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Storylines of family medicine XII: family medicine and the healthcare system 家庭医学的故事情节 XII:家庭医学与医疗保健系统
IF 6.1 3区 医学 Q1 Medicine Pub Date : 2024-04-01 DOI: 10.1136/fmch-2024-002829
W. Ventres, Leslie A Stone, J. South-Paul, Kendall M Campbell, Aerial R Petty, Hima Ekanadham, Kurt C Stange, Rebecca S. Etz, William L Miller, Robert L Ferrer, Marianna Kong, Thomas Bodenheimer, Roger Strasser, Sharon C M Reece, Joshua Freeman, John M Westfall
Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In ‘XII: Family medicine and the future of the healthcare system’, authors address the following themes: ‘Leadership in family medicine’, ‘Becoming an academic family physician’, ‘Advocare—our call to act’, ‘The paradox of primary care and three simple rules’, ‘The quadruple aim—melding the patient and the health system’, ‘Fit-for-purpose medical workforce’, ‘Universal healthcare—coverage for all’, ‘The futures of family medicine’ and ‘The 100th essay.’ May readers of these essays feel empowered to be part of family medicine’s exciting future.
家庭医学的故事情节》是一套由 12 个部分组成的系列丛书,其中的微型文章主题鲜明、图文并茂,探讨了美国和世界其他地方的家庭医生和医学教育工作者所诠释的家庭医学的方方面面。在 "XII:家庭医学和医疗保健系统的未来 "中,作者探讨了以下主题:"家庭医学的领导力"、"成为一名学术型家庭医生"、"Advocare--我们的行动号召"、"初级保健的悖论和三条简单规则"、"四重目标--患者和医疗保健系统的结合"、"适合目的的医疗队伍"、"全民医疗保健--人人享有"、"家庭医学的未来 "和 "第 100 篇文章"。祝愿这些文章的读者能够成为家庭医学激动人心的未来的一部分。
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引用次数: 0
Storylines of family medicine II: foundational building blocks—context, community and health 家庭医学的故事情节 II:基础构件--背景、社区和健康
IF 6.1 3区 医学 Q1 Medicine Pub Date : 2024-04-01 DOI: 10.1136/fmch-2024-002789
W. Ventres, Leslie A Stone, Rupal Shah, Tamala Carter, Geoffrey M Gusoff, Winston R. Liaw, Bich-May Nguyen, Joanna V Rachelson, Mary Alice Scott, Teresa L Schiff-Elfalan, Seiji Yamada, R. Like, Kathleen Zoppi, A. P. Catinella, Richard M Frankel, Shailendra Prasad
Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In ‘II: foundational building blocks—context, community and health’, authors address the following themes: ‘Context—grounding family medicine in time, place and being’, ‘Recentring community’, ‘Community-oriented primary care’, ‘Embeddedness in practice’, ‘The meaning of health’, ‘Disease, illness and sickness—core concepts’, ‘The biopsychosocial model’, ‘The biopsychosocial approach’ and ‘Family medicine as social medicine.’ May readers grasp new implications for medical education and practice in these essays.
家庭医学的故事情节》(Storylines of Family Medicine)是一套由 12 个部分组成的系列丛书,其中的微型文章主题鲜明、图文并茂,探讨了美国和世界其他地方的家庭医生和医学教育工作者所诠释的家庭医学的方方面面。在 "II:基础模块--背景、社区和健康 "中,作者探讨了以下主题:"背景--家庭医学在时间、地点和存在中的基础"、"重新定位社区"、"以社区为导向的初级保健"、"实践中的嵌入性"、"健康的意义"、"疾病、疾病和疾病--核心概念"、"生物心理社会模式"、"生物心理社会方法 "和 "作为社会医学的家庭医学"。愿读者能从这些文章中领悟到医学教育和实践的新意义。
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引用次数: 0
Knowledge and attitude on childhood cancer survivorship among healthcare trainees: a multicentre study from India 医疗保健受训人员对儿童癌症幸存者的认识和态度:印度的一项多中心研究
IF 6.1 3区 医学 Q1 Medicine Pub Date : 2024-04-01 DOI: 10.1136/fmch-2023-002618
Amritesh Grewal, Bhavik Bansal, Chetanya Mittal, Hardik Gupta, A. Sasi, Prasanth Ganesan, Aashima Dabas, Puneet Sahi, Lakshmi Ramamoorthy, H. T. Lalthanthuami, J. Ramamoorthy, Arwachi Sindhu, Suyash Arora, Anumeha Bhukya, Muthumani Hepzibah, Kanchana Devi, Karthick Krishnamurthy, S. K. Rai, Nikhil Mehta, Komal Antil, S. Bakhshi, S. Ganguly
Background The proportion of childhood cancer survivors (CCS) in low/middle-income countries (LMICs) is rising. CCS often develop several physical and psycho-social long-term adverse effects, with unique healthcare needs. Primary healthcare providers (primary care physicians (PCPs)), especially in LMICs, are often not equipped to handle survivorship care. This study aimed to assess knowledge, and attitude among trainee healthcare providers concerning major issues of paediatric survivorship care. Methods A multi-centre, cross-sectional, questionnaire-based study was conducted among nursing and medical undergraduate students, and postgraduate medical residents across three tertiary-care teaching hospitals in India—All India Institute of Medical Sciences, New Delhi; Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry; and Maulana Azad Medical College, New Delhi. A questionnaire with total of 24 questions (14 knowledge-based and 10 attitude-based) was finalised after validation by expert review and piloting. The major domains covered in the questionnaire included knowledge and attitude regarding long-term adverse effects and psychosocial, employment-related issues faced by the survivors. It was administered to the study participants electronically. The knowledge-based questions had true/false responses (scored as 0 or 1 if incorrect or correct, respectively). Attitude-based questions were scored as 5-point Likert scale. Results Total 898 responses were collected (median age: 21 years, 64% (576/898) female). Among the respondents, 44% were undergraduate medical students, 42% were nursing students and 14% were postgraduate medical residents. The mean (SD) of knowledge score was 8.72 (2.04) (out of 14). On multivariable analysis, only discipline of training predicted knowledge scores regarding survivorship care. Postgraduate medical residents (9.08) as well as undergraduate medical students (8.85), had significantly higher mean knowledge scores than nursing students (8.47) (p=0.004). Two questions were answered incorrectly by the majority; children and siblings of CCS need additional genetic screening (79% incorrectly answered true), and CCS face intimacy issues in relation to normal sexual functioning (59% incorrectly answered false). Nearly half (48%) of respondents believed that their knowledge of cancer survivorship issues was inadequate. Majority of respondents (84%) suggested that oncologists should handle long-term survivorship care rather than PCPs. Conclusion Trainee healthcare providers in India reported inadequate knowledge regarding survivorship care. Improving awareness by incorporating survivorship in teaching curriculum is imperative to equip future PCPs to provide survivorship care across the country.
背景 在低收入/中等收入国家(LMICs),儿童癌症幸存者(CCS)的比例正在上升。儿童癌症幸存者通常会对身体和社会心理产生多种长期不良影响,从而产生独特的医疗保健需求。初级医疗服务提供者(初级保健医生),尤其是在低收入和中等收入国家,往往不具备处理幸存者护理的能力。本研究旨在评估受训医疗服务提供者对儿科幸存者护理主要问题的认识和态度。方法 对印度三家三级教学医院--新德里全印度医学科学院、普度克里贾瓦哈拉尔研究生医学教育与研究学院和新德里毛拉纳-阿扎德医学院的护理和医学本科生以及研究生住院医师进行了一项多中心、横断面、基于问卷的研究。经过专家评审和试点验证后,最终确定了一份包含 24 个问题(14 个基于知识的问题和 10 个基于态度的问题)的调查问卷。问卷涉及的主要领域包括幸存者对长期不良影响的认识和态度,以及面临的社会心理和就业相关问题。该问卷以电子方式发放给研究参与者。以知识为基础的问题采用真/假回答(如果回答错误或正确,则分别记为 0 或 1)。态度类问题采用 5 点李克特量表计分。结果 共收集到 898 份答卷(年龄中位数:21 岁,64%(576/898)为女性)。受访者中,44%为医学本科生,42%为护理专业学生,14%为医学研究生住院医师。知识得分的平均值(标清)为 8.72(2.04)(满分 14 分)。在多变量分析中,只有培训学科能预测幸存者护理知识得分。研究生住院医师(9.08)和本科医学生(8.85)的平均知识得分明显高于护理专业学生(8.47)(P=0.004)。大多数人对两个问题的回答是错误的:CCS 的子女和兄弟姐妹需要额外的基因筛查(79% 错误地回答为 "是"),以及 CCS 在正常性功能方面面临亲密关系问题(59% 错误地回答为 "假")。将近一半的受访者(48%)认为他们对癌症幸存者问题的了解不够。大多数受访者(84%)建议由肿瘤专家而不是初级保健医生来处理长期的幸存者护理问题。结论 印度的受训医护人员表示对幸存者护理的认识不足。当务之急是通过将幸存者护理纳入教学课程来提高认识,使未来的初级保健医生能够在全国范围内提供幸存者护理。
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引用次数: 0
Storylines of family medicine V: ways of thinking—honing the therapeutic self 家庭医学的故事情节 V:锤炼治疗自我的思维方式
IF 6.1 3区 医学 Q1 Medicine Pub Date : 2024-04-01 DOI: 10.1136/fmch-2024-002792
W. Ventres, Leslie A Stone, Johanna F Shapiro, Cynthia Haq, Jéssica R B Leão, Donald E. Nease, Liz Grant, Stewart W Mercer, John Gillies, P. G. Blasco, M. D. de Benedetto, G. Moreto, M. Levites, J. DeVoe, William R. Phillips, Jane M Uygur, T. R. Egnew, Colette S Stanley
Storylines of Family Medicine is a 12-part series of thematically linked essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In ‘V: ways of thinking—honing the therapeutic self’, authors present the following sections: ‘Reflective practice in action’, ‘The doctor as drug—Balint groups’, ‘Cultivating compassion’, ‘Towards a humanistic approach to doctoring’, ‘Intimacy in family medicine’, ‘The many faces of suffering’, ‘Transcending suffering’ and ‘The power of listening to stories.’ May readers feel a deeper sense of their own therapeutic agency by reflecting on these essays.
家庭医学的故事情节》是一套由 12 个部分组成的系列丛书,这些文章主题鲜明、图文并茂,探讨了美国和世界其他地方的家庭医生和医学教育工作者所诠释的家庭医学的方方面面。在 "五:治疗自我的思考方式 "中,作者介绍了以下几个部分:行动中的反思性实践"、"作为药物的医生--巴林特小组"、"培养同情心"、"走向以人为本的医生之道"、"家庭医学中的亲密关系"、"痛苦的多面性"、"超越痛苦 "和 "倾听故事的力量"。愿读者通过对这些文章的思考,对自己的治疗机构有更深刻的感受。
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引用次数: 0
Storylines of family medicine III: core principles—primary care, systems and family 家庭医学的故事情节 III:核心原则--初级保健、系统和家庭
IF 6.1 3区 医学 Q1 Medicine Pub Date : 2024-04-01 DOI: 10.1136/fmch-2024-002790
W. Ventres, Leslie A Stone, Timothy A Joslin, J. Saultz, Sommer Aldulaimi, Paul R Gordon, John C Lane, Eric R Lee, Jacob Prunuske, Limor Gildenblatt, Michael H Friedman, Colleen T. Fogarty, Susan H. McDaniel, Tessa Rohrberg, Amy J Odom
Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In ‘III: core principles—primary care, systems, and family’, authors address the following themes: ‘Continuity of care—building therapeutic relationships over time’, ‘Comprehensiveness—combining breadth and depth of scope’, ‘Coordination of care—managing multiple realities’, ‘Access to care—intersectional, systemic, and personal’, ‘Systems theory—a core value in patient-centered care’, ‘Family-oriented practice—supporting patients’ health and well-being’, ‘Family physician as family member’ and ‘Family in the exam room’. May readers develop new understandings from these essays.
家庭医学的故事情节》是一套由 12 个部分组成的系列丛书,其中的微型文章主题鲜明,并配有插图,探讨了美国和世界其他地方的家庭医生和医学教育工作者对家庭医学的多方面理解。在 "III:核心原则--初级护理、系统和家庭 "中,作者探讨了以下主题:"护理的连续性--长期建立治疗关系"、"全面性--兼顾范围的广度和深度"、"护理协调--处理多种现实问题"、"获得护理--交叉、系统和个人"、"系统理论--以患者为中心的护理的核心价值"、"以家庭为导向的实践--支持患者的健康和福祉"、"作为家庭成员的家庭医生 "和 "检查室中的家庭"。愿读者能从这些文章中获得新的理解。
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引用次数: 0
Storylines of family medicine XI: professional identity formation—nurturing one’s own story 家庭医学的故事情节 XI:专业身份的形成--培养自己的故事
IF 6.1 3区 医学 Q1 Medicine Pub Date : 2024-04-01 DOI: 10.1136/fmch-2024-002827
W. Ventres, Leslie A Stone, Hamish J Wilson, S. Sexton, David J Doukas, Jessica P Cerdeña, David M Kelley, Michael D. Fetters, Jeffrey J Haney, John J Frey
Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In ‘XI: professional identity formation—nurturing one’s own story’, authors address the following themes: ‘The social construction of professional identity’, ‘On becoming a family physician’, ‘What’s on the test?—professionalism for family physicians’, ‘The ugly doc-ling’, ‘Teachers—the essence of who we are’, ‘Family medicine research—it starts in the clinic’, ‘Socially accountability in medical education’, ‘Personal philosophy and how to find it’ and ‘Teaching and learning with Storylines of Family Medicine’. May these essays encourage readers to find their own creative spark in medicine.
家庭医学的故事情节》是一个由 12 个部分组成的系列丛书,其中的微型文章主题鲜明、图文并茂,探讨了美国和世界其他地方的家庭医生和医学教育工作者对家庭医学的诸多理解。在 "十一:职业身份的形成--培养自己的故事 "中,作者探讨了以下主题:"职业身份的社会建构"、"成为一名家庭医生"、"考试内容是什么--家庭医生的职业精神"、"丑陋的医生"、"教师--我们的本质"、"家庭医学研究--从临床开始"、"医学教育中的社会责任"、"个人哲学及如何找到它 "以及 "家庭医学故事的教学与学习"。愿这些文章能鼓励读者在医学领域找到自己的创新火花。
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引用次数: 0
Storylines of family medicine X: standing up for diversity, equity and inclusion 家庭医学 X 的故事情节:坚持多样性、公平性和包容性
IF 6.1 3区 医学 Q1 Medicine Pub Date : 2024-04-01 DOI: 10.1136/fmch-2024-002828
W. Ventres, Leslie A Stone, Wayne W Bryant, Mario F Pacheco, Edgar Figueroa, Francis N Chu, Shailendra Prasad, David N Blane, Na'amah Razon, R. Mishori, Robert L Ferrer, Garrett S Kneese
Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In ‘X: standing up for diversity, equity and inclusion’, authors address the following themes: ‘The power of diversity—why inclusivity is essential to equity in healthcare’, ‘Medical education for whom?’, ‘Growing a diverse and inclusive workforce’, ‘Therapeutic judo—an inclusive approach to patient care’, ‘Global family medicine—seeing the world “upside down”’, ‘The inverse care law‘, ‘Social determinants of health as a lens for care’, ‘Why family physicians should care about human rights’ and ‘Toward health equity—the opportunome’. May the essays that follow inspire readers to promote change.
家庭医学的故事情节》是一套由 12 个部分组成的系列丛书,其中的微型文章主题鲜明、图文并茂,探讨了美国和世界其他地方的家庭医生和医学教育工作者对家庭医学的不同理解。在 "X:为多样性、公平性和包容性而奋斗 "中,作者探讨了以下主题:"多样性的力量--为什么包容性对医疗保健的公平性至关重要"、"医学教育为谁服务?医疗教育为谁服务?"、"培养一支多元化和包容性的医疗队伍"、"治疗性柔道--病人护理的包容性方法"、"全球家庭医疗--"颠倒 "看世界"、"逆向护理法"、"健康的社会决定因素作为护理的透镜"、"家庭医生为何应关注人权 "以及 "实现健康公平--机会"。愿后面的文章能激励读者推动变革。
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引用次数: 0
Storylines of family medicine I: framing family medicine – history, values and perspectives 家庭医学的故事情节 I:构建家庭医学--历史、价值观和视角
IF 6.1 3区 医学 Q1 Medicine Pub Date : 2024-04-01 DOI: 10.1136/fmch-2024-002788
W. Ventres, Leslie A Stone, Kathleen T Rowland, Richard H Streiffer, Michael D Macechko, Julia A Roulier, Jeffrey M Borkan, Larry A Green
Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In ‘I: framing family medicine—history, values, and perspectives’, the authors address the following themes: ‘Notes on Storylines of Family Medicine’, ‘Family medicine—the generalist specialty’, ‘Family medicine’s achievements—a glass half full assessment’, ‘Family medicine’s next 50 years—toward filling our glasses’, ‘Four enduring truths of family medicine’, ‘Names matter’, ‘Family medicine at its core’ and ‘The ecology of medical care.’ May readers find much food for thought in these essays.
家庭医学的故事情节》是一个由 12 个部分组成的系列丛书,其中的微型文章主题鲜明、图文并茂,探讨了美国和世界其他地方的家庭医生和医学教育工作者对家庭医学的不同理解。在 "I:构建家庭医学--历史、价值观和视角 "中,作者探讨了以下主题:"家庭医学故事情节笔记"、"家庭医学--全科专科"、"家庭医学的成就--半杯水的评估"、"家庭医学的下一个 50 年--装满我们的杯子"、"家庭医学的四个永恒真理"、"名字很重要"、"家庭医学的核心 "和 "医疗保健的生态学"。愿读者能从这些文章中找到许多思考的源泉。
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引用次数: 0
Storylines of family medicine VII: family medicine across the lifespan 家庭医学的故事情节 VII:跨越生命周期的家庭医学
IF 6.1 3区 医学 Q1 Medicine Pub Date : 2024-04-01 DOI: 10.1136/fmch-2024-002794
W. Ventres, Leslie A Stone, Katharine C Barnard, Sara G Shields, Mark J Nelson, M. Svetaz, Clara M Keegan, J. Heidelbaugh, Paige B Beck, Lucille Marchand
Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In ‘VII: family medicine across the lifespan’, authors address the following themes: ‘Family medicine maternity care’, ‘Seeing children as patients brings joy to work’, ‘Family medicine and the care of adolescents’, ‘Reproductive healthcare across the lifespan’, ‘Men’s health’, ‘Care of older adults’, and ‘Being with dying’. May readers appreciate the range of family medicine in these essays.
家庭医学的故事情节》(Storylines of Family Medicine)是一套由 12 个部分组成的系列丛书,其中的微型文章主题鲜明、图文并茂,探讨了美国和世界其他地方的家庭医生和医学教育工作者对家庭医学的多方面理解。在 "七:跨越生命周期的家庭医学 "中,作者探讨了以下主题:"家庭医学的孕产妇护理"、"将儿童视为病人为工作带来乐趣"、"家庭医学与青少年护理"、"跨越生命周期的生殖保健"、"男性健康"、"老年人护理 "和 "与临终者相处"。愿读者从这些文章中领略到家庭医学的博大精深。
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引用次数: 0
Storylines of family medicine VI: ways of being—in the office with patients 家庭医学的故事情节 VI:在诊室与病人相处的方式
IF 6.1 3区 医学 Q1 Medicine Pub Date : 2024-04-01 DOI: 10.1136/fmch-2024-002793
W. Ventres, Leslie A Stone, Lisa A LaVallee, David Loxterkamp, Jonisha R Brown, Dael M Waxman, Peter S Dorward, Jeanne Cawse-Lucas, Larry B Mauksch, A. Kieber-Emmons, Benjamin F. Crabtree, William L Miller, Veronica M Brohm, T. Daaleman, Kelly Bossenbroek Fedoriw
Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In ‘VI: ways of being—in the office with patients’, authors address the following themes: ‘Patient-centred care—cultivating deep listening skills’, ‘Doctor as witness’, ‘Words matter’, ‘Understanding others—metaphor and its use in medicine’, ‘Communicating with patients—making good use of time’, ‘The patient-centred medical home—aspirations for the future’, ‘Routine, ceremony or drama?’ and ‘The life course’. May readers better appreciate the nuances of patient care through these essays.
家庭医学的故事情节》(Storylines of Family Medicine)是一套由 12 个部分组成的系列丛书,其中的微型文章主题鲜明、图文并茂,探讨了美国和世界其他地方的家庭医生和医学教育工作者所诠释的家庭医学的方方面面。在 "VI:在诊室与患者相处的方式 "中,作者探讨了以下主题:"以患者为中心的护理--培养深度倾听的技能"、"医生作为见证人"、"言语的重要性"、"理解他人--隐喻及其在医学中的应用"、"与患者沟通--善用时间"、"以患者为中心的医疗之家--对未来的展望"、"常规、仪式还是戏剧?"以及 "生命历程"。愿读者通过这些文章更好地了解病人护理的细微差别。
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引用次数: 0
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Family Medicine and Community Health
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