性问题(30.9%)、膀胱问题(13.8%)和心脏不适(18.3%)。与绝经前(82 人)和绝经后(133 人)妇女相比,围绝经期妇女(141 人)的躯体和心理症状发生率较高。然而,泌尿生殖系统症状主要发生在绝经后妇女群体中:本研究中使用改良 MRS 的更年期症状发生率与其他针对亚洲女性的研究结果一致,但与针对白种女性的研究结果相比,潮热、出汗等典型更年期症状的发生率较低。
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引用次数: 0
Strengthening the Paediatricians Project 1: The need, content and process of a workshop to address the Priority Mental Health Disorders of adolescence in countries with low human resource for health. 加强儿科医生项目1:在卫生人力资源不足的国家解决青少年优先心理健康障碍问题讲习班的必要性、内容和过程。
Q1 Medicine Pub Date : 2010-02-18 DOI: 10.1186/1447-056X-9-4
Paul Ss Russell, Muttathu Kc Nair

Objective: World Health Organization has identified Priority Mental Health Disorders (PMHD) of adolescence. To effectively address these disorders at the primary care level paediatricians have to be trained in the low-income countries, which often have paucity of mental health resources. We studied: (1) the need of psychiatric training required among paediatricians; (2) if the content and process of the model workshop suits them to identify and treat these disorders.

Methods: Forty-eight paediatricians completed evaluation questionnaire at the end of a 3-day workshop on adolescent psychiatry. They participated in a focused group discussion addressing the areas in psychiatry that needs to be strengthened in these workshops, the changes in the content and process of the workshop to bolster their learning. Qualitative and descriptive analyses were appropriately used.

Results: Training in adolescent psychiatry was considered necessary among the paediatricians at zonal level frequently to develop their private practice, treat psychiatric disorders confidently, make correct referrals, and learn about counselling. Prioritizing training from under and postgraduate training, integrate psychiatry training with conference, conducting special workshops or Continuing Medical Education were suggested as ways of inculcating adolescent psychiatry proficiency. Mental status examination, psychopathology and management of the PMHD were considered by the respondents as important content that need to be addressed in the program but aspects of behavioural problems and developmental disabilities were also identified as areas of focus to gain knowledge and skill. Appropriate group size, flexibility in management decisions to fit the diverse clinical practice- settings was appreciated. Lack of skills in giving clinical reasoning in relation to PMHD, time management and feedback to individuals were identified as required components in the collaborative effort of this manner. Providing delegates with basic information on adolescent psychiatry prior to the workshop was suggested to make the workshop more valuable.

Conclusions: There is a need to expand training for paediatricians from various backgrounds in adolescent psychiatry to strengthen their clinical skills to address the PMHD at the primary-care level. The evaluation suggests that the design and collaborative approach evident in this programme have merit as a model for training paediatricians in adolescent psychiatry in countries with low human resource for health.

目的:世界卫生组织确定了青少年的重点精神健康障碍(PMHD)。为了在初级保健一级有效地处理这些疾病,必须在往往缺乏精神卫生资源的低收入国家对儿科医生进行培训。我们研究了:(1)儿科医生对精神病学培训的需求;(2)如果模型车间的内容和过程适合他们识别和治疗这些障碍。方法:48名儿科医生在为期3天的青少年精神病学研讨会结束时完成了评估问卷。他们参加了一个重点小组讨论,讨论了精神病学中需要在这些研讨会中加强的领域,以及研讨会内容和过程的变化,以促进他们的学习。适当地使用了定性和描述性分析。结果:青少年精神病学培训被认为是必要的,经常在地区一级的儿科医生中发展他们的私人执业,自信地治疗精神障碍,做出正确的转诊,并学习咨询。建议优先开展基层培训和研究生培训,将精神病学培训与会议相结合,举办专题讲习班或继续医学教育,作为灌输青少年精神病学技能的途径。受访者认为精神状态检查、精神病理学和PMHD的管理是该计划需要解决的重要内容,但行为问题和发育障碍方面也被确定为重点领域,以获得知识和技能。适当的小组规模,管理决策的灵活性,以适应不同的临床实践设置受到赞赏。缺乏与PMHD相关的临床推理技能,时间管理和对个人的反馈被确定为这种方式合作努力的必要组成部分。建议在研讨会之前向代表们提供青少年精神病学的基本信息,使研讨会更有价值。结论:有必要扩大对不同背景的儿科医生在青少年精神病学方面的培训,以加强他们在初级保健水平上解决PMHD的临床技能。评价表明,在卫生人力资源不足的国家,该方案明显采用的设计和协作方法值得作为培训青少年精神病学儿科医生的模式。
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引用次数: 7
Strengthening the Paediatricians Project 2: The effectiveness of a workshop to address the Priority Mental Health Disorders of adolescence in low-health related human resource countries. 加强儿科医生项目2:在卫生人力资源匮乏的国家解决青少年优先心理健康障碍问题讲习班的有效性。
Q1 Medicine Pub Date : 2010-02-18 DOI: 10.1186/1447-056X-9-3
Paul Ss Russell, Muttathu Kc Nair

Background: Paediatricians can be empowered to address the Priority Mental Health Disorders at primary care level. To evaluate the effectiveness of a collaborative workshop in enhancing the adolescent psychiatry knowledge among paediatricians.

Methods: A 3-day, 27-hours workshop was held for paediatricians from different regions of India under the auspices of the National Adolescent Paediatric Task Force of the Indian Academy of Paediatrics. A 5-item pretest-posttest questionnaire was developed and administered at the beginning and end of the workshop to evaluate the participants' knowledge acquisition in adolescent psychiatry. Bivariate and multivariate analyses were performed on an intention-to-participate basis.

Results: Forty-eight paediatricians completed the questionnaire. There was significant enhancement of the knowledge in understanding the phenomenology, identifying the psychopathology, diagnosing common mental disorder and selecting the psychotropic medication in the bivariate analysis. When the possible confounders of level of training in paediatrics and number of years spent as paediatrician were controlled, in addition to the above areas of adolescent psychiatry, the diagnostic ability involving multiple psychological concepts also gained significance. However, both in the bivariate and multivariate analyses, the ability to refer to appropriate psychotherapy remained unchanged after the workshop.

Conclusions: This workshop was effective in enhancing the adolescent psychiatry knowledge of paediatricians. Such workshops could strengthen paediatricians in addressing the priority mental health disorders at the primary-care level in countries with low-human resource for health as advocated by the World Health Organization. However, it remains to be seen if this acquisition of adolescent psychiatry knowledge results in enhancing their adolescent psychiatry practice.

背景:可以授权儿科医生在初级保健一级处理优先精神卫生障碍。评估合作工作坊在提高儿科医师青少年精神病学知识方面的有效性。方法:在印度儿科学会全国青少年儿科工作队的主持下,为来自印度不同地区的儿科医生举办了为期3天,27小时的讲习班。在研讨会开始和结束时,我们制作了一份包含5个项目的前测后测问卷来评估参与者在青少年精神病学方面的知识获取情况。在参与意向基础上进行双变量和多变量分析。结果:48名儿科医生完成了问卷调查。在双变量分析中,对现象学的认识、对精神病理的认识、对常见精神障碍的诊断、对精神药物的选择等方面的知识均有显著提高。当控制了儿科培训水平和儿科医师年数等可能的混杂因素后,除上述青少年精神病学领域外,涉及多种心理概念的诊断能力也具有重要意义。然而,在双变量和多变量分析中,在研讨会之后,参考适当的心理治疗的能力保持不变。结论:本次研讨会对提高儿科医师的青少年精神病学知识有较好的效果。这些讲习班可以加强儿科医生按照世界卫生组织的主张,在卫生人力资源不足的国家处理初级保健一级的优先精神健康障碍问题。然而,这种青少年精神病学知识的获取是否会提高他们的青少年精神病学实践,还有待观察。
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引用次数: 8
GP registrar well-being: a cross-sectional survey. 全科医生注册医生幸福感:一项横断面调查。
Q1 Medicine Pub Date : 2010-02-09 DOI: 10.1186/1447-056X-9-2
Peter Schattner, Dennis Mazalin, Ciaran Pier, Jo Wainer, Mee Yoke Ling

Objectives: To investigate the major stressors affecting GP registrars, how those at risk can be best identified and the most useful methods of managing or reducing their stress.

Design, setting and participants: Cross-sectional postal questionnaire of all GP registrars in one large regional training provider's catchment area.

Main outcome measures: The Depression, Anxiety and Stress Scale (DASS), a specifically developed Registrar Stressor Scale consisting of five subscales of potential stressors, plus closed questions on how to identify and manage stress in GP registrars.

Results: Survey response rate of 51% (102/199). Rural difficulties followed by achieving a work/life balance were the principal stressors. Ten percent of registrars were mildly or moderately depressed or anxious (DASS) and 7% mild to moderately anxious (DASS). Registrars preferred informal means of identifying those under stress (a buddy system and talks with their supervisors); similarly, they preferred to manage stress by discussions with family and friends, debriefing with peers and colleagues, or undertaking sport and leisure activities.

Conclusions: This study supports research which confirms that poor psychological well-being is an important issue for a significant minority of GP trainees. Regional training providers should ensure that they facilitate formal and informal strategies to identify those at risk and assist them to cope with their stress.

目的:调查影响全科医生登记员的主要压力源,如何最好地识别那些有风险的人,以及管理或减少他们压力的最有用的方法。设计,设置和参与者:在一个大型区域性培训提供商的集水区的所有GP注册者的横断面邮寄问卷。主要结果测量:抑郁、焦虑和压力量表(DASS),一个专门开发的登记员压力量表,由潜在压力源的五个子量表组成,加上关于如何识别和管理GP登记员压力的封闭问题。结果:调查回复率51%(102/199)。农村的困难,然后实现工作与生活的平衡是主要的压力源。10%的注册者有轻度或中度抑郁或焦虑(DASS), 7%为轻度至中度焦虑(DASS)。注册商更倾向于通过非正式的方式来识别那些有压力的人(伙伴制度,并与他们的主管交谈);同样,他们更喜欢通过与家人和朋友讨论、与同龄人和同事汇报、或参加体育和休闲活动来管理压力。结论:本研究支持的研究证实,心理健康不良是一个重要的问题,为显著少数全科医生学员。区域培训提供者应确保促进正式和非正式战略,以确定处于危险中的人并协助他们应付压力。
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引用次数: 16
Making the 2007-2010 Action Plan work for women in family medicine in the Asia Pacific. 使2007-2010年行动计划对亚太地区从事家庭医学的妇女起作用。
Q1 Medicine Pub Date : 2010-01-07 DOI: 10.1186/1447-056X-9-1
Jan Coles, Amanda Barnard, Amanda Howe, Jo Wainer, Zorayda Leopando, Sarah Strasser

The Wonca Working Party for Women and Family Medicine (WWPWFM) was organized in 2001 with the following objectives: to identify the key issues for women doctors; to review Wonca policies and procedures for equity and transparency; to provide opportunities to network at meetings and through the group's listserve and website; and to promote women doctors' participation in Wonca initiatives.In October 2008, at the Asia Pacific Regional conference, the Wonca Working Party on Women in Family Medicine (WWPWFM) held a preconference day and conference workshops, building on the success and commitment to initiatives which enhance women's participation in Wonca developed in Ontario, Canada (2006) and at the Singapore World Congress (2007). At this meeting fifty women workshopped issues for women in Family Medicine in the Asia Pacific. Using the Action Plan formulated in Singapore (2007) the participants identified key regional issues and worked towards a solution.Key issues identified were professional issues, training in family medicine and women's health. Solutions were to extend the understanding of women's contributions to family medicine, improved career pathways for women in family medicine and improving women's participation in practices, family medicine organizations and academic meetings.

2001年成立了Wonca妇女和家庭医学工作组,其目标如下:确定女医生面临的关键问题;审查Wonca政策和程序的公平性和透明度;在会议上、通过集团的名单服务和网站提供交流的机会;并促进女医生参与Wonca倡议。2008年10月,在亚太区域会议上,Wonca妇女参与家庭医学工作组(WWPWFM)在加拿大安大略省(2006年)和新加坡世界大会(2007年)制定的旨在加强妇女参与Wonca的举措的成功和承诺的基础上,举行了会前日和会议讲习班。在这次会议上,50名妇女讨论了亚太地区家庭医学领域妇女的问题。利用2007年在新加坡制定的行动计划,与会者确定了关键的区域问题,并努力寻求解决方案。确定的关键问题是专业问题、家庭医学培训和妇女保健。解决办法是扩大对妇女对家庭医学的贡献的了解,改善妇女在家庭医学领域的职业道路,改善妇女参加实践、家庭医学组织和学术会议的情况。
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引用次数: 2
期刊
Asia Pacific Family Medicine
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