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全科医生在多病共存背景下的临床推理:超越直观方法的认知。

A GP's clinical reasoning in the context of multimorbidity: beyond the perception of an intuitive approach.

机构信息

UDREM-Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland.

iEh2-Institute for Ethics, History, and the Humanities, Faculty of Medicine, University of Geneva, Geneva, Switzerland.

出版信息

Fam Pract. 2023 Feb 9;40(1):113-118. doi: 10.1093/fampra/cmac076.

Abstract

INTRODUCTION

GP's clinical reasoning processes in the context of patients suffering from multimorbidity are often a process which remains implicit. Therefore, the goal of this case study analysis is to gain a better understanding of the processes at play in the management of patients suffering from multimorbidity.

METHODS

A case study analysis, using a qualitative thematic analysis was conducted. This case follows a 54-year-old woman who has been under the care of her GP for almost 10 years and suffers from a number of chronic conditions. The clinical reasoning of an experienced GP who can explicitly unfold his processes was chosen for this case analysis.

RESULTS

Four main themes emerged from this case analysis: The different roles that GPs have to manage; the GP's cognitive flexibility and continual adaptation of their clinical reasoning processes, the patient's empowerment, and the challenges related to the collaboration with specialists and healthcare professionals.

CONCLUSION

This could help GPs gain a clearer understanding of their clinical reasoning processes and motivate them to communicate their findings with others during clinical supervision or teaching. Furthermore, this may emphasize the importance of valuing the role of the primary care physician in the management of multimorbid patients.

摘要

简介

在患有多种疾病的患者背景下,全科医生的临床推理过程通常是一个隐含的过程。因此,本案例研究分析的目的是更深入地了解管理多种疾病患者过程中所涉及的各种因素。

方法

采用案例研究分析,运用定性主题分析方法。该案例跟踪一位 54 岁女性,她在全科医生的照顾下已经近 10 年,患有多种慢性疾病。选择一位经验丰富的全科医生来进行案例分析,他能够明确阐述自己的过程。

结果

从这个案例分析中出现了四个主要主题:全科医生需要扮演的不同角色;全科医生的认知灵活性和持续调整临床推理过程的能力;患者的赋权;以及与专家和医疗保健专业人员合作相关的挑战。

结论

这可以帮助全科医生更清楚地了解他们的临床推理过程,并激励他们在临床监督或教学中与他人交流他们的发现。此外,这可能强调了在管理多种疾病患者方面重视初级保健医生角色的重要性。

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