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[家庭与社区医学住院医师在基层医疗诊所开展预防活动的情况]

[Implementation of preventive activities by family and community medicine residents in primary care clinics].

作者信息

Urbano David Paniagua, Pérula de Torres Luis Ángel, Ruiz del Moral Roger, Moral Enrique Gavilán

机构信息

Centro de Salud de Montoro, Unidad Docente de Medicina Familiar y Comunitaria, Córdoba, España.

出版信息

Aten Primaria. 2010 Oct;42(10):514-9. doi: 10.1016/j.aprim.2009.10.016. Epub 2010 Feb 2.

Abstract

OBJECTIVE

To determine the level of preventive activities carried out by Family and Community Medicine medical residents during their stay in the Health Centre, as well as to estimate the time involved in carrying them out.

DESIGN

Cross-sectional, descriptive, observational study.

SETTING

Teaching Health Centres in the Central- Cordoba and Guadalquivir Primary Care Districts.

PARTICIPANTS

Forty medical residents and 384 clinical interviews with patients who were seen at the clinic.

MAIN MEASUREMENTS

The consultations were video recorded and looked at by three medical residents who recorded the preventive activities carried out according to the 2005 PAPPS (Health Promotion and Disease Prevention Activities) recommendations, as well as the time employed in performing these activities.

RESULTS

No preventive activities were performed in 72.1% (95% CI: 67.6 to 76.5%) of the consultations. The most frequent activities were secondary prevention (70.1%), mainly the taking of blood pressure (8.1%). The mean consultation time when there were no preventive activities carried out was 5.6 min (SD=3.1), whilst in those that did perform them it was 7.04 min (SD=3.05) (P<0.0001).

CONCLUSIONS

The performing of preventive activities by medical residents in Primary Care clinics is very limited. A consultation that includes preventive activities requires a significantly longer time than in those that do not include them.

摘要

目的

确定家庭与社区医学住院医师在健康中心实习期间开展的预防活动水平,并估算开展这些活动所需的时间。

设计

横断面描述性观察研究。

地点

科尔多瓦中部和瓜达尔基维尔河初级保健区的教学健康中心。

参与者

40名住院医师以及对在诊所就诊的患者进行的384次临床访谈。

主要测量指标

对会诊进行录像,由三名住院医师观看,他们记录根据2005年PAPPS(健康促进和疾病预防活动)建议开展的预防活动以及开展这些活动所用的时间。

结果

72.1%(95%可信区间:67.6%至76.5%)的会诊未开展预防活动。最常见的活动是二级预防(70.1%),主要是测量血压(8.1%)。未开展预防活动时的平均会诊时间为5.6分钟(标准差=3.1),而开展了预防活动的会诊平均时间为7.04分钟(标准差=3.05)(P<0.0001)。

结论

基层医疗诊所的住院医师开展预防活动的情况非常有限。包含预防活动的会诊所需时间明显长于不包含预防活动的会诊。

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