Kamenski Gustav, Fink Waltraud, Maier Manfred, Pichler Ingrid, Zehetmayer Sonja
Department of General Medicine, Centre of Public Health, Medical University Vienna, Währingerstrasse 13a, A-1090 Wien, Austria.
BMC Fam Pract. 2006 Oct 1;7:55. doi: 10.1186/1471-2296-7-55.
Almost all societies carry responsibility towards patients who require continuous medical care at home. In many health systems the general practitioner cooperates with community based services of home care and coordinates all medical and non medical activities. In Austria the general practitioner together and in cooperation with relatives of the patient and professional organisations usually takes on this task by visiting his patients. This study was carried out to identify diseases that need home care and to describe the functional profile of home care patients in eastern Austria.
Cross sectional observational study with 17 GP practices participating during 2 study periods in 1997 and in 2004 in eastern Austria. Each GP identified patients requiring home care and assessed their underlying diseases and functional status by filling in a questionnaire personally after an encounter. Patients in nursing homes were excluded. Statistical tests used were t-tests, contingency tables, nonparametric Wilcoxon signed rank sum test and Fisher-combination test.
Patients with degenerative diseases of the central nervous system (65%) caused by Alzheimer's disease and cerebrovascular occlusive disease and patients with degenerative diseases of the skeletal system (53%) were the largest groups among the 198 (1997) and 261 (2004) home care cases of the 11 (1997) and 13 (2004) practices. Malignant diseases in a terminal state constituted only 5% of the cases. More than two thirds of all cases were female with an average age of 80 years. Slightly more than 70% of the patients were at least partially mobile.
Home care and home visits for patients with degenerative diseases of the central nervous and skeletal system are important elements of GP's work. Further research should therefore focus on effective methods of training and rehabilitation to better the mental and physical status of patients living in their private homes.
几乎所有社会都对需要在家接受持续医疗护理的患者负有责任。在许多卫生系统中，全科医生与社区居家护理服务合作，并协调所有医疗和非医疗活动。在奥地利，全科医生通常与患者亲属及专业组织共同承担这项任务，即上门探访患者。本研究旨在确定需要居家护理的疾病，并描述奥地利东部居家护理患者的功能状况。
1997年和2004年在奥地利东部进行了两个研究阶段，17个全科医生诊所参与的横断面观察性研究。每位全科医生识别出需要居家护理的患者，并在每次诊疗后亲自填写问卷评估其基础疾病和功能状态。养老院的患者被排除在外。使用的统计检验包括t检验、列联表、非参数Wilcoxon符号秩和检验以及Fisher组合检验。
在11个（1997年）和13个（2004年）诊所的198例（1997年）和261例（2004年）居家护理病例中，由阿尔茨海默病和脑血管闭塞性疾病引起的中枢神经系统退行性疾病患者（65%）以及骨骼系统退行性疾病患者（53%）是最大的群体。晚期恶性疾病仅占病例的5%。所有病例中超过三分之二为女性，平均年龄80岁。略超过70%的患者至少部分能够活动。
对中枢神经系统和骨骼系统退行性疾病患者的居家护理和上门探访是全科医生工作的重要内容。因此，进一步的研究应侧重于有效的培训和康复方法，以改善居家患者的心理和身体状况。
