Rubenstein L V, McCoy J M, Cope D W, Barrett P A, Hirsch S H, Messer K S, Young R T
Sepulveda VA Medical Center, CA 91343, USA.
J Gen Intern Med. 1995 Nov;10(11):607-14. doi: 10.1007/BF02602744.
To improve functional status among primary care patients.
Randomized controlled trial.
University primary care clinic.
All 73 internal medicine house officers and 557 of their new primary care patients.
Emotional well-being scores improved significantly for the patients of the experimental group physicians compared with those of the control group physicians (p < 0.03). Limitations in social activities indicated as "due to health" decreased among the elderly (> or = 70 years of age) individuals in the experimental group compared with the control group (p < 0.03). The experimental group physicians diagnosed more symptoms of stress or anxiety than did the control group physicians (p < 0.001) and took more actions recommended by the feedback form (p < 0.02).
Computer-generated feedback of functional status screening results accompanied by resource and management suggestions can increase physician diagnoses of impaired emotional well-being, can influence physician management of functional status problems, and can assist physicians in improving emotional well-being and social functioning among their patients.
改善初级保健患者的功能状态。
1）计算机生成的关于患者功能状态、患者自我报告的“主要诉求”以及针对特定问题的资源和管理建议的反馈信息给医生；2）为医生提供两次简短的互动式教育课程。
随机对照试验。
大学初级保健诊所。
所有73名内科住院医师及其557名新的初级保健患者。
1）使用功能状态问卷（FSQ）评估患者从入组到六个月后的功能状态变化；2）从病历中提取的关于功能状态的管理计划和其他信息；3）医生对内科医生是否应解决功能状态问题的态度。
与对照组医生的患者相比，实验组医生的患者的情绪幸福感得分显著提高（p < 0.03）。与对照组相比，实验组中老年人（≥70岁）因“健康原因”导致的社会活动受限情况有所减少（p < 0.03）。实验组医生诊断出的压力或焦虑症状比对照组医生更多（p < 0.001），并且采取反馈表中建议行动的比例更高（p < 0.02）。
计算机生成的功能状态筛查结果反馈信息并附带资源和管理建议，可增加医生对情绪幸福感受损的诊断，可影响医生对功能状态问题的管理，并可帮助医生改善患者的情绪幸福感和社会功能。
