基本医疗保健服务六项基本临床原则  

Six basic clinical principles of primary care practice

作　　者：李健 刘莹莹[2] 朴慧烘[1] 袁同玲 吴江 LI Jian;LIU Ying-ying;PIAO Hui-hong;YUAN Tong-ling;WU Jiang(Department of General Practice,Shenzhen People’s Hospital,Medical School of Southern University of Science and Technology(SUSTech)&Jinan University,Shenzhen,Guangdong 518020,China;不详)

机构地区：[1]南方科技大学附属第一医院暨南大学第二临床医学院深圳市人民医院全科医学科,广东深圳518020 [2]电子科技大学附属医院中国科学院转化医学研究医院四川省人民医院全科医学中心,四川成都610072 [3]深圳大学医学院第五附属医院深圳市宝安区中心医院全科医学科,广东深圳518103

出　　处：《中华全科医学》2021年第12期2141-2145,共5页Chinese Journal of General Practice

基　　金：四川省成都市科技局科技惠民项目(2015-HM02-00020-SF)。

摘　　要：目的基本医疗保健(primary care)是发达国家的全科医疗临床服务,其基本原则应该建立,本研究的目的就是建立基本医疗保健的临床服务原则。方法利用多种数据库,使用关键字"基本医疗保健(primary care)""基本医疗保健服务(primary care practice)""基本卫生医疗保健(primary health care)""全科医学(general practice)""家庭医学(family medicine)"结合"原则(principle)""理念(ideal)""描述(description)""特点(characteristic)"和"特色(feature)"搜索文献,共筛选出54篇符合要求的文献,总结基本医疗保健的基本临床原则。结果基本医疗保健服务的六项临床基本原则如下。(1)整体性:包括整体性、全人关怀、生物-心理-社会模式、横向临床思维、克服碎片化专科服务。(2)整合性:包括补充医学,协调医疗,整体整合医学(HIM)的结合。(3)连续性:连续的临床医患关系、无缝服务、随时随地的全程医疗服务。(4)预防性:包括未分化性疾病诊治、健康咨询、无症状疾病筛查和免疫接种。(5)以患者为中心:包括尊重个人的需求和价值,以人为本的医疗保健和实践PCMH。(6)规范化:循证医学应用,遵循临床指南,应用临床路径。结论基本医疗保健服务的六项基本临床原则是全科医疗服务的脊梁,推荐用于全科医疗临床实践学科知识的构建。Objective Primary care is a general medical clinical service in developed countries,and its basic principles should be established.The purpose of this study is to establish the clinical service principles of primary care.Methods We searched literature in multiple databases using the key words’primary care,’’primary care practice,’’primary health care,’’general practice’and’family medicine’in combination with’principle,’’ideal,’’description,’’characteristic’and’feature’.A total of 54 articles were selected to summarize the basic clinical principles of primary care practice.Results Six basic clinical principles of primary care practice were synthesised.(1)A holistic principle included holism,whole person care,bio-psycho-social model,lateral clinical thinking and overcoming fragmented specialisation.(2)An integrative principle consisted of the combination of complementary medicine,coordinated care and practicing holistic integrated medicine.(3)A continuous principle dealed with continuous clinician-patient relationship,seamless services,life-cycle medical services and full medical care at any time and place.(4)A preventive principle contained undifferentiated disease care,health habit counselling,screening for asymptomatic diseases and immunisation.(5)A patient-centred principle referred to responses to individual patient needs and values,people-oriented care and practicing patient-centred medical home.(6)A standardised principle involved the use of evidence-based medicine,following the clinical guideline and applying the clinical pathway.Conclusion The six basic clinical principles might be the backbone of primary care practice,which can be used to construct the disciplinary knowledge of clinical primary care practice.

关 键 词：基本医疗保健 基本医疗保健服务 基本健康保健 全科医学 家庭医学 

分 类 号：R499[医药卫生—康复医学]