Abstract:
PURPOSE:We wanted to understand the views of patients and clinicians on the central concept of healing and to identify major facilitators of and barriers to promoting healing in primary care. METHODS:We undertook a qualitative analysis of focus group discussions. Participants were drawn from primary care clinics of a large, integrated, health care system in Washington State in 2005. Nine focus groups included 84 participants: 28 patients, 23 primary care physicians (19 family physicians), 20 registered nurses, 11 licensed practical nurses, and 2 medical assistants. Randomly sampled established patients were aged from 21 to 65 years; 71% were female. RESULTS:We found remarkable concordance across focus groups and among types of participants in the definition of healing: Healing is a dynamic process of recovering from a trauma or illness by working toward realistic goals, restoring function, and regaining a personal sense of balance and peace. Healing is a multidimensional process with physical, emotional, and spiritual dimensions. The key themes are as follows: (1) healing is multidimensional and holistic; (2) healing is a process, a journey; (3) the goal of healing is recovery or restoration; (4) healing requires the person to reach a place of personal balance and acceptance; and (5) relationships are essential to healing. Factors that facilitate healing help build relationships, improve communication, and share responsibility between the patient and clinician. Major barriers are logistical factors that limit high-quality time with healing professionals. CONCLUSIONS:Patients and health care team members share a vision of healing and agree on ways to enhance the process in primary care.
journal_name
Ann Fam Medjournal_title
Annals of family medicineauthors
Hsu C,Phillips WR,Sherman KJ,Hawkes R,Cherkin DCdoi
10.1370/afm.838subject
Has Abstractpub_date
2008-07-01 00:00:00pages
307-14issue
4eissn
1544-1709issn
1544-1717pii
6/4/307journal_volume
6pub_type
杂志文章abstract:PURPOSE:The health care system in the United States is inherently hierarchical. Patients are "nested" within physicians who in turn are "nested" within practices. Much of the research data gathered in practice-based research networks (PBRNs) also have similar patterns of nesting (clustering). When research data are nes...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.340
更新日期:2005-05-01 00:00:00
abstract:PURPOSE:To assess the effect of a primary care-based community-links practitioner (CLP) intervention on patients' quality of life and well-being. METHODS:Quasi-experimental cluster-randomized controlled trial in socioeconomically deprived areas of Glasgow, Scotland. Adult patients (aged 18 years or older) referred to ...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1370/afm.2429
更新日期:2019-11-01 00:00:00
abstract::Cultural values and beliefs about the primary care physician bolster the myth of the lone physician: a competent professional who is esteemed by colleagues and patients for his or her willingness to sacrifice self, accept complete responsibility for care, maintain continuity and accessibility, and assume the role of l...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1353
更新日期:2012-03-01 00:00:00
abstract::We propose a new set of priorities for quality management in primary care, acknowledging that payers and regulators likely will continue to insist on reporting numerical quality metrics. Primary care practices have been described as complex adaptive systems. Traditional quality improvement processes applied to linear ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2014
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:We wanted to determine the frequency of self-reported receipt of screening mammography and Papanicolaou (Pap) tests in older women and investigate important predictors of utilization, based on 2 national longitudinal surveys. METHODS:This cohort study includes participants from 4 waves (1994-2000) of the He...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.54
更新日期:2003-11-01 00:00:00
abstract::PURPOSE We examined how the closure of a large safety-net hospital in Los Angeles County, California, affected local primary care physicians. METHODS We conducted semistructured interviews with 42 primary care physicians who practiced in both underserved and nonunderserved settings in Los Angeles County. Two investiga...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1317
更新日期:2011-11-01 00:00:00
abstract:PURPOSE:Hot tea and coffee have been found to have antimicrobial properties. The purpose of this study was to determine whether the consumption of tea, coffee, or both is associated with less frequent nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA). METHODS:We performed a secondary analysis of dat...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1262
更新日期:2011-07-01 00:00:00
abstract::Large panel sizes are often held responsible for worse access to appointments in primary care. We evaluated the relationship between appointment backlog, panel size, and primary care clinician time in clinic, using Spearman correlation and multiple regression in a retrospective analysis. We found no independent associ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2313
更新日期:2018-11-01 00:00:00
abstract:PURPOSE:Unexplained gastrointestinal symptoms are more common in adults who recall abuse as a child; however, data available on children are limited. The aim of this study was to investigate the association of childhood maltreatment and early development of gastrointestinal symptoms and whether this relation was mediat...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1053
更新日期:2010-03-01 00:00:00
abstract:PURPOSE:Our goal was to monitor the progress of 3 Healthy People 2010 (HP2010) objectives encouraging self-management education and clinician counseling for weight loss and physical activity among adults with doctor-diagnosed arthritis. METHODS:Using the national 2002 and 2006 National Health Interview Survey (NHIS) a...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1210
更新日期:2011-03-01 00:00:00
abstract:PURPOSE:This study was conducted to document current immunization practices by family physicians. METHODS:In 2008 the American Academy of Family Physicians (AAFP) conducted a survey among a random sample of 2,000 of its members who reported spending 80% or more of their time in direct patient care. The survey consiste...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1185
更新日期:2010-11-01 00:00:00
abstract:PURPOSE:The purpose of this study was to characterize graduates of family medicine (FM) residencies from 1994 to 2017 and determine whether they continue to practice family medicine after residency. METHOD:We sampled physicians who completed FM residency training from 1994-2017 using 2017 American Medical Association ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2535
更新日期:2020-07-01 00:00:00
abstract:PURPOSE:Postpartum depression is common but inadequately recognized and undertreated. Continuing depressive symptoms are associated with adverse outcomes for the woman, her infant, and family. We wanted to determine the effect of a practice-based training program for screening, diagnosis, and management of depression i...
journal_title:Annals of family medicine
pub_type: 杂志文章,随机对照试验
doi:10.1370/afm.1418
更新日期:2012-07-01 00:00:00
abstract:PURPOSE:Primary care practices in the United Kingdom have received substantial financial rewards for achieving standards set out in the Quality and Outcomes Framework since April 2004. This article reviews the growing evidence for the impact of the framework on the quality of primary medical care. METHODS:Five hundred...
journal_title:Annals of family medicine
pub_type: 杂志文章,评审
doi:10.1370/afm.1377
更新日期:2012-09-01 00:00:00
abstract:PURPOSE:In screening for type 2 diabetes, guidelines recommend targeting high-risk individuals. Our objectives were to assess the yield of opportunistic targeted screening for type 2 diabetes in primary care and to assess the diagnostic value of various risk factors. METHODS:In 11 family practices (total practice popu...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.997
更新日期:2009-09-01 00:00:00
abstract:PURPOSE:The risk of an injury increases exponentially with alcohol consumption on a given occasion, but the conclusion that alcohol-related injuries are attributable primarily to heavy drinking may or may not be correct. The prevention paradox states that a large number of people at small risk may contribute more cases...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.243
更新日期:2005-01-01 00:00:00
abstract:PURPOSE:A randomized controlled trial found that patients with diabetes had lower HbA1c levels after 6 months of peer health coaching than patients who did not receive coaching. This paper explores whether the peer coaches in that trial, all low-income patients with diabetes, mastered and utilized an evidence-based hea...
journal_title:Annals of family medicine
pub_type: 杂志文章,随机对照试验
doi:10.1370/afm.1756
更新日期:2015-08-01 00:00:00
abstract:PURPOSE:Hearing loss, the second most common disability in the United States, is under-diagnosed and under-treated. Identifying it in early stages could prevent its known substantial adverse outcomes. METHODS:A multiple baseline design was implemented to assess a screening paradigm for identifying and referring patien...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2590
更新日期:2020-11-01 00:00:00
abstract::Tobacco use, lack of physical activity and poor diet, and alcohol consumption are leading causes of death in the United States. We estimated screening and counseling rates by using a nationally representative sample of adults aged 35 years and older with a preventive care supplement to the 2014 Medical Expenditure Pan...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2363
更新日期:2019-03-01 00:00:00
abstract:PURPOSE:Qualitative research projects often involve the collaborative efforts of a research team. Challenges inherent in teamwork include changes in membership and differences in analytical style, philosophy, training, experience, and skill. This article discusses teamwork issues and tools and techniques used to improv...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.290
更新日期:2005-07-01 00:00:00
abstract:PURPOSE:Most new mothers return to work soon after childbirth. A need exists to reexamine the definition of postpartum health and evaluate employed women's recovery from childbirth in association with such factors as delivery type and breastfeeding. METHODS:Using a prospective cohort design, we recruited Minnesota wom...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.519
更新日期:2006-03-01 00:00:00
abstract:PURPOSE:We wanted to obtain perspectives of mothers and daughters on facilitators of and barriers to with adolescent girls' timely access to risk-appropriate reproductive care. METHODS:We conducted 5 separate focus groups with Latina and black mothers and their adolescent daughters. All participants resided in impover...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究
doi:10.1370/afm.601
更新日期:2006-11-01 00:00:00
abstract:PURPOSE:Potentially inappropriate prescribing (PIP) is a common yet preventable medical error among older persons in primary care. It is uncertain whether PIP produces adverse outcomes in this population, however. We conducted a systematic review with meta-analysis to pool the adverse outcomes of PIP specific to primar...
journal_title:Annals of family medicine
pub_type: 杂志文章,meta分析
doi:10.1370/afm.2373
更新日期:2019-05-01 00:00:00
abstract:PURPOSE:Multimorbidity is associated with adverse outcomes, yet research on the determinants of its incidence is lacking. We investigated which sociodemographic, health, and individual lifestyle (eg, physical activity, smoking behavior, body mass index) characteristics predict new cases of multimorbidity. METHODS:We u...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2271
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:The 5As (ask, advise, assess, assist, arrange) are recommended as a strategy for brief physical activity counseling in primary care. There is no reference standard for measurement, however, and patient participation is not well understood. This study's objectives were to (1) develop a coding scheme to measur...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1299
更新日期:2011-09-01 00:00:00
abstract:PURPOSE:Automated office blood pressure monitoring during 30 minutes (OBP30) may reduce overtreatment of patients with white-coat hypertension in primary health care. OBP30 results approximate those of ambulatory blood pressure monitoring, but OBP30 is much more convenient. In this study, we compared OBP30 with routine...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2041
更新日期:2017-03-01 00:00:00
abstract:PURPOSE:Recent national guidelines encourage a trial of labor after cesarean (TOLAC) as a means of increasing vaginal births after cesarean (VBACs) and decreasing the high US cesarean birth rate and its consequences (2010 National Institute of Health Consensus Statement and American College of Obstetricians and Gynecol...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1403
更新日期:2012-11-01 00:00:00
abstract:PURPOSE:We aimed to advance the internal and external validity of research by sharing our empirical experience and recommendations for systematically reporting contextual factors. METHODS:Fourteen teams conducting research on primary care practice transformation retrospectively considered contextual factors important ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1549
更新日期:2013-05-01 00:00:00
abstract:PURPOSE:Despite growing calls for team-based care, the current staff composition of primary care practices is unknown. We describe staffing patterns for primary care practices in the Centers for Medicare and Medicaid Services (CMS) Comprehensive Primary Care (CPC) initiative. METHODS:We undertook a descriptive analysi...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1626
更新日期:2014-03-01 00:00:00
abstract:PURPOSE:The explosion of evidence in the last decade supporting the role of spirituality in whole-person patient care has prompted proposals for a move to a biopsychosocial-spiritual model for health. Making this paradigm shift in today's multicultural societies poses many challenges, however. This article presents 2 t...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.864
更新日期:2008-09-01 00:00:00