Asia Pacific Family Medicine最新文献

{"title":"Paradigms of family medicine: bridging traditions with new concepts; meeting the challenge of being the good doctor from 2011.","authors":"John E Murtagh","doi":"10.1186/1447-056X-10-9","DOIUrl":"https://doi.org/10.1186/1447-056X-10-9","url":null,"abstract":"<p><p> This is the paper for the Wes Fabb Oration for the WONCA Asia Pacific Regional Conference 2011. This paper will review the case for the important role of the family physician/general practitioner in worldwide health care as determined by the WHO. The importance of continuing care is highlighted. The features of a good doctor will be defined and the process of meeting this challenge for excellence of care is presented.</p>","PeriodicalId":39050,"journal":{"name":"Asia Pacific Family Medicine","volume":"10 ","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2011-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1447-056X-10-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30008398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural aspects of primary healthcare in india: A case- based analysis.","authors":"Roger P Worthington,&nbsp;Anupriya Gogne","doi":"10.1186/1447-056X-10-8","DOIUrl":"https://doi.org/10.1186/1447-056X-10-8","url":null,"abstract":"<p><p> Delivering quality primary care to large populations is always challenging, and that is certainly the case in India. While the sheer magnitude of patients can create difficulties, not all challenges are about logistics. Sometimes patient health-seeking behaviour leads to delays in obtaining medical help for reasons that have more to do with culture, social practice and religious belief. When primary care is accessed via busy state-run outpatient departments there is often little time for the physician to investigate causes behind a patient's condition, and these factors can adversely affect patient outcomes. We consider the case of a woman with somatic symptoms seemingly triggered by psychological stresses associated with social norms and familial cultural expectations. These expectations conflict with her personal and professional aspirations, and although she eventually receives psychiatric help and her problems are addressed, initially, psycho-social factors underlying her condition posed a hurdle in terms of accessing appropriate medical care. While for many people culture, belief and social norms exert a stabilising, positive influence, in situations where someone's personal expectations differ significantly from accepted social norms, individual autonomy can be directly challenged, and in which case, something has to give. The result of such challenges can negatively impact on health and well-being, and for patients with immature defence mechanisms for dealing with inner conflict, such an experience can be damaging and ensuing somatic disturbances are often difficult to treat. Patients with culture-bound symptoms are not uncommon within primary care in India or in other Asian countries and communities. We argue that such cases need to be properly understood if satisfactory patient outcomes are to be achieved. While some causes are structural, having to do with how healthcare is accessed and delivered, others are about cultural values, social practices and beliefs. We note how some young adult women are adversely affected and discuss some of the ethical issues that arise.</p>","PeriodicalId":39050,"journal":{"name":"Asia Pacific Family Medicine","volume":"10 ","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2011-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1447-056X-10-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29941155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In a free healthcare system, why do men not consult for lower urinary tract symptoms (LUTS)?","authors":"U Chong Lai,&nbsp;Yuk Tsan Wun,&nbsp;Tze Chao Luo,&nbsp;Sai Meng Pang","doi":"10.1186/1447-056X-10-7","DOIUrl":"https://doi.org/10.1186/1447-056X-10-7","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of lower urinary tract symptoms (LUTS) varies among different populations but the rate of seeking medical advice is consistently low. Little is known about the reasons for this low rate. In the city of Macau, China, primary healthcare is free and easily accessible to all citizens. We aim to study the patients' rate of consulting for LUTS and their reasons for not consulting under a free healthcare system.</p><p><strong>Method: </strong>A convenience sample of 549 male patients aged 40-85 years in a government health centre filled in the International Prostate Symptoms Scale (IPSS) questionnaire. They were also asked if they had consulted doctors for LUTS, and if not, why not.</p><p><strong>Result: </strong>Of the whole sample, 64 men (11.7%) had ever consulted doctors for LUTS. Of 145 with moderate to severe LUTS, 35 (24.1%) consulted. Of 73 who were dissatisfied with their quality of life, 22 (30.1%) consulted. Regarding the symptoms as normal or not problematic was the main reason for not consulting. Advancing age and duration of symptoms were the significant factors for consulting.</p><p><strong>Conclusion: </strong>Primary care doctors could help many of LUTS patients by sensitively initiating the discussion when these patients consult for other problems.</p>","PeriodicalId":39050,"journal":{"name":"Asia Pacific Family Medicine","volume":"10 1","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2011-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1447-056X-10-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29919831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contact dermatitis presenting as non-healing wound: case report.","authors":"M Leelavathi,&nbsp;Yy Le,&nbsp;H Tohid,&nbsp;Ah Hasliza","doi":"10.1186/1447-056X-10-6","DOIUrl":"https://doi.org/10.1186/1447-056X-10-6","url":null,"abstract":"<p><p> Topical antiseptics are commonly used in the management of minor wounds, burns, and infected skin. These agents are widely used by health professionals and are often self-prescribed by patients as they are easily available over-the-counter. This case illustrates a 73 year old man who presented with a non-healing wound on his right forearm for 4 weeks. The wound started from an insect bite and progressively enlarged with increasing pruritus and burning sensation. Clinically an ill-defined ulcer with surrounding erythema and erosion was noted. There was a yellow crust overlying the center of the ulcer and the periphery was scaly. Further inquiry revealed history of self treatment with a yellow solution to clean his wound for 3 weeks. Patient was provisionally diagnosed to have allergic contact dermatitis secondary to acriflavine. Topical acriflavine was stopped and the ulcer resolved after treatment with non-occlusive saline dressing. Skin patch test which is the gold standard for detection and confirmation of contact dermatitis showed a positive reaction (2+) to acriflavine. Acriflavine is widely used as a topical antiseptic agent in this part of the world. Hence, primary care physicians managing a large variety of poorly healing wounds should consider the possibility of contact allergy in recalcitrant cases, not responding to conventional treatment. Patient education is an important aspect of management as this would help curb the incidence of future contact allergies.</p>","PeriodicalId":39050,"journal":{"name":"Asia Pacific Family Medicine","volume":"10 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2011-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1447-056X-10-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29885887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators affecting vasectomy acceptability (a multi stages study in a sample from north eastern of Iran), 2005-2007.","authors":"Afsaneh Keramat,&nbsp;Afsaneh Zarei,&nbsp;Masoumeh Arabi","doi":"10.1186/1447-056X-10-5","DOIUrl":"https://doi.org/10.1186/1447-056X-10-5","url":null,"abstract":"<p><strong>Background: </strong>In this study we aimed to find factors affecting vasectomy acceptability in Shahroud (north eastern Iran).</p><p><strong>Methods: </strong>This study was carried out in three stages. The first stage was a survey of couples that had the vasectomy procedure during 2004-2007 in the Shahroud area. In the second stage of the study we compared characteristics of the cases (the couples who had the vasectomy procedure during the study period) and controls (including couples with at least one child that choose other contraceptive methods excluding a vasectomy) using χ² and T student tests. In the third stage of the study we aimed to assess the knowledge and attitudes of those who did not choose to have a vasectomy as there contraception method by filling out questionnaires in personal interviews.</p><p><strong>Results: </strong>An increasing trend toward the vasectomy procedure was observed during 2005 to 2007. We found positive associations between male and female educational levels and choosing to have a vasectomy (p < 0.05). Majority of women (88.44%) thought that their husbands would prefer to have a tubectomy to a vasectomy.</p><p><strong>Conclusion: </strong>The study results show a necessity for both couples to participate in educational programs about the vasectomy procedure.</p>","PeriodicalId":39050,"journal":{"name":"Asia Pacific Family Medicine","volume":"10 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2011-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1447-056X-10-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29863942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are patient-centered care values as reflected in teaching scenarios really being taught when implemented by teaching faculty? A discourse analysis on an Indonesian medical school's curriculum.","authors":"Mora Claramita,&nbsp;Adi H Sutomo,&nbsp;Mark A Graber,&nbsp;Albert Jj Scherpbier","doi":"10.1186/1447-056X-10-4","DOIUrl":"https://doi.org/10.1186/1447-056X-10-4","url":null,"abstract":"<p><strong>Background: </strong>According to The Indonesian Medical Council, 2006, Indonesian competence-based medical curriculum should be oriented towards family medicine. We aimed to find out if the educational goal of patient-centered care within family medicine (comprehensive care and continuous care) were adequately transferred from the expected curriculum to implemented curriculum and teaching process.</p><p><strong>Methods: </strong>Discourse analysis was done by 3 general practitioners of scenarios and learning objectives of an Indonesian undergraduate medical curriculum. The coders categorized those sentences into two groups: met or unmet the educational goal of patient-centered care.</p><p><strong>Results: </strong>Text analysis showed gaps in patient-centered care training between the scenarios and the learning objectives which were developed by both curriculum committee and the block planning groups and the way in which the material was taught. Most sentences in the scenarios were more relevant to patient-centered care while most sentences in the learning objectives were more inclined towards disease-perspectives.</p><p><strong>Conclusions: </strong>There is currently a discrepancy between expected patient-centered care values in the scenario and instructional materials that are being used.</p>","PeriodicalId":39050,"journal":{"name":"Asia Pacific Family Medicine","volume":"10 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2011-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1447-056X-10-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29833308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 13 item Family Support Scale: Reliability and validity of the Greek translation in a sample of Greek health care professionals.","authors":"Athanasios Tselebis,&nbsp;Tania Anagnostopoulou,&nbsp;Dionisios Bratis,&nbsp;Aikaterini Moulou,&nbsp;Alexia Maria,&nbsp;Christos Sikaras,&nbsp;Ioannis Ilias,&nbsp;Athanasios Karkanias,&nbsp;Georgios Moussas,&nbsp;Nikolaos Tzanakis","doi":"10.1186/1447-056X-10-3","DOIUrl":"https://doi.org/10.1186/1447-056X-10-3","url":null,"abstract":"<p><strong>Background: </strong>The Julkunen Family Support Scale aims to record the sense of support that a subject receives from the members of his family. The object of the present study was to investigate the reliability and to assess the validity of the Greek translation of the Julkunen Family Support Scale in Greek health care professionals in a public general hospital.</p><p><strong>Methods: </strong>In order to determine the indicator of validity of content we addressed nine expert professionals and one sociologist, asking them to evaluate how much relevant to the sense of familial support are the items of the questionnaire. Additionally, to assess reliability we used a sample of health care professionals.</p><p><strong>Results: </strong>There was agreement among experts for the validity of content. Cronbach's alpha for the total items was 0.820, pointing to high validity. Only replacing item four could increase the scale's validity, but without significant differences.</p><p><strong>Conclusions: </strong>The scale, in its Greek version, appears to be a brief and reliable tool that can be used for inpatients, in clinics as well as in epidemiologic studies of received family support.</p>","PeriodicalId":39050,"journal":{"name":"Asia Pacific Family Medicine","volume":"10 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2011-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1447-056X-10-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29813933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the gap in ageing: Translating policies into practice in Malaysian Primary Care.","authors":"Krishnapillai S Ambigga,&nbsp;Anis Safura Ramli,&nbsp;Ariaratnam Suthahar,&nbsp;Norlaili Tauhid,&nbsp;Lyn Clearihan,&nbsp;Colette Browning","doi":"10.1186/1447-056X-10-2","DOIUrl":"10.1186/1447-056X-10-2","url":null,"abstract":"<p><p> Population ageing is poised to become a major challenge to the health system as Malaysia progresses to becoming a developed nation by 2020. This article aims to review the various ageing policy frameworks available globally; compare aged care policies and health services in Malaysia with Australia; and discuss various issues and challenges in translating these policies into practice in the Malaysian primary care system. Fundamental solutions identified to bridge the gap include restructuring of the health care system, development of comprehensive benefit packages for older people under the national health financing scheme, training of the primary care workforce, effective use of electronic medical records and clinical guidelines; and empowering older people and their caregivers with knowledge, skills and positive attitudes to ageing and self care. Ultimately, family medicine specialists must become the agents for change to lead multidisciplinary teams and work with various agencies to ensure that better coordination, continuity and quality of care are eventually delivered to older patients across time and settings.</p>","PeriodicalId":39050,"journal":{"name":"Asia Pacific Family Medicine","volume":"10 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2011-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1447-056X-10-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29724982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dengue Fever (DF) in Pakistan.","authors":"Fridous Jahan","doi":"10.1186/1447-056X-10-1","DOIUrl":"https://doi.org/10.1186/1447-056X-10-1","url":null,"abstract":"<p><p> Dengue is a widespread mosquito-borne infection in human beings, which in recent years has become a major international public health concern. Symptomatic dengue virus infections can present with a wide range of clinical manifestations, from a mild febrile illness to a life-threatening shock syndrome. Both viral and host factors are thought to contribute to the manifestations of disease in each infected. It is important to understand its burden on health care, morbidity and mortality. Early diagnosis and suspicion of DF in primary care might reduce the complications if handled properly. We must understand the depth of the problem in terms of its transmission, clinical presentation, diagnosis, management and prevention.</p>","PeriodicalId":39050,"journal":{"name":"Asia Pacific Family Medicine","volume":"10 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2011-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1447-056X-10-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29696158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Truth or fallacy? Three hour wait for three minutes with the doctor: Findings from a private clinic in rural Japan.","authors":"Adam N Wooldridge,&nbsp;Nóra Arató,&nbsp;Ananda Sen,&nbsp;Masaki Amenomori,&nbsp;Michael D Fetters","doi":"10.1186/1447-056X-9-11","DOIUrl":"https://doi.org/10.1186/1447-056X-9-11","url":null,"abstract":"<p><strong>Introduction: </strong>While previous reports examine various aspects of Family Medicine in Japan, there is sparse research on consultation lengths. A common phrase permeates throughout Japan, sanjikan machi, sanpun shinsatsu that means, \"Three hour wait, three minute visit.\" The purpose of this study is to examine consultation length in Japan, and how it is affected by patient variables.</p><p><strong>Case description: </strong>We conducted a case study of consultation length and how it varies in relation to the demographics, presenting illness, and diagnoses at a rural clinic in central Japan. Data were coded according to the standards of the International Classification of Primary Care. Descriptive statistics were obtained to identify features of the data. Further, regression analysis was performed to characterize and to quantify the association between length of consultation and various subject level characteristics.</p><p><strong>Discussion and evaluation: </strong>A total of 263 patients aged 0 - 93 years old had consultations during the 8-day study period. The mean consultation duration was 6.12 minutes. Of all consultations, 11.8% lasted 3 minutes or less. The mean (median) consultation time among males was 6.29 (5.2) minutes and among females was 6.03 (5.4) minutes. The duration of visits increased with age. Among different International Classification of Primary Care categories, psychological issues required the most time (mean = 10.75 min, median = 10.9 min) while urological issues required the least (mean = 5.08 min, median = 4.9 min). The majority of cases seen in the clinic were stable, chronic conditions and required shorter consultation times.</p><p><strong>Conclusions: </strong>While the mean and median consultation length in this study extends beyond the anecdotal three minutes, the average length of consultation is still remarkably short. Trends affecting consultation length were similar to other international studies. These data present only one aspect of primary care delivery in Japan. To better understand the significance of consultation length relative to the delivery of primary care, future research should examine issues such as continuity, frequency of consultations over time and comprehensiveness of care.</p>","PeriodicalId":39050,"journal":{"name":"Asia Pacific Family Medicine","volume":"9 1","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2010-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1447-056X-9-11","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29481833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}