ABSTRACT
Many contemporary medical conditions have been found to be the consequence of lifestyle choices. These adverse habit patterns have their origin in the individuals family and/or natural social network. Primary care practitioners frequently interact with their patients for the purpose of helping them resolve medical problems by clarifying issues or presenting different options. In lifestyle related conditions, the initiation and maintenance of possible behaviour changes is usually the optimal resolution. How people intentionally change well-established behaviour patterns is still not well understood, and most clinicians are not confident in their ability to help patients alter adverse behaviours. Several studies provide support for a 'stage-matched framework' of behaviour change that integrates readiness for change with intervention processes from various theoretical models. This article provides a brief overview of the current thinking with respect to self-initiated and professionally facilitated behaviour change, and then describes a generic five-step approach to individualized lifestyle counselling for use in primary care clinical settings.
Subject(s)
Counseling , Life Style , Primary Health Care , Counseling/methods , Health Knowledge, Attitudes, Practice , Humans , Risk FactorsABSTRACT
Lifestyle and prevention are increasingly emphasized as ways to promote cardiovascular health. Family physicians will play a central role in detecting risk and encouraging lifestyle changes. This article outlines an effective preventive approach to coronary artery disease. The steps and skills involved are discussed as well as aspects of practice cultures that influence family physicians' activities.
ABSTRACT
The family with a handicapped member experiences stress and faces a variety of potential problems. The response of the family unit will vary according to the timing of this experience in the family life cycle, the health of the family, and the nature of the handicapped member's disability. Awareness of the needs of the family unit will help the physician to ensure its members' proper education and support, and to identify those families that may require family assessment and therapy. Dealing with the handicapped may also have implications for the physician.
ABSTRACT
The biomedical model provides an incomplete conceptual framework for the practice of family medicine. Whole-person medicine-the biopsychosocial model-and the integration of the family into medical care help to extend the conceptual framework of the family physician in a clinically useful way. This paper outlines methods of incorporating the family into medical care.
ABSTRACT
A review of the literature discloses that prostitutes are distinguishable into distinct classes, each with distinct clinical implications. The spectre of AIDS suggests that we review the implications of the health risks associated with this profession. This article discusses the potential causes, health problems, and treatment of prostitutes.
ABSTRACT
The College of Family Physicians of Canada uses a simulated office oral examination to test candidates for certification in family medicine. This examination has been highly successful. An analysis of this instrument provides a description of skills required for a certificant of the college. Its basic outline can be used to assess residents' interviewing skills during training and to help prepare them for practice.
Subject(s)
Certification , Clinical Competence , Family Practice , Interviews as Topic/standards , Medical History Taking/standards , Canada , Educational Measurement/methods , Family Practice/education , Humans , Physician-Patient Relations , Videotape RecordingABSTRACT
Widowhood is perhaps the most stressful life event. Recognition of the factors involved in normal and abnormal grief allows the family physician to intervene, when necessary, to facilitate healing. Studying the relationship between this stressful event and subsequent illness in the bereaved has furthered our understanding of the links bridging stress, coping and illness. This paper will examine some of the critical issues in the care of the elderly bereaved person.
ABSTRACT
Senile dementia is an increasingly important disease in family medicine, because our population is growing old. Dementia can have many causes, some of which are reversible. Its definition varies with time, discipline, and country. Correctly diagnosing reversible dementing processes as early as possible may lead to reversal of an otherwise devastating process. This article discusses definition and diagnosis of senile dementia.
ABSTRACT
A survey of Canada's medical schools and family practice residencies, conducted in 1979-80 to determine the extent and quality of teaching in family assessment and counselling, showed that many programs are not accomplishing their objectives in this area. Recommendations are made on the basis of the information collected.
