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Patients' resistance to change. 病人对改变的抗拒。
S I Haider, S S Haider
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引用次数: 0
Measles--mumps--rubella immunization: the role of the general practitioner in achieving a high uptake. 麻疹-腮腺炎-风疹免疫:全科医生在实现高接种率方面的作用。
D Walker, M Roworth, H Carter, I G Jones

A survey of all general practitioners in Fife conducted prior to the introduction of measles-mumps-rubella immunization on a pilot basis in May 1987 showed that 85% considered mumps worth preventing and 94% believed the rubella programme worth augmenting with universal childhood immunization. Ninety seven per cent considered measles worth preventing and 98% were prepared to recommend measles-mumps-rubella immunization to parents instead of measles vaccine. One year after introducing the measles-mumps-rubella vaccine in Fife, 91% of children had been immunized with the combined vaccine or measles vaccine before their second birthday. This compares with the 83% that received measles vaccine before the combined vaccine was introduced. Eighty per cent of preschool children were also immunized with the combined vaccine at school entry in a catch-up exercise. This study demonstrates that there are few major professional barriers to achieving a high uptake of the measles-mumps-rubella vaccine in this area. The vaccine was introduced nationally on 1 October 1988 and its uptake is likely to exceed the current unsatisfactory level achieved with measles vaccine. However, this outcome will largely depend on the commitment of doctors to the programme.

1987年5月,在法夫郡试行麻疹-腮腺炎-风疹免疫之前,对所有全科医生进行的调查显示,85%的人认为腮腺炎值得预防,94%的人认为风疹规划值得通过普及儿童免疫来加强。97%的人认为麻疹值得预防,98%的人准备向父母推荐麻疹-腮腺炎-风疹免疫接种,而不是麻疹疫苗。在法夫引入麻疹-腮腺炎-风疹疫苗一年后,91%的儿童在两岁之前接种了联合疫苗或麻疹疫苗。相比之下,在引入联合疫苗之前,接种麻疹疫苗的人数为83%。80%的学龄前儿童在入学时也接受了联合疫苗的免疫接种。这项研究表明,在该地区实现麻疹-腮腺炎-风疹疫苗的高接种率几乎没有主要的专业障碍。该疫苗于1988年10月1日在全国推广,其吸收量可能超过目前麻疹疫苗所达到的令人不满意的水平。然而,这一结果将在很大程度上取决于医生对该计划的承诺。
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引用次数: 0
Should performance indicators in general practice relate to whole practices or to individual doctors? 全科实践的绩效指标应该与整个实践有关还是与个别医生有关?
M O Roland, J Middleton, B Goss, A T Moore

In a study of referrals to East Anglian hospitals 737 referrals in six specialties from three general practices were examined to see how accurately the hospital computer master index had identified the referring practice, the referring general practitioner and the doctor with whom the patient was registered. Although the practice was accurately identified by the hospital computer in 97% of referrals, the identification of the referring doctor and the patient's registered general practitioner were less reliable (72% and 49% respectively). It is concluded that at present the practice rather than the individual doctor may be the appropriate unit of analysis for studies of general practitioners' referral rates. This may be true for other performance indicators where information on a doctor's case mix and workload is not available. The results of this study emphasize that problems may arise if data relating to individual general practitioners are interpreted out of context of the practice and the way in which it is organized.

在一项对东安格利亚医院转诊的研究中,研究人员检查了来自三个全科诊所的六个专业的737个转诊,以了解医院计算机主索引识别转诊诊所、转诊全科医生和患者注册的医生的准确性。虽然医院计算机在97%的转诊中准确地识别了这种做法,但转诊医生和患者注册全科医生的识别可靠性较低(分别为72%和49%)。结论是,目前的做法,而不是个别医生可能是适当的单位分析全科医生的转诊率的研究。对于无法获得医生病例组合和工作量信息的其他绩效指标,这可能是正确的。这项研究的结果强调,如果与个体全科医生有关的数据被解释为脱离实践的背景和组织方式,可能会出现问题。
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引用次数: 0
Foreign body inhalation: a danger of metered dose inhalers. 异物吸入:计量吸入器的一种危险。
P M Cuckow, T A English
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引用次数: 0
Effect of small group education on the outcome of chronic asthma. 小团体教育对慢性哮喘转归的影响。
P T White, C A Pharoah, H R Anderson, P Freeling
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引用次数: 0
Trainer and trainee workloads. 培训师和学员工作量。
I R Wakefield
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引用次数: 0
The future role of mental illness hospitals. 精神疾病医院未来的角色。
E M Armstrong
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引用次数: 0
Ethical decision making by British general practitioners. 英国全科医生的道德决策。
R J Christie, C Freer, C B Hoffmaster, M A Stewart

General practitioners in England and Wales were sent a questionnaire asking how they would handle the ethical problems posed by six case vignettes and their reasons for their decisions. The ethical problems included: how much information to divulge to patients, how extensively a physician should become involved in the lifestyles of patients and how to deal with a possible family problem. The varying patterns of response to the six cases suggested that ethical issues are resolved in a case-by-case, not a theoretical, basis.

英格兰和威尔士的全科医生被发送了一份调查问卷,询问他们如何处理六个案例所带来的道德问题以及他们做出决定的原因。伦理问题包括:向病人透露多少信息,医生应该在多大程度上参与病人的生活方式,以及如何处理可能出现的家庭问题。对六个案例的不同反应模式表明,道德问题是在逐个案例而不是理论基础上解决的。
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引用次数: 0
Quality assessment or quality control? 质量评估还是质量控制?
G Westman
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引用次数: 0
Direct access to hospital investigative facilities. 直接进入医院调查设施
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引用次数: 0
期刊
The Journal of the Royal College of General Practitioners
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