| 心身医学在全科实践中的作用思考 |
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| 引用本文： | 杨燕青,陶莹,李达,刘欢,孙文江,柏涌海.心身医学在全科实践中的作用思考[J].中华全科医学,2020,18(6):998-1001. |
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| 作者姓名： | 杨燕青 陶莹 李达 刘欢 孙文江 柏涌海 |
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| 作者单位： | 1. 海军军医大学附属长征医院预防保健科, 上海 200003; |
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| 基金项目： | 国家社会科学基金重大招标项目(17ZDA327) |
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| 摘 要： | 随着心身医学的研究发展,当今大部分疾病可归属到心身疾病范畴,且处于高发状态。我国提出了“首诊在基层”的服务模式,但全科医学尚处于发展阶段,基层卫生服务中全科医生存在医疗水平参差不齐的问题,其岗位胜任能力有待提高,在心身疾病诊疗能力层面尤为明显。通过心身医学与全科医学相结合,可以提升全科医生对心身疾病的认知应对能力,改善全科医生的岗位胜任能力不足现状,同时促进社区居民精神卫生健康,充分体现全科医生“健康守门人”的作用。本文阐述了目前国内全科医学起步晚、需求高的发展现状,总结归纳了国内外对心身医学的认知,揭示出我国精神卫生资源供不应求的现象。笔者根据我国存在心身疾病临床诊断率低,全科医生缺乏相关的心理干预技术,缺乏适合中国国情的诊断评估标准等问题,认为应从多角度进行促进,从政府部门制定相关政策、完善全科医生的院校教育和培训体系及结合本土中医全科特色方面,提出了增强全科医生心身疾病诊疗能力的三点建议。心身医学和全科医学相结合符合当前我国医疗服务发展需求,通过强化全科医生在首诊中的心身疾病认知与应对能力,对于提升基层医疗卫生服务能力,控制医保费用,减少患者与社会的经济负担,具有显著的促进意义,从而更好实现“健康2030”的目标。
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| 关 键 词： | 心身医学 全科医学 精神卫生 初级卫生保健 |
| 收稿时间： | 2019-08-17 |
Thoughts on the role of psychosomatic medicine in general practice |
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| Affiliation: | Preventive Health Service Department of Changzheng Hospital, Naval Military Medical University, Shanghai 200003, China |
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| Abstract: | With the development of psychosomatic medicine, most of today's diseases can be classified into psychosomatic diseases, and are in a high incidence state. China has put forward the service mode of "first visit at the grass-roots level", but general practice is still in the stage of development. There are problems of uneven medical level among general practitioners in primary health services, and their post competence needs to be improved, especially in the level of psychosomatic disease diagnosis and treatment ability. Combining psychosomatic medicine with general practice medicine can improve the general practitioner's cognitive and coping ability to psychosomatic diseases, improve the status quo of general practitioner's inadequate post competency, and promote the mental health of community residents, fully reflecting the role of general practitioner's "health gatekeeper". This paper expounds the current situation of the late start and high demand of general practice medicine in China, summarizes the recognition of psychosomatic medicine at home and abroad, and reveals the phenomenon that the supply of mental health resources in China exceeds the demand. According to the problems of low clinical diagnosis rate of psychosomatic diseases, lack of psychosomatic intervention technology, lack of diagnostic evaluation criteria suitable for China's national conditions and so on, the author believes that it should be promoted from various perspectives. From the aspects of formulating relevant policies by government departments, improving the education and training system of general practitioners in colleges and universities, and combining with the characteristics of local general practice of traditional Chinese medicine, the author proposes to strengthen general practice. Three suggestions on physician's ability to diagnose and treat psychosomatic diseases. The combination of psychosomatic medicine and general practice medicine meets the needs of the development of medical services in China. By strengthening the general practitioner's cognitive and coping ability of psychosomatic diseases in the first diagnosis, it has significant promotion significance for improving the ability of primary medical services, controlling medical insurance costs and reducing the economic burden of patients and society, thus better realizing the goal of "Health 2030". |
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