Division of Alcohol and Drug Abuse: Treatment and Research, University of Miami Miller School of Medicine, Miami, Florida, USA.
J Eval Clin Pract. 2011 Apr;17(2):354-6. doi: 10.1111/j.1365-2753.2010.01581.x. Epub 2010 Nov 30.
RATIONAL AND AIMS: As diagnosis is a critical first step for clinical care, it was early recognized that an appropriate diagnostic model was necessary as informational basis for person-centred clinical care.
The design of a person-centred integrative diagnosis model was based on literature reviews and work meetings in London, Paris, Geneva, Preston, UK and Uppsala, Sweden over the past 2 years.
The current person-centred integrative diagnosis model argues for a broader concept of diagnosis and covers both ill health and positive health through the following three levels: Health Status (from illness to recovery/wellness and from disabilities to adaptive functioning), Experience of Health (cultural factors and values concerning ill health and positive health) and Contributory Factors (including internal and external risk and protective factors). Each of these domains will be evaluated with standardized categories and dimensions as well as narratives. Specific attention is paid to evaluators (clinicians, patient, family and other carers) and the interactive evaluation process.
由于诊断是临床护理的关键第一步,因此很早就认识到,需要一个适当的诊断模型作为信息基础,为以患者为中心的临床护理提供支持。
以过去两年在伦敦、巴黎、日内瓦、英国普雷斯顿和瑞典乌普萨拉举行的文献回顾和工作会议为基础,设计了以患者为中心的综合诊断模型。
目前的以患者为中心的综合诊断模型提出了一个更广泛的诊断概念,通过以下三个层面涵盖了不健康和健康积极两个方面:健康状况(从疾病到康复/健康,从残疾到适应功能)、健康体验(与不健康和健康积极相关的文化因素和价值观)和促成因素(包括内部和外部风险和保护因素)。这些领域中的每一个都将使用标准化的类别和维度以及描述进行评估。特别关注评估者(临床医生、患者、家庭和其他照顾者)以及互动评估过程。