Journal of family medicine and disease prevention最新文献_第5页

Medical Student and Resident Burnout: A Review of Causes, Effects, and Prevention 医学生和住院医师倦怠：原因、影响和预防综述

Journal of family medicine and disease prevention Pub Date : 2018-12-31 DOI: 10.23937/2469-5793/1510094

Mian Amir, Kim Dahye, C. Duane, L WardWendy

{"title":"Medical Student and Resident Burnout: A Review of Causes, Effects, and Prevention","authors":"Mian Amir, Kim Dahye, C. Duane, L WardWendy","doi":"10.23937/2469-5793/1510094","DOIUrl":"https://doi.org/10.23937/2469-5793/1510094","url":null,"abstract":"Professional burnout is a multi-dimensional phenomenon, which may result from prolonged unhealthy occupational stress. Symptoms in burnout cluster in three domains: emotional exhaustion, feeling isolated, and low work satisfaction. Medical students and residents are at particular risk because of their dual student pressures and in-training clinical care responsibilities. Common sources of personal and professional stressors include lack of time for leisure activities, inordinate workloads and sleep deprivation, emotional drain stemming from sick and dying patients, and training coinciding with major events of life. Symptoms of burnout include distress and depression, anxiety/worry, dropping out, substance abuse, and suicidality. If not managed appropriately, burnout can result in a lowered quality of life, negative impacts on patient care, and in extreme cases, professional impairment. The literature not only provides guidance regarding structural components and preventive programs that are effective in reducing burnout risk in medical students and residents but also summarizes the leading sources of professional stress amongst medical trainees, their impact on professional performance and personal lives as well as potential impact of interventional programs. In this manuscript, we performed a narrative review that considers the causes and effects of burnout, protective factors against burnout, and eventual prevention of burnout. Through analysis of the literature, implementation of widespread monitoring of burnout levels, prevention programs, and the consideration of changes in the structural components of the medical student and residency curriculum is recommended across medical schools.","PeriodicalId":91906,"journal":{"name":"Journal of family medicine and disease prevention","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46784108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 23

Blue Finger Syndrome in an Elderly Patient 老年患者蓝指综合征

Journal of family medicine and disease prevention Pub Date : 2018-12-31 DOI: 10.23937/2469-5793/1510091

JJ Castillo-Santizo, E. Alvarez-Pérez, A. González-López, C. Blanco-Rubio, M. Ortega-Calvo, I. Gabaldón-Rodríguez

引用次数: 0

Health Care Practitioners Level of Awareness on Antimicrobial Resistance in Grenada 格林纳达卫生保健从业人员对抗菌素耐药性的认识水平

Journal of family medicine and disease prevention Pub Date : 2018-12-31 DOI: 10.23937/2469-5793/1510093

Glasgow Lindonne, F. Stephanie, G. Owen, F. Martin

{"title":"Health Care Practitioners Level of Awareness on Antimicrobial Resistance in Grenada","authors":"Glasgow Lindonne, F. Stephanie, G. Owen, F. Martin","doi":"10.23937/2469-5793/1510093","DOIUrl":"https://doi.org/10.23937/2469-5793/1510093","url":null,"abstract":"Health care practitioners’ level of awareness on antimicrobial resistance in Grenada. Antimicrobial Resistance (AMR) has become a global public health emergency and there is limited evidence of the extent of healthcare practitioners’ knowledge and attitude to the issue in Grenada. A cross-sectional study utilising self-administered surveys was conducted with registered physicians, pharmacists, and pathology laboratory technicians to evaluate health care workers knowledge about antimicrobial resistance in Grenada. The study found that while most practitioners could correctly define AMR, there was variability in knowledge about the judicious use of antimicrobials. About one in four physicians (26.4%) did not know whether AMR was a significant problem in the institution(s) where they practiced, compared with the majority (61.7%) who said it was not a problem. However, 41.6% of pharmacists felt that AMR was a national problem; although all (100%) laboratory technicians reportedly did not know if AMR was a significant national problem. Three key factors were perceived by more than 50.0% of each health practitioner group to have contributed to AMR: patients demanding antibiotics, unnecessarily prescribing antimicrobials, and insufficient patient advice about antibiotics. The vast majority of physicians (75.5%), pharmacists (83.3%), and all laboratory technicians (100.0%) agreed that the lack of a surveillance system for monitoring patient history of antibiotic use was a key factor contributing to lack of understanding of AMR issues in Grenada. This study highlights the urgent need for continuing professional development on AMR and the development of accessible policies, guidelines and a robust surveillance system on the safe and judicious use of antimicrobials to improve antimicrobial stewardship in Grenada.","PeriodicalId":91906,"journal":{"name":"Journal of family medicine and disease prevention","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44720776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

A Hidden Epidemic and What You Can Do About It 一种隐藏的流行病和你能做些什么

Journal of family medicine and disease prevention Pub Date : 2018-12-31 DOI: 10.23937/2469-5793/1510085

Post Robert M

{"title":"A Hidden Epidemic and What You Can Do About It","authors":"Post Robert M","doi":"10.23937/2469-5793/1510085","DOIUrl":"https://doi.org/10.23937/2469-5793/1510085","url":null,"abstract":"Introduction: In the United States 3⁄4 of the children of a parent with a mood disorder will develop a major psychiatric diagnosis upon a 7 year follow up. Moreover, the earlier the onset of symptoms, the longer the delay to first treatment, and this is posing major short and long-term health threats for a sizable portion of the population. Methods: We review data that childhood onset mood and behavioral disorders are more frequent in the US than in many European countries and suggest possible approaches to this problem. Results: Despite the high incidence of psychiatric illness in the US, many children are not being evaluated and treated in a timely fashion. Multiple factors including those related to stigma around psychiatric diagnosis and treatment of very young children account for this deficit. There is also a shortage of child psychiatrists, and most children are being seen in primary care settings. We suggest that parents and older children themselves play a key role in screening and longitudinal assessment of mood and behavioral problems to assist physicians in decisions about diagnosis, need and effectiveness of treatment. Conclusions: Childhood onsets of mood and externalizing disorders appear to be increasing in the US population in more recently born individuals reflecting a cohort effect. Greater attention to these problems by pediatricians and primary care providers by enlisting the help of parents and children themselves in screening and monitoring of symptoms may be one way to better address this ongoing and worsening health problem. ReseaRch aRticle","PeriodicalId":91906,"journal":{"name":"Journal of family medicine and disease prevention","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68751575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Connecting Physician Preceptors with Medical Students in the Ambulatory Setting 在门诊环境中将医师戒律与医学生联系起来

Journal of family medicine and disease prevention Pub Date : 2018-12-31 DOI: 10.23937/2469-5793/1510083

R. Kristen, B. Diana, L. Deborah, C. Victoria, McAlearney Ann Scheck

引用次数: 0

Cytomegalovirus-Associated Pseudotumor of the Rectum in an Immunocompromised Patient 免疫功能低下患者的直肠巨细胞病毒相关假瘤

Journal of family medicine and disease prevention Pub Date : 2018-12-31 DOI: 10.23937/2469-5793/1510084

Cannon Lisa Marie, L. Steven

引用次数: 0

Social and Demographics Factors Associated with the Breast Self-Examination (BSE) in Women in Primary Care 初级保健妇女乳腺自检（BSE）相关的社会和人口学因素

Journal of family medicine and disease prevention Pub Date : 2018-12-31 DOI: 10.23937/2469-5793/1510081

Valderrama-Urreta Ada Leticia, Jímenez-Báez María Valeria, Espinoza-Rodriguez Juan Carlos, Sandoval-Jurado Luis, Reyes Gabino Patricia Teresa, Guerra-Renteria Sergio, Chavez-Hernández María Margarita

{"title":"Social and Demographics Factors Associated with the Breast Self-Examination (BSE) in Women in Primary Care","authors":"Valderrama-Urreta Ada Leticia, Jímenez-Báez María Valeria, Espinoza-Rodriguez Juan Carlos, Sandoval-Jurado Luis, Reyes Gabino Patricia Teresa, Guerra-Renteria Sergio, Chavez-Hernández María Margarita","doi":"10.23937/2469-5793/1510081","DOIUrl":"https://doi.org/10.23937/2469-5793/1510081","url":null,"abstract":"Background: Some social and demographic factors in the population may contribute to the practice of Breast Self-Examination (BSE) allowing timely detection of cancer in the early stages. Objective: To determine the socio-demographic factors associated with breast self-examination in women attending primary care. Patients and method: Analytical, observational, cross-sectional study in women aged 20-59, entitled to a primary care unit in Cancún, Quintana Roo, Mexico. Sociodemographic data were recorded: age, occupation, schooling, marital status, religion, socioeconomic status. Risk factors: Family history with breast cancer and body mass index. We performed bivariate analysis and logistic regression with BSE as a dependent variable. Results: We surveyed 380 women, mean age 38 ± 10.5 years, 22% performed BSE. There is a significant difference (p < 0.05), for primary education or less, single civil status, socioeconomic worker level, Jehovah’s Witness religion; Without difference for the occupation between the groups of BSE and those that do not realize BSE. There is a risk of not carrying out BSE in women of socio-economic workers RP (Prevalence Ratio) = 2.06, with primary or less PR = 1.27, Jehovah’s Witnesses PR = 3.34, single marital status RP 1.29, common PR = 1.49. Conclusions: Eight out of ten women do not have BSE. In primary care centers, it is necessary to strengthen BSE programs in health service providers. Despite the diffusion for the prevention of breast cancer in health institutions, sociodemographic factors limit BSE in urban women.","PeriodicalId":91906,"journal":{"name":"Journal of family medicine and disease prevention","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49063648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Why do Patients Miss their Appointments at Primary Care Clinics? 为什么患者会错过初级保健诊所的预约？

Journal of family medicine and disease prevention Pub Date : 2018-09-30 DOI: 10.23937/2469-5793/1510090

Ullah Saif, Rajan Sangeetha, L. Todd, D. Ellen, J. Regina, Anandan Swapna, Gentile Christina, Gill Angad

{"title":"Why do Patients Miss their Appointments at Primary Care Clinics?","authors":"Ullah Saif, Rajan Sangeetha, L. Todd, D. Ellen, J. Regina, Anandan Swapna, Gentile Christina, Gill Angad","doi":"10.23937/2469-5793/1510090","DOIUrl":"https://doi.org/10.23937/2469-5793/1510090","url":null,"abstract":"Introduction: Missed appointments or no-shows are defined as “patients who neither kept nor canceled their scheduled appointments”. Studies conducted previously in primary care settings found that the rates of missed appointments in the United States vary from 5% to 55%. We conducted a pilot study amongst the healthcare providers at Griffin Faculty Physicians (GFP) and Griffin Hospital Wellness Clinic (GHWC). Methods: We conducted a telephone survey in which the patients who missed scheduled appointments from July-September 2016 at GFP and January-September 2016 for GHWC were contacted by telephone from August-October 2016 following a standard script. We examined the free text data from the telephone survey relating to reasons for missed appointments and discussed and categorized the main themes. We used SAS 9.4 for the data analysis. Results: Out of a total of 675 patients who missed their appointments, 218 (32.3%) attended the telephone calls. Out of these 218 patients, 82 (37.6%) reported that they forgot about their appointment or did not know that they had an appointment. 35 (16.1%) of the patients reported personal issues as the reason for missing their appointments. 15 (6.9%) of the patients reported a lack of transportation as the reason for not completing their appointment. Conclusion: This study emphasized the need for more research for a better understanding of the problem. We made recommendations for prompting patients about their upcoming appointments, helping patients get transportation to healthcare facilities and making efforts to ensure better communication between the patients and the healthcare providers to understand the complex interplay between personal, systemic and financial barriers in completing appointments.","PeriodicalId":91906,"journal":{"name":"Journal of family medicine and disease prevention","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43532418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 19

The Reasons and Strategies of High Cesarean Section Rate from Chinese Obstetricians and Midwives Perspective in the Public Hospitals: An Interpretative Phenomenologic Analysis 公立医院产科医师与助产士视角下剖宫产率高的原因与对策:解释性现象学分析

Journal of family medicine and disease prevention Pub Date : 2018-09-30 DOI: 10.23937/2469-5793/1510087

L. Minjie, Gu Wei, L. Xiaomei, Wang Xiaoqin

{"title":"The Reasons and Strategies of High Cesarean Section Rate from Chinese Obstetricians and Midwives Perspective in the Public Hospitals: An Interpretative Phenomenologic Analysis","authors":"L. Minjie, Gu Wei, L. Xiaomei, Wang Xiaoqin","doi":"10.23937/2469-5793/1510087","DOIUrl":"https://doi.org/10.23937/2469-5793/1510087","url":null,"abstract":"Background: Despite the ever-increasing rate of Cesarean Section (CS) in China, little is known about both the reasons and strategies of high Cesarean Section Rate (CSR) from the perceptions of obstetricians and midwives, who have great influence on deciding the delivery mode. The study aims to describe obstetricians and midwives’ perceptions of the essence of the increasing CSR in the tertiary (city) and secondary (county) hospitals in China. Methods: A descriptive qualitative study design with individual interviews was used. A purposive sampling of obstetricians and midwives from the tertiary and secondary hospitals were recruited. Open-ended questions on their perceptions of high CSR were asked. Braun and Clark’s thematic analysis steps were followed for the data analysis. Results: Twelve obstetricians and fifteen midwives were interviewed. Two themes on perceptions of increasing rate of CS emerged from the in-depth interviews: The causes of CS and proposals to decrease CSR. The reasons of increasing CSR included: High-risk pregnancy and perverse labor, fear of pain in Natural Vaginal Delivery (NVD), wrong cognitions to delivery mode, women’s lack of knowledge and unmatched expectations to medical intervention, tense doctor-patient relationship, deficits of professional technique, incomplete health care system. The proposals to decrease CSR were: Strengthening prenatal education, improving professional level of health care professionals, managing labor process, strengthening hospital patient communication, managing personnel and material resources. The findings support the gap of perceptions of CS among health care professionals from different levels of hospitals. Conclusion: The obstetricians and midwives identified various reasons for the high CSR and proposed different strategies to control the high CSR.","PeriodicalId":91906,"journal":{"name":"Journal of family medicine and disease prevention","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41825411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Individualized, Assessment-Based Manual Therapy to Reduce Chronic Pain and Increase Function: Case Study of a Patient with Fibromyalgia and Diabetes 个性化、基于评估的手动治疗减轻慢性疼痛并提高功能：一例纤维肌痛和糖尿病患者的个案研究

Journal of family medicine and disease prevention Pub Date : 2018-09-30 DOI: 10.23937/2469-5793/1510086

Bowyer Thuy, S HiremathLeena, R LarsonJennifer, M GrzybowskiDeborah, McAlearney Ann Scheck, L BowyerBrian

{"title":"Individualized, Assessment-Based Manual Therapy to Reduce Chronic Pain and Increase Function: Case Study of a Patient with Fibromyalgia and Diabetes","authors":"Bowyer Thuy, S HiremathLeena, R LarsonJennifer, M GrzybowskiDeborah, McAlearney Ann Scheck, L BowyerBrian","doi":"10.23937/2469-5793/1510086","DOIUrl":"https://doi.org/10.23937/2469-5793/1510086","url":null,"abstract":"Fibromyalgia is a medical condition characterized by chronic pain that is attributed to an imbalance in neurotransmitter function. It is now estimated to affect more than 10 million adults in the U.S. and 0.2-6.6% of the general population worldwide. Current treatment options include both pharmacological and nonpharmacological interventions, with massage therapy and physical therapy predominant among nonpharmacological approaches. We conducted a case study of a novel treatment modality, Medical Restorative Massage Therapy (MRMT®), which includes a detailed patient assessment and individualized treatment to address chronic pain. In this case, MRMT® was used over a 6-month period to assess and treat a female patient with fibromyalgia and diabetes. Assessments included patient perceptions of pain, therapist assessments of pain, and patient and therapist assessments of function. We found differences in levels of patient-perceived pain and therapist-assessed pain as well as differences in patient-assessed and therapist-assessed function ratings. These differences are suspected to be due to the psychological component of chronic pain that may impact patients’ perceptions of pain and function. The individualized MRMT® approach was successful in evaluating these differences, and helped guide treatment appropriately to reduce pain, improve function and increase activity. Treatments also resulted in improved control of diabetes, as measured by HbA1C levels and reduction in antidiabetic medication. This case study provides evidence that a care ful assessment of a patient’s condition (i.e., pain level and physical function), together with hands-on therapy and a patient education approach, can improve a patient’s ability to self-manage medical conditions through a targeted intervention that reduces pain and increases physical function.","PeriodicalId":91906,"journal":{"name":"Journal of family medicine and disease prevention","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48833350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1