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家庭医生与健康倡导:真的难以两全吗?

Family physicians and health advocacy: Is it really a difficult fit?

机构信息

Assistant Professor and Associate Program Director of Curriculum and Remediation for the postgraduate program in the Department of Family and Community Medicine at the University of Toronto in Ontario and Assistant Clinical Professor in the Department of Family Medicine at McMaster University in Hamilton, Ont.

Independent Scientist and Interim Director of Education Research at the Centre for Addiction and Mental Health in Toronto and Assistant Professor in the Department of Psychiatry at the University of Toronto.

出版信息

Can Fam Physician. 2019 Jul;65(7):491-496.

Abstract

OBJECTIVE

To examine whether family medicine residents and faculty members appreciate the full spectrum of health advocacy as described in articles published in in 2016 and to identify the perceived challenges and enablers of advocating across the entire spectrum.

DESIGN

Analysis of a subset of data from a qualitative study using semistructured interviews and focus groups.

SETTING

University of Toronto in Ontario.

PARTICIPANTS

A total of 9 family medicine faculty members and 6 family medicine residents.

METHODS

A subset of transcripts from a 2015 qualitative study that explored family medicine and psychiatry residents' and faculty members' understanding of the CanMEDS-Family Medicine health advocate role were reviewed, guided by interpretive descriptive methodology.

MAIN FINDINGS

Results indicated that family medicine physicians and residents were able to identify the full spectrum of advocacy described in the articles and that they valued the role. Further, there was widespread agreement that being a health advocate was linked with their identities as health professionals. The time it takes to be a health advocate was seen as a barrier to being effective in the role, and the work was seen as extremely challenging owing to system constraints. Participants also described a gap in training relating to advocacy at the system level as a challenge.

CONCLUSION

Team-based care was seen as one of the most important enablers for becoming involved in the full spectrum of advocacy, as was time for personal reflection.

摘要

目的

探讨家庭医学住院医师和教师是否理解 2016 年《家庭医学杂志》中所描述的全方位健康倡导,并确定在整个范围内倡导所面临的挑战和促进因素。

设计

使用半结构式访谈和焦点小组对来自定性研究的子数据集进行分析。

地点

安大略省多伦多大学。

参与者

共 9 名家庭医学教师和 6 名家庭医学住院医师。

方法

对 2015 年一项探索家庭医学和精神病学住院医师和教师对 CanMEDS-家庭医学健康倡导角色理解的定性研究的部分转录本进行了回顾,研究采用解释性描述方法。

主要发现

结果表明,家庭医生和住院医师能够识别《家庭医学杂志》文章中描述的全方位倡导,并重视这一角色。此外,广泛认为成为健康倡导者与其作为健康专业人员的身份相关。担任健康倡导者所需的时间被视为在该角色中发挥效力的障碍,而且由于系统限制,这项工作被认为极具挑战性。参与者还描述了在系统层面倡导方面培训方面的差距是一个挑战。

结论

团队为基础的医疗护理被视为参与全方位倡导的最重要的促进因素之一,个人反思的时间也是如此。

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Comprehensiveness of care by family physicians in Edmonton.埃德蒙顿家庭医生的综合护理服务
Adv Med Educ Pract. 2011 May 15;2:127-38. doi: 10.2147/AMEP.S18747. Print 2011.

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