Neale A V, Hodgkins B J, Demers R Y
Department of Family Medicine, Wayne State University, Detroit, MI 48201.
Fam Med. 1992 Jan;24(1):36-40.
A home visit rotation was developed to provide family practice residents with a more comprehensive understanding of the effect of patient life-style on health status. The rotation emphasizes geriatric, community, and rehabilitative medicine. In addition, the curriculum addresses issues related to patient compliance, assessment of activities of daily living, patient psychosocial needs, community services, and exposure to medical equipment of potential use to homebound individuals. Over a three-year period, 209 home visits were made. Program evaluation data suggest that at the end of the three-month rotation, residents were less concerned with personal safety and more likely to agree that home visits were an important part of residency training. A comparison of pre- and post-test knowledge scores indicated significant increases in geriatric medicine, patient compliance issues, patient functional status, and community services. A follow-up telephone interview with patients found that some patients experienced anxiety when the home visit was scheduled, but the majority were positive about the experience.
开展了一次家访轮转,以使家庭医学住院医师更全面地了解患者生活方式对健康状况的影响。该轮转强调老年医学、社区医学和康复医学。此外,课程还涉及与患者依从性、日常生活活动评估、患者心理社会需求、社区服务以及接触居家患者可能使用的医疗设备相关的问题。在三年时间里,共进行了209次家访。项目评估数据表明,在为期三个月的轮转结束时,住院医师对个人安全的担忧减少,并且更有可能认同家访是住院医师培训的重要组成部分。前后测知识分数的比较表明,在老年医学、患者依从性问题、患者功能状态和社区服务方面有显著提高。对患者的后续电话访谈发现,一些患者在安排家访时会感到焦虑,但大多数患者对这次经历持积极态度。