Nelson E, Conger B, Douglass R, Gephart D, Kirk J, Page R, Clark A, Johnson K, Stone K, Wasson J, Zubkoff M
JAMA. 1983 Jun 24;249(24):3331-8.
A cross-sectional study was conducted on functional status of adults visiting primary care practices. Limitations in physical and mental function were assessed independently in 28 practices by patients (N = 1,227) and physicians (N = 47) using a simple global index of disability. Results indicated 12% of patients rated their physical limitations as major and 8% rated major emotional limitations during the past month. Comparable assessments by physicians were 5% and 4%, respectively. Differences between patients and physicians were statistically significant and are demonstrated to be clinically relevant. Patients' functional limitations were associated with increased utilization of ambulatory care, older age, lower level of education, unemployment, and a primary diagnosis of a chronic condition. We conclude that functional status can be routinely recorded in medical practice to help describe severity, predict utilization, and improve the physician-patient relationship.
一项针对就诊于基层医疗诊所的成年人功能状况的横断面研究展开。在28家诊所中，患者（N = 1227）和医生（N = 47）使用一个简单的整体残疾指数，分别对身体和心理功能受限情况进行了评估。结果显示，在过去一个月中，12%的患者将其身体受限评为严重，8%的患者将严重情绪受限评为严重。医生的可比评估分别为5%和4%。患者和医生之间的差异具有统计学意义，并被证明具有临床相关性。患者的功能受限与门诊护理利用率增加、年龄较大、教育水平较低、失业以及慢性病的初步诊断有关。我们得出结论，在医疗实践中可以常规记录功能状况，以帮助描述严重程度、预测利用率并改善医患关系。
