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本文引用的文献

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The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. Finasteride Long-Term Efficacy and Safety Study Group.非那雄胺对良性前列腺增生男性急性尿潴留风险及手术治疗需求的影响。非那雄胺长期疗效和安全性研究组。
N Engl J Med. 1998 Feb 26;338(9):557-63. doi: 10.1056/NEJM199802263380901.
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Guidelines for estimating the real cost of an objective structured clinical examination.客观结构化临床考试实际成本估算指南。
Acad Med. 1993 Jul;68(7):513-7. doi: 10.1097/00001888-199307000-00001.
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Practice-based small-group CME.基于实践的小组继续医学教育。
Acad Med. 1994 Oct;69(10):800-2. doi: 10.1097/00001888-199410000-00002.
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Changing physician performance. A systematic review of the effect of continuing medical education strategies.改变医生的行为表现。对继续医学教育策略效果的系统评价。
JAMA. 1995 Sep 6;274(9):700-5. doi: 10.1001/jama.274.9.700.
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Clinical guidelines: their implementation in general practice.临床指南：其在全科医疗中的实施
Br J Gen Pract. 1995 Jul;45(396):371-5.
6
No magic bullets: a systematic review of 102 trials of interventions to improve professional practice.没有万灵药：对102项改善专业实践干预措施试验的系统评价
CMAJ. 1995 Nov 15;153(10):1423-31.
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Paradox, process and perception: the role of organizations in clinical practice guidelines development.悖论、过程与认知：组织在临床实践指南制定中的作用
CMAJ. 1995 Oct 15;153(8):1073-7.
8
Natural history of prostatism: relationship among symptoms, prostate volume and peak urinary flow rate.前列腺增生症的自然病史：症状、前列腺体积与最大尿流率之间的关系。
J Urol. 1995 May;153(5):1510-5. doi: 10.1016/s0022-5347(01)67448-2.
9
Benign prostatic hyperplasia. Medical and minimally invasive treatment options.良性前列腺增生。医学及微创治疗方案。
N Engl J Med. 1995 Jan 12;332(2):99-109. doi: 10.1056/NEJM199501123320207.
10
Benign prostatic hyperplasia: diagnosis and treatment. Agency for Health Care Policy and Research.良性前列腺增生：诊断与治疗。医疗保健政策与研究机构。
Clin Pract Guidel Quick Ref Guide Clin. 1994 Feb(8):1-17.

基层医疗中良性前列腺增生的管理。以患者为中心的方法。

Managing benign prostatic hyperplasia in primary care. Patient-centred approach.

作者信息

McSherry J, Weiss R

机构信息

Department of Family Medicine, University of Western Ontario.

出版信息

Can Fam Physician. 2000 Feb;46:383-9.

PMID:10690495
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1987686/
Abstract

PROBLEM ADDRESSED

Management of benign prostatic hyperplasia (BPH) is changing from a surgical approach to a medical approach, and the role of primary care physicians is expanding.

OBJECTIVE OF PROGRAM

To introduce a patient-centred approach to managing BPH in primary care through a continuing medical education (CME) program.

MAIN COMPONENTS OF PROGRAM

A practice-based, small group, peer-led CME program focused on application of the International Prostate Symptom Score and Quality of Life Assessment in four case studies on prostatism, including BPH. At 86 workshops held across Canada, 658 physicians participated in discussions with case materials that included videos and a handbook. A before-after practice behaviour questionnaire was administered at each workshop to evaluate "intent to change."

CONCLUSIONS

Participating physicians showed willingness to learn new skills for patient-centred management of BPH. These results suggest that peer-led, small group CME can successfully encourage use of new practice guidelines in primary are and teach physicians practical steps for developing therapeutic alliances with their patients.

摘要

解决的问题

良性前列腺增生（BPH）的管理正从手术方法转向医学方法，基层医疗医生的作用正在扩大。

项目目标

通过继续医学教育（CME）项目，在基层医疗中引入以患者为中心的BPH管理方法。

项目的主要组成部分

一个基于实践的、小组形式、由同行主导的CME项目，重点是在四个关于前列腺增生（包括BPH）的案例研究中应用国际前列腺症状评分和生活质量评估。在加拿大各地举办的86场研讨会上，658名医生参与了对包含视频和手册的案例材料的讨论。在每个研讨会上都发放了一份前后实践行为问卷，以评估“改变意愿”。

结论

参与的医生表现出愿意学习以患者为中心的BPH管理新技能。这些结果表明，由同行主导的小组CME可以成功地鼓励在基层医疗中使用新的实践指南，并教会医生与患者建立治疗联盟的实际步骤。