Wenrich M D, Carline J D, Curtis J R, Paauw D S, Ramsey P G
Department of Medicine, University of Washington, Seattle 98195-5302, USA.
Am J Prev Med. 1996 Mar-Apr;12(2):116-22.
Our objectives were to (1) assess primary care physicians' performance at screening patients for HIV risks using patient report; (2) compare patient recall concerning screening with physician report; and (3) compare HIV risk screening with general preventive health screening. Up to 20 patients from 126 physicians' practices anonymously completed 1,820 questionnaires. Questionnaires assessed screening from physicians about HIV risks and general preventive health care. Two scales were developed to measure comprehensiveness of screening. Based on patient recall, physicians performed poorly in HIV risk screening. On an HIV risk-screening scale, patients were screened concerning 11% of items assessed. In comparison, patients recalled screening concerning 75% of general prevention items assessed. Patients with acknowledged HIV risk factors and younger patients were screened more for HIV risk, but many patients with risks were still missed. Physicians' estimates of their screening were relatively concordant with patient report in general prevention areas but were discordant with patient recall of HIV risk screening; physicians estimated considerably more screening than their patients recalled. Female physicians performed better than male physicians in both HIV risk screening and general preventive health screening; physicians with more HIV experience performed better at HIV risk screening. HIV risk screening in the primary care setting remains inadequate. Comparable attention to that given to general prevention by primary care physicians is needed in screening patients for HIV risk behaviors.
（1）使用患者报告评估初级保健医生对患者进行艾滋病毒风险筛查的表现；（2）比较患者对筛查的回忆与医生报告；（3）比较艾滋病毒风险筛查与一般预防性健康筛查。来自126名医生诊所的多达20名患者匿名完成了1820份问卷。问卷评估了医生对艾滋病毒风险和一般预防性医疗保健的筛查情况。开发了两个量表来衡量筛查的全面性。基于患者的回忆，医生在艾滋病毒风险筛查方面表现不佳。在艾滋病毒风险筛查量表上，患者接受筛查的项目占评估项目的11%。相比之下，患者回忆接受筛查的一般预防项目占评估项目的75%。有公认艾滋病毒风险因素的患者和年轻患者接受艾滋病毒风险筛查的比例更高，但仍有许多有风险的患者被漏筛。医生对其筛查的估计在一般预防领域与患者报告相对一致，但与患者对艾滋病毒风险筛查的回忆不一致；医生估计的筛查量比患者回忆的要多得多。在艾滋病毒风险筛查和一般预防性健康筛查方面，女医生的表现均优于男医生；有更多艾滋病毒相关经验的医生在艾滋病毒风险筛查方面表现更好。初级保健环境中的艾滋病毒风险筛查仍然不足。在筛查患者的艾滋病毒风险行为时，需要给予与初级保健医生对一般预防相同的关注。
