Steven I D, Thomas S A, Eckerman E, Browning C, Dickens E
Royal Australian College of General Practitioners, North Adelaide, SA.
J Qual Clin Pract. 1999 Dec;19(4):195-201. doi: 10.1046/j.1440-1762.1999.00332.x.
The objective of this study was, by means of patient self-report, to measure the provision of preventive care to patients of a sample of Australian general practitioners. Patient-completed questionnaires from a consecutive sample of Australian general practitioners enrolled in the Quality Assurance and Continuing Medical Education Program of the Royal Australian College of General Practitioners were used. Patients were attendees at Australian general practices. The main outcome measures included the following: the provision of tetanus immunization within the last 10 years; blood pressure measurement within the last 12 months; cholesterol screening within the past 5 years; provision of adequate information to enable patients to stop smoking if they desired; discussion about the benefits of diet and exercise to enhance life, and about alcohol intake; provision of cervical smears in the past 2 years; provision of adequate instruction in breast self-examination and overall satisfaction with service provision. A total of 12,605 questionnaires from 133 general practices were completed. There was wide variability between practices in the reported provision of preventive care items including an average of 86% (range 36-100) of patients reporting the provision of blood pressure checking in the past 12 months, 62% (range 25-97%) reporting the provision of tetanus immunization in the past 10 years, and 63% (range 10-91%) reporting having had a cervical smear in the past 2 years. Patients who were very satisfied were more likely to have reported that they had received blood pressure measurement in the past 12 months, participated in discussions about the benefits of diet and exercise in enhancing life, and participated in discussions about alcohol intake and provision of adequate instruction in the technique of breast self-examination. Patient self-reporting identified variability between practitioners in the provision of preventive care conforming to accepted guidelines. Patients who reported that they were very satisfied or who regularly attend only one general practice reported the provision of more preventive care than those who were not very satisfied or who regularly visited two or more general practitioners.
本研究的目的是通过患者自我报告,衡量澳大利亚全科医生样本为患者提供预防性护理的情况。使用了来自参加澳大利亚皇家全科医生学院质量保证和继续医学教育项目的连续样本澳大利亚全科医生的患者填写问卷。患者为澳大利亚全科诊所的就诊者。主要结局指标如下:过去10年内是否接种破伤风疫苗;过去12个月内是否测量血压;过去5年内是否进行胆固醇筛查;是否提供足够信息以使有意愿的患者戒烟;是否讨论饮食和运动对增进健康的益处以及饮酒情况;过去2年内是否进行宫颈涂片检查;是否提供乳房自我检查的充分指导以及对服务提供的总体满意度。共完成了来自133家全科诊所的12,605份问卷。在所报告的预防性护理项目提供情况方面,各诊所之间存在很大差异,包括过去12个月内平均86%(范围36%-100%)的患者报告接受了血压检查,过去10年内62%(范围25%-97%)的患者报告接种了破伤风疫苗,过去2年内63%(范围10%-91%)的患者报告进行了宫颈涂片检查。非常满意的患者更有可能报告在过去12个月内接受了血压测量、参与了关于饮食和运动对增进健康益处的讨论、参与了关于饮酒情况的讨论以及接受了乳房自我检查技术的充分指导。患者自我报告发现,从业者在提供符合公认指南的预防性护理方面存在差异。报告非常满意或仅定期就诊于一家全科诊所的患者,比那些不太满意或定期就诊于两家或更多全科医生的患者报告接受了更多的预防性护理。