Kumar Raman, Chattu Vijay Kumar
President, Academy of Family Physicians of India, New Delhi, India.
Unit of Public Health and Primary Care, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago.
J Family Med Prim Care. 2018 May-Jun;7(3):487-488. doi: 10.4103/jfmpc.jfmpc_61_18.
The traditional "medical model" of health care has a paternalistic approach where patients are reassured and not decision makers, but some individuals and families prefer it. But there are some other confusing terminologies in health-care delivery and quality improvement namely patient-centered, person-centered, and patient-directed care. By changing the language, it is emphasizing that people are more than diseases and their socioeconomic determinants can affect their disease trajectories and care choices. Patient-centered denotes more holism and empowerment as it promotes and increases the access to personal health information through various modes using updated technology such as computers or mobile phones and keeping them informed through their active participation. Whereas person-centered care would focus on the whole person not just the medical conditions. In patient-directed care model, again the approach puts individuals in control of decisions about their care. One of the reasons why family medicine fraternity sprang up was to provide an antidote for high-tech specialty care that did not respect patients' values and concerns which is seen by their emphasis on the patient as a whole.
传统的医疗保健“医学模式”采用家长式方法，患者只是被安抚的对象，而非决策者，不过一些个人和家庭更喜欢这种模式。但在医疗服务提供和质量改进方面，还有一些令人困惑的术语，即“以患者为中心”“以人为本”和“患者主导型”护理。通过改变措辞，强调人不仅仅是疾病，其社会经济决定因素会影响疾病发展轨迹和护理选择。“以患者为中心”意味着更多的整体性和赋权，因为它通过使用计算机或手机等最新技术的各种方式促进并增加患者获取个人健康信息的机会，并通过他们的积极参与让他们了解情况。而“以人为本”的护理则关注整个人，而不仅仅是医疗状况。在“患者主导型”护理模式中，该方法同样让个人掌控有关自身护理的决策。家庭医学群体兴起的原因之一是为高科技专科护理提供一种解药，高科技专科护理不尊重患者的价值观和关切，而家庭医学强调将患者视为一个整体。
