資深醫師與第一年住院醫師對社區健康議題之認知差異

Awareness of Community Health Issues in First Year Residents and Senior Physicians

楊慎絢(Sun-Shen Yang) ； 黃芬芬(Fen-Fen Huang) ； 李志清(Chih-Ching Lee)

《北市醫學雜誌》 2卷6期 (2005/06) Pp. 545-553

https://doi.org/10.6200/TCMJ.2005.2.6.06

摘要

Background and Purpose: Since September 2003, and as part of medical education and training courses in Taiwan, first-year postgraduate (PGY-1) residents are asked to spend one month in community medicine. This paper describes the concept of community health issues and its evaluation by PGY-1 residents, hospital physicians and clinic physicians. The differences between the three groups' evaluations are described and future improvements highlighted. Method: An instrument was developed to include four hypothetical cases and four health issues that may be encountered by a physician. The points allocated to various alternatives for eight situations are compared between the three groups by the Analysis of Variance (ANOVA) method. Results: In the PGY-1 residents group, regular health examinations is the major factor influencing health and its allocated points are significantly higher than from the hospital and clinic physician groups (p＜0.05). In contrast, clinical treatment is the major factor influencing health for the hospital and clinic physician groups and the allocated points are significantly higher than those from the PGY-1 residents group (p＜0.05). Conclusion: The importance of preventative and community-orientated primary care is suggested for directors and PGY-1 residents in training courses and further clinical practice.

關鍵字

畢業後一般醫學訓練計畫 ； 社區導向基層醫療 ； 生物－心理與社會層面 ； 整合性健康照護體系

並列摘要

Background and Purpose: Since September 2003, and as part of medical education and training courses in Taiwan, first-year postgraduate (PGY-1) residents are asked to spend one month in community medicine. This paper describes the concept of community health issues and its evaluation by PGY-1 residents, hospital physicians and clinic physicians. The differences between the three groups' evaluations are described and future improvements highlighted. Method: An instrument was developed to include four hypothetical cases and four health issues that may be encountered by a physician. The points allocated to various alternatives for eight situations are compared between the three groups by the Analysis of Variance (ANOVA) method. Results: In the PGY-1 residents group, regular health examinations is the major factor influencing health and its allocated points are significantly higher than from the hospital and clinic physician groups (p＜0.05). In contrast, clinical treatment is the major factor influencing health for the hospital and clinic physician groups and the allocated points are significantly higher than those from the PGY-1 residents group (p＜0.05). Conclusion: The importance of preventative and community-orientated primary care is suggested for directors and PGY-1 residents in training courses and further clinical practice.

並列關鍵字

postgraduate year residency program ； community-orientated primary care ； bio-psychosocial model ； integrated health care delivery system