Meineche-Schmidt V, Rubin G, de Wit N J
Centre for Preventive Medicine, Glostrup University Hospital, 2600 Glostrup, Denmark.
Fam Pract. 2000 Aug;17 Suppl 2:S2-5. doi: 10.1093/fampra/17.suppl_2.s2.
A central feature of general practice is the use of time in the management of patients and their illnesses. The use of active interventions such as investigations or therapies within the context of this dimension has implications for the development of clinical guidelines for primary care. Importantly, their recommendations of best practice must be compatible with the complexities of the holistic relationship between GP and patient. Many existing guidelines adopt a reductionist, algorithmic approach, losing applicability and relevance to primary care in the process. Here we identify the key features in the primary care management of the patient with dyspepsia, and examine the utility of existing guidelines for the management of Helicobacter pylori infection. Through this comparative analysis, the scope and nature of primary care-centred management guidelines are identified.
全科医疗的一个核心特点是在患者及其疾病管理中对时间的运用。在这一维度背景下使用诸如检查或治疗等积极干预措施，对制定初级保健临床指南具有影响。重要的是，其最佳实践建议必须与全科医生和患者之间整体关系的复杂性相契合。许多现有指南采用还原论、算法式方法，在此过程中失去了对初级保健的适用性和相关性。在此，我们确定消化不良患者初级保健管理的关键特征，并审视现有幽门螺杆菌感染管理指南的实用性。通过这种比较分析，确定以初级保健为中心的管理指南的范围和性质。
