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家庭医生提出的有关患者护理问题的分析。

Analysis of questions asked by family doctors regarding patient care.

作者信息

Ely J W, Osheroff J A, Ebell M H, Bergus G R, Levy B T, Chambliss M L, Evans E R

机构信息

Department of Family Medicine, University of Iowa College of Medicine, 200 Hawkins Drive, 01291-D PFP, Iowa City, IA 52242, USA.

出版信息

BMJ. 1999 Aug 7;319(7206):358-61. doi: 10.1136/bmj.319.7206.358.

Abstract

OBJECTIVES

To characterise the information needs of family doctors by collecting the questions they asked about patient care during consultations and to classify these in ways that would be useful to developers of knowledge bases.

DESIGN

Observational study in which investigators visited doctors for two half days and collected their questions. Taxonomies were developed to characterise the clinical topic and generic type of information sought for each question.

SETTING

Eastern Iowa.

PARTICIPANTS

Random sample of 103 family doctors.

MAIN OUTCOME MEASURES

Number of questions posed, pursued, and answered; topic and generic type of information sought for each question; time spent pursuing answers; information resources used.

RESULTS

Participants asked a total of 1101 questions. Questions about drug prescribing, obstetrics and gynaecology, and adult infectious disease were most common and comprised 36% of all questions. The taxonomy of generic questions included 69 categories; the three most common types, comprising 24% of all questions, were "What is the cause of symptom X?" "What is the dose of drug X?" and "How should I manage disease or finding X?" Answers to most questions (702, 64%) were not immediately pursued, but, of those pursued, most (318, 80%) were answered. Doctors spent an average of less than 2 minutes pursuing an answer, and they used readily available print and human resources. Only two questions led to a formal literature search.

CONCLUSIONS

Family doctors in this study did not pursue answers to most of their questions. Questions about patient care can be organised into a limited number of generic types, which could help guide the efforts of knowledge base developers.

摘要

目的

通过收集家庭医生在会诊期间询问的有关患者护理的问题,来描述他们的信息需求,并以对知识库开发者有用的方式对这些问题进行分类。

设计

观察性研究,研究人员对医生进行了两个半天的走访并收集他们提出的问题。开发了分类法来描述每个问题所寻求的临床主题和信息的一般类型。

地点

爱荷华州东部。

参与者

103名家庭医生的随机样本。

主要观察指标

提出、追问和回答的问题数量;每个问题所寻求的信息的主题和一般类型;追问答案所花费的时间;使用的信息资源。

结果

参与者共提出1101个问题。关于药物处方、妇产科和成人传染病的问题最为常见,占所有问题的36%。一般问题的分类法包括69个类别;三种最常见的类型,占所有问题的24%,分别是“症状X的病因是什么?”“药物X的剂量是多少?”以及“我应该如何处理疾病或检查结果X?”大多数问题(702个,64%)没有立即追问答案,但在追问的问题中,大多数(318个,80%)得到了回答。医生追问一个答案平均花费不到2分钟,他们使用的是现成的印刷资源和人力资源。只有两个问题导致了正式的文献检索。

结论

本研究中的家庭医生没有追问大多数问题的答案。关于患者护理的问题可以组织成有限数量的一般类型,这有助于指导知识库开发者的工作。

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