Department of Family Medicine, Queen's University, Kingston, Ont.
Can Fam Physician. 2012 Aug;58(8):e442-9.
To determine whether the original continuity of care framework is still applicable to family medicine today.
Qualitative descriptive study.
Kingston, Ont.
Three groups of first-year family medicine residents (18 in total), 2 groups of family physicians in established comprehensive practices (9 in total), and 2 groups of family physicians working in episodic care settings (10 in total).
Using focus groups, a semistructured discussion guide, and a qualitative descriptive design, we explored the residents' and practising physicians' conceptions about continuity of care. Qualitative content analysis was used to identify themes.
Focus group participants consisting of family physicians providing comprehensive care, episodic care physicians, and family medicine residents exposed 2 new dimensions of continuity of care-community continuity of care (the physicians' roles in understanding the lives of their patients, and how this affects their overall health) and continuity of care within the health care team (the continuity between a patient and members of the interprofessional team, including the family physician). Geographic continuity of care (the care of a patient in various settings by the same physician) was not prominently discussed, perhaps reflecting the paucity of family physicians in the hospital setting.
Both of these new dimensions of continuity of care are consistent with the ongoing evolution of family medicine as a discipline, and have important implications for how family medicine training programs should be designed to best prepare trainees for future practice.
确定最初的连续性护理框架在当今的家庭医学中是否仍然适用。
定性描述性研究。
安大略省金斯顿。
3 组第一年家庭医学住院医师(共 18 人)、2 组在综合性实践中工作的家庭医生(共 9 人)和 2 组在偶发性护理环境中工作的家庭医生(共 10 人)。
使用焦点小组、半结构化讨论指南和定性描述性设计,我们探讨了住院医师和执业医生对连续性护理的概念。使用定性内容分析来确定主题。
由提供全面护理的家庭医生、偶发性护理医生和家庭医学住院医师组成的焦点小组参与者揭示了连续性护理的 2 个新维度——社区连续性护理(医生在了解患者生活方面的角色,以及这如何影响他们的整体健康)和医疗团队内的连续性护理(患者与跨专业团队成员之间的连续性,包括家庭医生)。地理连续性护理(同一名医生在不同环境中为同一患者提供的护理)并未得到突出讨论,这可能反映了医院环境中家庭医生的稀缺。
这两个连续性护理的新维度都与家庭医学作为一门学科的持续发展相一致,并且对家庭医学培训计划应该如何设计以最好地为未来的实践培训学员具有重要意义。