Leclère H, Beaulieu M D, Bordage G, Sindon A, Couillard M
Bureau de pédagogie des sciences de la santé, Faculté de médecine, Université Laval, Ste-Foy, PQ.
CMAJ. 1990 Dec 15;143(12):1305-15.
This study was conducted to describe the difficulties perceived by general practitioners concerning 24 common clinical problems and to compare their perceptions with those of faculty members in family medicine. A random sample of 467 general practitioners and all 182 faculty members in family medicine in Quebec were sent one of four open-ended questionnaires, each of which dealt with six clinical problems; 214 general practitioners and 114 faculty members participated. A total of 5111 difficulties were reported; the number reported by each subject varied from 0 to 13 (mean 2.6 [standard deviation 2.09]) per problem. The problems that generated the most difficulties were depression, confusion in the elderly, chronic back pain, loss of autonomy in the elderly and sexually transmitted disease. The most frequent difficulties were with the patient's noncompliance with treatment, clinical diagnosis, failure of a specific treatment, inadequate health care resources and the physician's own emotional reactions. The difficulties for each problem were the same in the two groups 70% of the time. Physician's perceptions of their difficulties can be useful in the planning of initial training and continuing medical education.
本研究旨在描述全科医生在24个常见临床问题上所感知到的困难，并将他们的看法与家庭医学教员的看法进行比较。向魁北克的467名全科医生和182名家庭医学教员的随机样本发送了四份开放式问卷中的一份，每份问卷涉及六个临床问题；214名全科医生和114名教员参与了调查。共报告了5111个困难；每个受试者报告的每个问题的困难数量从0到13不等（平均2.6 [标准差2.09]）。产生最多困难的问题是抑郁症、老年人意识模糊、慢性背痛、老年人自主能力丧失和性传播疾病。最常见的困难是患者不遵医嘱治疗、临床诊断、特定治疗失败、医疗保健资源不足以及医生自身的情绪反应。两组在70%的时间里对每个问题的困难看法相同。医生对自身困难的看法在初始培训和继续医学教育的规划中可能会有所帮助。
