Padma-Nathan H
The Male Clinic, Beverly Hills, CA 90212, USA.
Int J Impot Res. 2000 Oct;12 Suppl 4:S119-21. doi: 10.1038/sj.ijir.3900589.
The new era of erectile dysfunction medicine ushered in by the availability of an effective and safe oral medication paves the evolution of the field toward a multi-disciplinary and primary care setting. There exists a paucity of guidelines regarding the assessment and management of the patient with erectile dysfunction in the primary care arena. The 'Process of Care' model for the evaluation and treatment of erectile dysfunction has been developed to advance new guidelines for the diagnosis and management of erectile dysfunction in the primary care and multi-disciplinary setting. This model was developed under the auspices of the University of Medicine and Dentistry of New Jersey (UMDNJ)-Robert Wood Johnson Medical School (chairman: R Rosen) with input from a multi-disciplinary group of experts including representation from primary care, internal medicine, endocrinology, psychiatry, psychology and urology. The methodology employed was a modified delphi-technique (RAND method). The key components of the model are: 1)a rational approach to diagnosis and treatment, 2) emphasis on clinical history-taking and a focused physical examination 3) specialized testing and referral in pre-defined situations 4) step-wise management approach with ranking of treatment options and 5)incorporation of patient and partner needs and preferences in the decision making process when possible (a goal-directed approach). The management algorithm is conceptually organized into progressive stages from Process--> Action--> Outcome. International Journal of Impotence Research (2000) 12, Suppl 4, S119-S121.
一种有效且安全的口服药物的出现开创了勃起功能障碍医学的新时代，推动该领域朝着多学科和初级保健方向发展。在初级保健领域，关于勃起功能障碍患者评估和管理的指南匮乏。为了推进初级保健和多学科环境中勃起功能障碍诊断和管理的新指南，已制定了勃起功能障碍评估和治疗的“护理流程”模型。该模型是在新泽西医学与牙科大学（UMDNJ）-罗伯特·伍德·约翰逊医学院（主席：R·罗森）的支持下，由包括初级保健、内科、内分泌学、精神病学、心理学和泌尿学代表在内的多学科专家小组参与制定的。所采用的方法是改良的德尔菲技术（兰德方法）。该模型的关键组成部分包括：1）合理的诊断和治疗方法，2）强调临床病史采集和重点体格检查，3）在预定义情况下进行专门检测和转诊，4）采用逐步管理方法并对治疗方案进行排序，5）在可能的决策过程中纳入患者及其伴侣的需求和偏好（目标导向方法）。管理算法在概念上分为从流程→行动→结果的递进阶段。《国际阳痿研究杂志》（2000年）12卷，增刊4，S119 - S121。
