Lauteslager M, Brouwer H J, Mohrs J, Bindels P J E, Grundmeijer H G L M
Department of General Practice, Academic Medical Center, Amsterdam, The Netherlands.
Fam Pract. 2002 Apr;19(2):167-71. doi: 10.1093/fampra/19.2.167.
The problem list is an important tool in general practice for care as well as research purposes. As the central part of the problem-oriented medical record, it lists the main medical problems which the GP wants to have knowledge of during any patient encounter. The assessment of its quality is usually made by comparing with other sources of information on the patient's problems.
This study addresses the question of to what extent the problem list can be improved by asking the patient about their own medical problems.
During 7 weeks, all patients who visited three GPs in a health care centre in an Amsterdam suburb were interviewed. During the interview, they were confronted with the problem list made by their own GP and stimulated to make suggestions for addition or removal of problems.
All in all, patients were in agreement with 88% of all listed problems. The completeness of the problem list could be increased by 28%, while 4% ultimately were removed: a net gain of 24%.
The patient can be used as a sourcetool for improvement of the quality of the problem list when its prime function is patient care. It becomes more complicated when the problem list also serves a research purpose. Clear inclusion rules will then have to be formulated.
问题清单是全科医疗中用于医疗及研究目的的重要工具。作为问题导向型病历的核心部分，它列出了全科医生在每次接诊患者时希望了解的主要医疗问题。其质量评估通常是通过与关于患者问题的其他信息来源进行比较来进行的。
本研究探讨通过询问患者自身的医疗问题，问题清单在多大程度上能够得到改进。
在7周时间里，对阿姆斯特丹郊区一家医疗中心的三位全科医生接诊的所有患者进行了访谈。在访谈过程中，让他们对照自己的全科医生所列出的问题清单，并鼓励他们提出增减问题的建议。
总体而言，患者对所有列出问题中的88%表示认同。问题清单的完整性可提高28%，同时最终有4%的问题被删除：净增加24%。
当问题清单的主要功能是患者护理时，患者可作为提高问题清单质量的来源/工具。当问题清单也用于研究目的时，情况会变得更加复杂。届时必须制定明确的纳入规则。
