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家庭医学中无法用医学解释的症状:确定一项研究议程。世界家庭医生组织(WONCA)2007年会议论文集。

Medically unexplained symptoms in family medicine: defining a research agenda. Proceedings from WONCA 2007.

作者信息

Olde Hartman Tc, Hassink-Franke Lja, Dowrick C, Fortes S, Lam C, van der Horst He, Lucassen Plbj, van Weel-Baumgarten Em

机构信息

Department of Family Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands.

出版信息

Fam Pract. 2008 Aug;25(4):266-71. doi: 10.1093/fampra/cmn041. Epub 2008 Jul 1.

Abstract

BACKGROUND

Medically unexplained symptoms (MUSs) are frequently presented in primary care. Unfortunately, knowledge of these patients and/or symptoms in primary care is still limited. Available research comes mainly from Europe and North America, while the perspectives of cultures such as Africa, Asia and South America are relatively unknown. To bring cultural perspectives together, a symposium and workshop on MUS in primary care was held at the WONCA World Conference 2007 in Singapore.

OBJECTIVE

Main goals of this symposium and workshop-apart from presenting ongoing research and bringing together experts in MUS-were to detect knowledge gaps in MUS and to establish priorities in MUS research. This publication focuses on the proposed research agenda.

METHODS

Using a nominal group technique, we generated research topics and set priorities. Research topics were grouped into research themes.

RESULTS

Participants' (66 researchers and GPs from 29 nationalities) most important research topics were 'formulating a broadly accepted definition of MUS', 'finding a strategy to recognize MUS better and at an earlier stage', 'studying the value of self-management and empowerment in patients with MUS' and 'finding predictors to decide which strategy will best help the individual patient with MUS'. Priorities in research themes of MUS are as follows: (i) therapeutic options for patients with MUS and (ii) problems in consultations with these patients.

CONCLUSIONS

More research on MUS in primary care is needed to improve the consultations with and management of these patients. Internationally primary care conferences are excellent for exchanging ideas and formulating central issues of research.

摘要

背景

医学上无法解释的症状(MUSs)在基层医疗中经常出现。遗憾的是,基层医疗中对这些患者和/或症状的了解仍然有限。现有研究主要来自欧洲和北美,而非洲、亚洲和南美洲等文化背景下的观点相对鲜为人知。为了汇聚不同文化背景的观点,一场关于基层医疗中MUS的研讨会在2007年于新加坡举行的世界家庭医生组织(WONCA)世界大会上召开。

目的

本次研讨会的主要目标——除了展示正在进行的研究并汇聚MUS领域的专家外——是发现MUS方面的知识空白,并确定MUS研究的优先事项。本出版物聚焦于所提出的研究议程。

方法

我们采用名义群体技术生成研究主题并确定优先事项。研究主题被归为研究领域。

结果

参与者(来自29个国家的66名研究人员和全科医生)最重要的研究主题是“制定一个被广泛接受的MUS定义”“找到一种更好且更早识别MUS的策略”“研究自我管理和赋权在MUS患者中的价值”以及“找到预测因素以确定哪种策略最有助于个体MUS患者”。MUS研究领域的优先事项如下:(i)MUS患者的治疗选择和(ii)与这些患者会诊中的问题。

结论

需要在基层医疗中对MUS进行更多研究,以改善对这些患者的会诊和管理。国际基层医疗会议是交流想法和确定研究核心问题的绝佳平台。

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