Furler John, Young Doris
Department of General Practice, University of Melbourne, Victoria.
Aust Fam Physician. 2005 Oct;34(10):821-4.
Counselling in behavioural risk factors links chronic disease prevention and chronic disease care in the day-to-day work of general practice. This is particularly so in diabetes and cardiovascular disease. Each of these conditions is significantly more common in socioeconomically disadvantaged communities, suggesting that preventive activity may be particularly important for these groups; but what does that mean for general practitioners working with individual patients in their practice?
This article sets out some broad approaches to making sure that preventive activity in general practice reaches effectively those living in adverse socioeconomic circumstances.
Rather than different preventive care, we require extra and targeted effort and a modified approach. We need to ensure that preventive care reaches those most in need and is implemented in a way that is sensitive to patient context. Collecting data on patient socioeconomic status is an important step in applying an 'equity lens' to our preventive care. A practice team approach is required to develop clear goals and address any gaps identified in preventive care. At a one-to-one level we need to allocate extra time to patients as well as reflect on our own attitudes and assumptions about social disadvantage and health.
在全科医疗的日常工作中，对行为风险因素的咨询将慢性病预防与慢性病护理联系起来。在糖尿病和心血管疾病方面尤其如此。这些疾病在社会经济条件不利的社区中更为常见，这表明预防活动对这些群体可能尤为重要；但这对在诊所中为个体患者提供服务的全科医生意味着什么呢？
本文提出了一些广泛的方法，以确保全科医疗中的预防活动有效地惠及生活在不利社会经济环境中的人群。
我们需要的不是不同的预防保健，而是额外的、有针对性的努力和一种改进的方法。我们需要确保预防保健惠及最需要的人群，并以一种对患者情况敏感的方式实施。收集患者社会经济状况的数据是在预防保健中应用“公平视角”的重要一步。需要一个实践团队的方法来制定明确的目标，并解决预防保健中发现的任何差距。在一对一的层面上，我们需要为患者分配额外的时间，并反思我们自己对社会劣势和健康的态度及假设。
