家庭访视在以家庭为单位的健康照顾中的实施效果研究  

Implementation Effect of Home Care:a Case Report and Exploratory Home Follow-up Study

作　　者：杨凯文 姜岳 赵付英 YANG Kaiwen;JIANG Yue;ZHAO Fuying(Liulimiao Community Health Center,Huairou District,Beijing 101409,China;Gaobeidian Community Health Center,Chaoyang District,Beijing 100124,China;School of General Practice and Continuing Education,Capital Medical University,Beijing 100069,China)

机构地区：[1]北京市怀柔区琉璃庙镇社区卫生服务中心,101409 [2]北京市朝阳区高碑店社区卫生服务中心,100124 [3]首都医科大学全科医学与继续教育学院,北京市100069

出　　处：《中国全科医学》2021年第22期2880-2884,共5页Chinese General Practice

基　　金：首都医科大学教学改革项目(2020JYJX079);北京市中医住院医师规范化培训三优教学团队项目(2018-140)。

摘　　要：对家庭的照顾是全科医学的核心特征之一,家庭中各种因素、家庭成员间的相互作用关系及家庭资源的利用等对患者患病、治疗和康复具有重要意义,因此,全科医生在临床诊疗中,在考虑患者个人健康问题的同时,还需关注患者的家庭。本文的主要目的是探讨通过家庭访视实施以家庭为单位的健康照顾在全科诊疗中的优势,以期为全科医生进行全家庭照顾提供参考。本文从1例“评估性家庭访视”案例出发,全科医生通过深入患者家庭、进行个人评估和家庭评估、协调家庭内外部资源及全家庭管理,可快速识别家庭中的安全隐患,有效解决家庭问题,减少生活不良事件的发生。通过长期、连续性随访及对干预效果的不断正反馈,全科医生见证了家庭问题日益得到改善,巩固了良好的医患关系。可见,家庭访视是一项灵活而高效的诊疗服务,具有很高的实用价值,适用于基层医疗卫生机构在社区环境中开展。Home care is one type of essential services included in primary care services.Various family-related factors,interaction between family members and family resource utilization are important for disease incidence,treatment and rehabilitation of a family member.So it is necessary for a general practitioner(GP)to pay attention to the patient's familyrelated factors besides the health problem when delivering diagnosis and treatment services clinically.To explore the benefits of home care via follow-up investigation as useful evidence,we analyzed the data of home care for a case obtained by home followups.The analysis indicates that by home follow-up assessment of the patient and his family,family resource management and family management,GPs may identify the potential family health risks,effectively address family health problems,and reduce the possibility of the patient having an adverse event.Moreover,long-term continuous home follow-ups and patient's positive feedback of interventions may also facilitate the solving of family health problems,and the building and strengthening of a good patient-physician relationship.Furthermore,home follow-up has been proved applicable for community care as a flexible and efficient consultation way.

关 键 词：全科医学 以家庭为单位的照顾 家庭访视 全科医生 基层卫生保健 

分 类 号：R197[医药卫生—卫生事业管理]