Wolff M, Bower D J, Marbella A M, Casanova J E
Department of Family and Community Medicine, Medical College of Wisconsin, USA.
Fam Med. 1998 Feb;30(2):117-21.
Practice guidelines were developed to improve medical outcomes and cost-effectiveness. The experiences of family physicians, who may need to use multiple guidelines in their practices, are crucial for effective development and implementation of practice guidelines. We surveyed a national sample of US family physicians about factors that affect their adoption and use of practice guidelines.
We mailed a structured survey to a national random sample of 400 family physician members of the American Academy of Family Physicians.
The response rate was 51%. Most respondents (69%) reported a positive attitude about practice guidelines, but only 44% reported using any guidelines. More younger physicians thought that guidelines could be useful tools. Most preferred guidelines that could be modified (87%) and that were no longer than two pages. Only 27% of respondents knew where to locate a guideline on a particular topic. Forty-three percent of respondents reported that it would be useful if guidelines were a component of an electronic medical record.
If guidelines are to be used by practicing family physicians, a generalist perspective needs to be considered in future guideline development and implementation. Younger physicians had more positive attitudes toward guidelines.
制定实践指南是为了改善医疗结果和成本效益。家庭医生在其诊疗过程中可能需要使用多种指南，他们的经验对于实践指南的有效制定和实施至关重要。我们对美国家庭医生的全国样本进行了调查，了解影响他们采用和使用实践指南的因素。
我们向美国家庭医生学会的400名家庭医生成员全国随机样本邮寄了一份结构化调查问卷。
回复率为51%。大多数受访者（69%）对实践指南持积极态度，但只有44%的人报告使用了任何指南。更多年轻医生认为指南可能是有用的工具。大多数人更喜欢可以修改（87%）且不超过两页的指南。只有27%的受访者知道在哪里可以找到关于特定主题的指南。43%的受访者表示，如果指南是电子病历的一个组成部分，将会很有用。
如果执业家庭医生要使用指南，在未来指南的制定和实施中需要考虑通科医生的观点。年轻医生对指南的态度更为积极。
