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基于初级保健的记忆诊所体格检查基本组成部分的共识达成

Towards Consensus on Essential Components of Physical Examination in Primary Care-based Memory Clinics.

作者信息

Heckman George A, Franco Bryan B, Lee Linda, Hillier Loretta, Boscart Veronique, Stolee Paul, Crutchlow Lauren, Dubin Joel A, Molnar Frank, Seitz Dallas

机构信息

Schlegel-University of Waterloo Research Institute for Aging, University of Waterloo, Waterloo.

School of Public Health and Health Systems, University of Waterloo, Waterloo.

出版信息

Can Geriatr J. 2018 Jun 30;21(2):143-151. doi: 10.5770/cgj.21.296. eCollection 2018 Jun.

DOI:10.5770/cgj.21.296
PMID:29977429
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6028174/
Abstract

BACKGROUND

Primary care-based memory clinics were established to meet the needs of persons with memory concerns. We aimed to identify: 1) physical examination maneuvers required to assess persons with possible dementia in specialist-supported primary care-based memory clinics, and 2) the best-suited clinicians to perform these maneuvers in this setting.

METHODS

We distributed in-person and online surveys of clinicians in a network of 67 primary care-based memory clinics in Ontario, Canada.

RESULTS

90 surveys were completed for an overall response rate of 66.7%. Assessments of vital signs, gait, and for features of Parkinsonism were identified as essential by most respondents. There was little consensus on which clinician should be responsible for specific physical examination maneuvers.

CONCLUSIONS

While we identified specific physical examination maneuvers deemed by providers to be both necessary and feasible to perform in the context of primary care-based memory clinics, further research is needed to clarify interprofessional roles related to the examination.

摘要

背景

基于初级保健的记忆诊所旨在满足有记忆问题者的需求。我们的目标是确定:1)在专科支持的基于初级保健的记忆诊所中评估可能患有痴呆症的患者所需的体格检查操作,以及2)在此环境中最适合执行这些操作的临床医生。

方法

我们对加拿大安大略省67家基于初级保健的记忆诊所网络中的临床医生进行了面对面和在线调查。

结果

共完成90份调查问卷,总体回复率为66.7%。大多数受访者认为生命体征、步态和帕金森症特征的评估至关重要。对于应由哪位临床医生负责特定的体格检查操作,几乎没有达成共识。

结论

虽然我们确定了提供者认为在基于初级保健的记忆诊所环境中进行既必要又可行的特定体格检查操作,但仍需要进一步研究以阐明与检查相关的跨专业角色。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/307c/6028174/ace01374978e/cgj-21-143f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/307c/6028174/e372f55cd431/cgj-21-143f4a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/307c/6028174/0a8b6a92a204/cgj-21-143f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/307c/6028174/ace01374978e/cgj-21-143f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/307c/6028174/e372f55cd431/cgj-21-143f4a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/307c/6028174/0a8b6a92a204/cgj-21-143f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/307c/6028174/ace01374978e/cgj-21-143f3.jpg

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Quality of Dementia Care in the Community: Identifying Key Quality Assurance Components.社区痴呆症护理质量:确定关键的质量保证要素。
Can Geriatr J. 2016 Dec 23;19(4):164-181. doi: 10.5770/cgj.19.233. eCollection 2016 Dec.
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Dementia: timely diagnosis and early intervention.痴呆症:及时诊断与早期干预。
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Physicians' perceptions of capacity building for managing chronic disease in seniors using integrated interprofessional care models.医生对采用综合跨专业护理模式管理老年人慢性病能力建设的看法。
Can Fam Physician. 2015 Mar;61(3):e148-57.
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Systematic review of recent dementia practice guidelines.近期痴呆症诊疗指南的系统评价
Age Ageing. 2015 Jan;44(1):25-33. doi: 10.1093/ageing/afu143. Epub 2014 Oct 22.
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The geriatrician and geriatric psychiatrist workforce in Texas: characteristics, challenges, and policy implications.德克萨斯州老年医学家和老年精神科医生劳动力:特征、挑战和政策影响。
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Characteristics of primary care practices associated with high quality of care.与高质量医疗保健相关的初级保健实践的特征。
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Alzheimers Dement. 2013 Jan;9(1):1-11.e3. doi: 10.1016/j.jalz.2012.11.006.