North S, Marvel M K, Hendricks B, Morphew P, North D
University of Wisconsin-Madison.
J Fam Pract. 1993 Jul;37(1):30-4.
Family-oriented patient care is a cornerstone of family practice. Family practice educators have proposed various methods to help the physician to better assess and treat families. Little is known, however, of the usefulness of family-oriented clinical tools to practicing physicians.
On a mailed survey questionnaire, 595 members of the Wisconsin Academy of Family Physicians were asked to rate the usefulness of 10 family-oriented tools and indicate the frequency of use and level of training received for each item. In addition, physicians rated their current and desired level of competency for involving families in patient care.
Two hundred ninety-nine (50%) physicians responded. Most of the tools were rated as useful but used infrequently. Identifying the effects of chemical dependency on the health of families and conducting family conferences were rated as highly useful and frequently used skills. Clinical tools rated as least useful were record keeping by family charts and folders and family function assessment by the Family APGAR: Physicians who had received training in the use of a tool rated it as more useful, except for the Family APGAR and family charts or folders. Physicians with busier practices rated some of the tools as less useful than did other physicians. Respondents indicated a desire to develop their family counseling skills.
Most family-oriented tools were reported to be useful but used infrequently by practicing physicians. Residency programs should continue to provide training for assessing and treating families, particularly in the areas of family systems theory, self-awareness of the physician's own family background, and the effect of chemical dependency on families. Future research should target larger and more varied groups of family physicians.
以家庭为导向的患者护理是家庭医疗的基石。家庭医疗教育工作者提出了各种方法来帮助医生更好地评估和治疗家庭。然而，对于执业医生而言，以家庭为导向的临床工具的实用性却鲜为人知。
通过邮寄调查问卷，要求595名威斯康星州家庭医生学会的成员对10种以家庭为导向的工具的实用性进行评分，并指出每种工具的使用频率和接受培训的程度。此外，医生们还对他们目前和期望的让家庭参与患者护理的能力水平进行了评分。
299名（50%）医生做出了回应。大多数工具被评为有用，但使用频率不高。识别药物依赖对家庭健康的影响以及召开家庭会议被评为非常有用且经常使用的技能。被评为最没用的临床工具是家庭图表和文件夹记录以及家庭功能A量表评估：接受过工具使用培训的医生认为其更有用，但家庭功能A量表以及家庭图表或文件夹除外。工作较忙的医生认为某些工具不如其他医生认为的那么有用。受访者表示希望提高他们的家庭咨询技能。
据报告，大多数以家庭为导向的工具都很有用，但执业医生使用频率不高。住院医师培训项目应继续提供评估和治疗家庭方面的培训，特别是在家庭系统理论、医生自身家庭背景的自我认知以及药物依赖对家庭的影响等领域。未来的研究应针对更大、更多样化的家庭医生群体。
