8thBeijingHongKongMedicalExchange

第八屆京港醫(yī)學(xué)交流會(huì)議

TheNeedsofgoodFamilyMedicinePractice優(yōu)質(zhì)家庭醫(yī)學(xué)服務(wù)的需求By講者xxx1感謝你的欣賞2019-8-118thBeijingHongKongMedicalWhydoweneedgoodfamilypractice?

我們?yōu)槭裁葱枰獌?yōu)質(zhì)家庭醫(yī)學(xué)服務(wù)？Howdoweachievethoseneeds?

我們?cè)鯓訉?shí)踐那些需要?2感謝你的欣賞2019-8-11WhydoweneedgoodfamilypraWhydoweneedgoodfamilypractice? 我們?yōu)槭裁葱枰獌?yōu)質(zhì)家庭醫(yī)學(xué)服務(wù)？

(1)

Themoderntrendofspecializationischanging.Holisticmedicalcareisnowinvogue. 醫(yī)學(xué)的迅速發(fā)展和專業(yè)化的趨勢(shì)改變了大部分醫(yī)學(xué)景象。

(2)Differentdiseasesaretreatedbydifferentspecialists.Thereforemanymedicinescouldbeprescribedforonepersonwithmanyconditions.Thusweneedagoodfamilydoctortoco-ordinatebetteruseofallthesemedicines. 多方面的專家治療不同的疾病。一個(gè)患有多種疾病的人將被處方很多藥物。因此，我們需要一位良好家庭醫(yī)生，有效地協(xié)調(diào)使用所有藥物。3感謝你的欣賞2019-8-11Whydoweneedgoodfamilypra(3)Letmeuseacasetoillustratemypoints. MrsChan,a76yearoldwidow,livingalonewithadomestichelper,hadjustbeendischargedfromhospitaloneweekago.Thiswashersecondadmissionin5weeks.Shehadbeenfeelingdizzy,noappetite,chestdiscomfort,weaknessinthelimbsandcouldnotsleepforthelast3-4days.Herhusbanddied9monthsagoofacardiovascularaccident.Shehas3sonsandone

daughter,allmarriedandliveawayfromher.

用以下一種情況來說明我的觀點(diǎn)。 陳太太，一位76歲寡婦，獨(dú)居，有一家務(wù)助。一個(gè)月前出院，這次是她在五周內(nèi)第二次入院了。最近3至4天，她感到眩暈、沒胃口、胸口不安、四肢乏力及不能入睡。九個(gè)月前，她的丈夫死于心血管意外。她有3個(gè)兒子和一個(gè)女兒。他們?nèi)恳鸦榍也桓　?感謝你的欣賞2019-8-11(3)Letmeuseacasetoillus Sheshowedmeshehadbeentaking2medicinesfordiabetes,2medicinesforbloodpressure,onemedicineforchestdiscomfort,oneforloweringhercholesterol,oneforheruricacid,andoneforarthritisofherknees.Shehadbeentakingatotalof8differenttypesofmedicine. Afteracarefulhistoryandexamination,MrsChan'sconditionsappearedundercontrol.

她讓我看她正服用的藥物，包括2種糖尿病藥，2種血壓藥，1種胸口不安藥，1種降膽固醇藥，1種尿酸藥和1種膝關(guān)節(jié)炎藥?？梢娝偣卜?類不同藥物。

在小心記錄病歷和檢查之后，陳太太的情況開始受到控制。5感謝你的欣賞2019-8-11 Sheshowedmeshehadbeenta.However,Mrs.Chanappearedunhappy,livingalone,cryingeasily,notsleepingwellandnotwantingtoliveanymore. ItisobviousthatMrs.Chan,inadditiontohermultipleproblems,hasabereavementanddepressivedisorder.Howarewegoingtomanageher?Arewegoingtotreatherwithadditionalanti-psycholyticsandanti-depressants?Thelistofdrugsisgettingverylongindeed.

可惜，陳太太看來不愉快，單居，易哭，睡不好并且不想再活下去。明顯地，陳太太除了多種身體毛病之外，還有喪親情緒和抑郁癥。我們將怎樣幫助她？我們可用更多的情神病藥和抗抑郁藥嗎？她現(xiàn)在的藥單已經(jīng)非常長了。6感謝你的欣賞2019-8-11.However,Mrs.Chanappeared Withanagingpopulation,therearemorechronicdegenerativediseasesandincreasingpsychosocialproblems,Indeed,manycountrieslikeHongKongneedwelltrained,goodfamilydoctorstodealwithprogressivelymoreandmorepatientslikeMrsChan.

隨著人口老化，更多慢性退化疾病和社會(huì)精神問題將會(huì)出現(xiàn)。的確，很多國家像香港一樣，為了應(yīng)付更多如陳太太這樣的病人，需要訓(xùn)練有素的優(yōu)質(zhì)家庭醫(yī)學(xué)服務(wù)。7感謝你的欣賞2019-8-11 Withanagingpopulation,the(4).Withmanynewguidelines,treatmentprotocolsanddrugusages,everyyear,goodfamilydoctorsarerequiredtokeepabreastofnewknowledgeallthetime.Forinstance,intreatmentofhypertensiontheNICE(NationalInstituteforHealthandClinicalExcellence,2006)haspublishednewclinicalguidelinesforcarepathwaysanddrugtreatments.

由于每年會(huì)有很多新指引，治療協(xié)議和藥用慣例，良好的家庭醫(yī)生須要一直學(xué)習(xí)新知識(shí)。例如，在治療高血壓過程，NICE(NationalInstituteforHealthandClinicalExcellence,2006)已經(jīng)出版關(guān)于治療路線和治療藥物的新臨床指引。8感謝你的欣賞2019-8-11(4).Withmanynewguidelines,(5)Governmentsaroundtheworldhaveacknowledgedthathealthcaresystemswithprimarycareorientationwillachievebetterlevelsofhealthcare,highersatisfactionofserviceamongtheirpopulationandlowercosts. Centraltotheprimaryhealthcareteamisthegoodfamilymedicinepractice.

世界各地政府已經(jīng)認(rèn)同醫(yī)療保健系統(tǒng)中，初級(jí)護(hù)理的發(fā)展方向，因?yàn)槌跫?jí)護(hù)理將取得更好的保健水平，更高的服務(wù)滿意度和更低的費(fèi)用。

初級(jí)護(hù)理隊(duì)伍的中心點(diǎn)是優(yōu)質(zhì)家庭醫(yī)學(xué)服務(wù)。 Theneedsofgoodfamilymedicinepracticearemany.Theabove5arethemoreimportantones.

需要優(yōu)質(zhì)家庭醫(yī)學(xué)服務(wù)的原因其實(shí)是很多，上述五個(gè)原因是比較重要的。9感謝你的欣賞2019-8-11(5)GovernmentsaroundtheworHowdoweachievetheseneeds? 我們?cè)鯓訉?shí)現(xiàn)這些需要?

(1).Governmentshouldallocatemoreresourcesforthetrainingoffamilymedicineatbothundergraduateandpostgraduatelevel. 政府應(yīng)該在大學(xué)生和研究生的家庭醫(yī)學(xué)訓(xùn)練中，分配更多的資源 (2).CollegesorAcademiesforvocationaltrainingoffamilydoctorsshouldbeestablishedandappropriatelyfunded.

訓(xùn)練的家庭醫(yī)生或者高等學(xué)校應(yīng)被建立并且恰當(dāng)?shù)刭Y助。10感謝你的欣賞Howdoweachievetheseneeds?(3).Collegesshouldberesponsibleforeducation,trainingandassessmentofgoodqualityfamilymedicinepractice.

學(xué)院應(yīng)該負(fù)責(zé)教育、訓(xùn)練和評(píng)價(jià)良好質(zhì)量家庭醫(yī)學(xué)服務(wù)。(4).Collegeshouldalsoberesponsibleforaccreditationofcontinuingmedicaleducationandqualityprofessionaldevelopment.學(xué)院也應(yīng)該檢定持續(xù)醫(yī)學(xué)教育和專業(yè)發(fā)展的質(zhì)量。11感謝你的欣賞(4).Collegeshouldalsober(5).TheGovernmentshouldberesponsibletosetupaPrimaryCareRegistryandmonitorthestandardsoftheprimarycareproviders. 政府應(yīng)該有責(zé)任建立一個(gè)初保健護(hù)理登記處并且監(jiān)控初保健護(hù)理提供者的標(biāo)準(zhǔn)。

(6).Thegoodfamilydoctorshouldbecompetentnotonlyinbiophysicalmedicinebutalsounderstandtheimportanceofbiopsychosocialmedicine. 優(yōu)質(zhì)家庭醫(yī)生應(yīng)該除了擁有生理醫(yī)學(xué)知識(shí)外，還要掌握社會(huì)精神醫(yī)學(xué)的重要性。12感謝你的欣賞12感謝你的欣賞(7).Thegoodfamilydoctorshouldalsounderstandtheimportanceoffamilydynamicsandfamilyvalues. 優(yōu)質(zhì)家庭醫(yī)生也應(yīng)該理解家庭多元化和家庭價(jià)值的重要性。(8)Thegoodfamilydoctorshouldmakeeverycontactwithpatientsanopportunityforpreventionorhealtheducation. 良好家庭醫(yī)生應(yīng)該把握每次與病人接觸時(shí)間，作為預(yù)防疾病或健康教育機(jī)會(huì)。(9).Thegoodfamilydoctorshouldbeagoodmanagerofresourcesandcoordinatorofhealthservices. 良好家庭醫(yī)生應(yīng)該是一位資源分配的好經(jīng)理和醫(yī)療衛(wèi)生服務(wù)的協(xié)調(diào)者。13感謝你的欣賞13感謝你的欣賞TheEnd

完ThankYou謝謝14感謝你的欣賞2019-8-11TheEnd

完ThankYou14感謝你的欣賞201915感謝你的欣賞2019-8-1115感謝你的欣賞2019-8-1116感謝你的欣賞2019-8-1116感謝你的欣賞2019-8-118thBeijingHongKongMedicalExchange

第八屆京港醫(yī)學(xué)交流會(huì)議

TheNeedsofgoodFamilyMedicinePractice優(yōu)質(zhì)家庭醫(yī)學(xué)服務(wù)的需求By講者xxx17感謝你的欣賞2019-8-118thBeijingHongKongMedicalWhydoweneedgoodfamilypractice?

我們?yōu)槭裁葱枰獌?yōu)質(zhì)家庭醫(yī)學(xué)服務(wù)？Howdoweachievethoseneeds?

我們?cè)鯓訉?shí)踐那些需要?18感謝你的欣賞2019-8-11WhydoweneedgoodfamilypraWhydoweneedgoodfamilypractice? 我們?yōu)槭裁葱枰獌?yōu)質(zhì)家庭醫(yī)學(xué)服務(wù)？

(1)

Themoderntrendofspecializationischanging.Holisticmedicalcareisnowinvogue. 醫(yī)學(xué)的迅速發(fā)展和專業(yè)化的趨勢(shì)改變了大部分醫(yī)學(xué)景象。

(2)Differentdiseasesaretreatedbydifferentspecialists.Thereforemanymedicinescouldbeprescribedforonepersonwithmanyconditions.Thusweneedagoodfamilydoctortoco-ordinatebetteruseofallthesemedicines. 多方面的專家治療不同的疾病。一個(gè)患有多種疾病的人將被處方很多藥物。因此，我們需要一位良好家庭醫(yī)生，有效地協(xié)調(diào)使用所有藥物。19感謝你的欣賞2019-8-11Whydoweneedgoodfamilypra(3)Letmeuseacasetoillustratemypoints. MrsChan,a76yearoldwidow,livingalonewithadomestichelper,hadjustbeendischargedfromhospitaloneweekago.Thiswashersecondadmissionin5weeks.Shehadbeenfeelingdizzy,noappetite,chestdiscomfort,weaknessinthelimbsandcouldnotsleepforthelast3-4days.Herhusbanddied9monthsagoofacardiovascularaccident.Shehas3sonsandone

daughter,allmarriedandliveawayfromher.

用以下一種情況來說明我的觀點(diǎn)。 陳太太，一位76歲寡婦，獨(dú)居，有一家務(wù)助。一個(gè)月前出院，這次是她在五周內(nèi)第二次入院了。最近3至4天，她感到眩暈、沒胃口、胸口不安、四肢乏力及不能入睡。九個(gè)月前，她的丈夫死于心血管意外。她有3個(gè)兒子和一個(gè)女兒。他們?nèi)恳鸦榍也桓　?0感謝你的欣賞2019-8-11(3)Letmeuseacasetoillus Sheshowedmeshehadbeentaking2medicinesfordiabetes,2medicinesforbloodpressure,onemedicineforchestdiscomfort,oneforloweringhercholesterol,oneforheruricacid,andoneforarthritisofherknees.Shehadbeentakingatotalof8differenttypesofmedicine. Afteracarefulhistoryandexamination,MrsChan'sconditionsappearedundercontrol.

她讓我看她正服用的藥物，包括2種糖尿病藥，2種血壓藥，1種胸口不安藥，1種降膽固醇藥，1種尿酸藥和1種膝關(guān)節(jié)炎藥?？梢娝偣卜?類不同藥物。

在小心記錄病歷和檢查之后，陳太太的情況開始受到控制。21感謝你的欣賞2019-8-11 Sheshowedmeshehadbeenta.However,Mrs.Chanappearedunhappy,livingalone,cryingeasily,notsleepingwellandnotwantingtoliveanymore. ItisobviousthatMrs.Chan,inadditiontohermultipleproblems,hasabereavementanddepressivedisorder.Howarewegoingtomanageher?Arewegoingtotreatherwithadditionalanti-psycholyticsandanti-depressants?Thelistofdrugsisgettingverylongindeed.

可惜，陳太太看來不愉快，單居，易哭，睡不好并且不想再活下去。明顯地，陳太太除了多種身體毛病之外，還有喪親情緒和抑郁癥。我們將怎樣幫助她？我們可用更多的情神病藥和抗抑郁藥嗎？她現(xiàn)在的藥單已經(jīng)非常長了。22感謝你的欣賞2019-8-11.However,Mrs.Chanappeared Withanagingpopulation,therearemorechronicdegenerativediseasesandincreasingpsychosocialproblems,Indeed,manycountrieslikeHongKongneedwelltrained,goodfamilydoctorstodealwithprogressivelymoreandmorepatientslikeMrsChan.

隨著人口老化，更多慢性退化疾病和社會(huì)精神問題將會(huì)出現(xiàn)。的確，很多國家像香港一樣，為了應(yīng)付更多如陳太太這樣的病人，需要訓(xùn)練有素的優(yōu)質(zhì)家庭醫(yī)學(xué)服務(wù)。23感謝你的欣賞2019-8-11 Withanagingpopulation,the(4).Withmanynewguidelines,treatmentprotocolsanddrugusages,everyyear,goodfamilydoctorsarerequiredtokeepabreastofnewknowledgeallthetime.Forinstance,intreatmentofhypertensiontheNICE(NationalInstituteforHealthandClinicalExcellence,2006)haspublishednewclinicalguidelinesforcarepathwaysanddrugtreatments.

由于每年會(huì)有很多新指引，治療協(xié)議和藥用慣例，良好的家庭醫(yī)生須要一直學(xué)習(xí)新知識(shí)。例如，在治療高血壓過程，NICE(NationalInstituteforHealthandClinicalExcellence,2006)已經(jīng)出版關(guān)于治療路線和治療藥物的新臨床指引。24感謝你的欣賞2019-8-11(4).Withmanynewguidelines,(5)Governmentsaroundtheworldhaveacknowledgedthathealthcaresystemswithprimarycareorientationwillachievebetterlevelsofhealthcare,highersatisfactionofserviceamongtheirpopulationandlowercosts. Centraltotheprimaryhealthcareteamisthegoodfamilymedicinepractice.

世界各地政府已經(jīng)認(rèn)同醫(yī)療保健系統(tǒng)中，初級(jí)護(hù)理的發(fā)展方向，因?yàn)槌跫?jí)護(hù)理將取得更好的保健水平，更高的服務(wù)滿意度和更低的費(fèi)用。

初級(jí)護(hù)理隊(duì)伍的中心點(diǎn)是優(yōu)質(zhì)家庭醫(yī)學(xué)服務(wù)。 Theneedsofgoodfamilymedicinepracticearemany.Theabove5arethemoreimportantones.

需要優(yōu)質(zhì)家庭醫(yī)學(xué)服務(wù)的原因其實(shí)是很多，上述五個(gè)原因是比較重要的。25感謝你的欣賞2019-8-11(5)GovernmentsaroundtheworHowdoweachievetheseneeds? 我們?cè)鯓訉?shí)現(xiàn)這些需要?

(1).Governmentshouldallocatemoreresourcesforthetrainingoffamilymedicineatbothundergraduateandpostgraduatelevel. 政府應(yīng)該在大學(xué)生和研究生的家庭醫(yī)學(xué)訓(xùn)練中，分配更多的資源 (2).CollegesorAcademiesforvocationaltrainingoffamilydoctorsshouldbeestablishedandappropriatelyfunded.

訓(xùn)練的家庭醫(yī)生或者高等學(xué)校應(yīng)被建立并且恰當(dāng)?shù)刭Y助。26感謝你的欣賞Howdoweachievetheseneeds?(3).Collegesshouldberesponsibleforeducation,trainingandassessmentofgoodqualityfamilymedicinepractice.

學(xué)院應(yīng)該負(fù)責(zé)教育、訓(xùn)練和評(píng)價(jià)良好質(zhì)