Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 6 de 6
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Fam Med ; 56(1): 35-37, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37725775

RESUMO

BACKGROUND AND OBJECTIVES: Training residents in family systems and family-oriented care holds the potential to increase empathy for patients and to grow self-awareness of how one's own family of origin affects clinical practice. Little has been studied about how training residents in family systems affects their clinical practice after they graduate residency. METHODS: We surveyed all the residency graduates (N=60) who completed the longitudinal family systems curriculum during their third year of residency, from 2016 to 2021. The former residents were emailed a survey and asked to respond to Likert-scale and qualitative questions regarding the effects of the family systems curriculum on their clinical practice. RESULTS: Thirty-five graduates (58.3%) returned completed surveys. Overall, 26 of 35 (74.3%) respondents felt that the family systems curriculum had helped them a fair amount or a great deal in the care of their patients. In particular, 29 of 35 (82.9%) felt that the curriculum helped them a fair amount or a great deal in maintaining empathy. Compared to other longitudinal courses, 32 of 35 (91.4%) respondents indicated that they liked the curriculum somewhat or a great deal.  Conclusions: More than half the respondents found all elements of the curriculum helpful in their clinical practice, especially in the areas of caring for patients and maintaining empathy. The responses will be used as a baseline for comparison to improve the training. Continued research, perhaps in the form of randomized controlled trials using several residencies, could help in developing elements for more standardized curriculum in family-oriented care training.


Assuntos
Internato e Residência , Humanos , Médicos de Família , Currículo , Educação de Pós-Graduação em Medicina , Inquéritos e Questionários
2.
Fam Med ; 53(1): 54-57, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33471923

RESUMO

BACKGROUND AND OBJECTIVES: Training residents in family-centered approaches offers an opportunity to investigate how learners translate skills to real clinical encounters. Previous evaluations of a family systems curriculum have relied on self-assessment and narrative reflection to assess resident learning. Assessment of learning using encounter observation and objective tools, including evaluation of empathy, allows for a deeper understanding of how residents transform curricular education into clinical practice. METHODS: We evaluated resident learning from a longitudinal family systems curriculum delivered during the third year of a four-year residency training program. Using the Family-Centered Observation Form (FCOF), we analyzed seven pre- and postcurriculum videotaped encounters for changes in family-centered interviewing skills. We assessed changes in empathy before and after the curriculum using the Jefferson Empathy Scale. RESULTS: There was a trend toward improvement in all family-centered skills, as measured by the FCOF, though the improvements were only statistically significant in the area of rapport building. Statistically significant improvement in empathy occurred for all participants. Narrative reflection demonstrated that residents found the curriculum valuable in ways that we were unable to objectively measure. CONCLUSIONS: Training in family systems can enhance patient interactions and may improve empathy. Evaluation of family-centered skills is challenging and takes a significant amount of time and planning. The FCOF can help learners identify how to use family-centered concepts and skills in a typical family medicine outpatient visit. Further study is needed to determine whether patients seen by doctors who use family-oriented skills have better experiences or outcomes.


Assuntos
Empatia , Internato e Residência , Competência Clínica , Currículo , Medicina de Família e Comunidade , Humanos
4.
Fam Syst Health ; 36(4): 528-534, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30070545

RESUMO

Current and developing models of integrated behavioral health service delivery have proven successful for the general population; however, these approaches may not sufficiently address the unique needs of individuals living in rural and remote areas. For all communities to benefit from the opportunities that the current trend toward integration has provided, it is imperative that cultural and contextual factors be considered determining features in care delivery. Rural integrated primary care practice requires specific training, expertise, and adjustments to service delivery and intervention to best meet the needs of rural and underserved communities. In this commentary, the authors present trends in integrated behavioral health service delivery in rural integrated primary care settings. Flexible and creative strategies are proposed to promote increased access to integrated behavioral health services, while simultaneously addressing patient care needs that arise as a result of the barriers to treatment that are prevalent in rural communities. (PsycINFO Database Record (c) 2018 APA, all rights reserved).


Assuntos
Prestação Integrada de Cuidados de Saúde/métodos , Prestação Integrada de Cuidados de Saúde/normas , Serviços de Saúde Comunitária/métodos , Serviços de Saúde Comunitária/normas , Acessibilidade aos Serviços de Saúde/normas , Humanos , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/normas , Desenvolvimento de Programas/métodos , Serviços de Saúde Rural/normas , Serviços de Saúde Rural/estatística & dados numéricos
5.
Int J Psychiatry Med ; 53(5-6): 384-394, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30092676

RESUMO

Objective This article will describe a pilot study to explore associations between adult attachment style, resilience, Adverse Childhood Experiences, and adult health. Method A self-report survey was mailed to 180 randomly selected primary care patients and linked to a retrospective chart review. The patients met the following criteria: (1) enrolled for at least the previous year at their primary care clinic, (2) 21 years of age or greater, (3) English as their primary language, and (4) were seen by their provider on selected dates of the study. The survey was made up of three instruments: (1) the Adverse Childhood Experiences Questionnaire which consists of 10 questions about the respondent's adverse experiences during their first 18 years of life; (2) the Relationship Scales Questionnaire which measures adult attachment style; and (3) the Connor-Davidson Resilience Scale, a self-report scale that measures individual's perceptions of their resilience. For each returned questionnaire, we calculated a measure of medical complexity using the Elixhauser Comorbidity Index. Results Of the 180 randomly selected patients from four clinic sites, 84 (46.6%) returned completed questionnaires. We found that Adverse Childhood Experience scores were significantly correlated with health and attachment style and trended toward association with resilience. Conclusion This pilot study revealed expected relationships of the complex associations between Adverse Childhood Experiences, attachment style, and resiliency. Further research with more subjects is warranted in order to continue to explore these relationships.


Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Experiências Adversas da Infância , Apego ao Objeto , Resiliência Psicológica , Adulto , Feminino , Humanos , Masculino , Projetos Piloto , Estudos Retrospectivos , Adulto Jovem
6.
Fam Med ; 49(7): 558-562, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28724155

RESUMO

BACKGROUND AND OBJECTIVES: Although both residents and teaching faculty endorse its value, a recent review of family medicine residency programs confirms minimal formal family systems theory training. We consider the historical context of family systems training in family medicine and other competing priorities in practice and residency curricula. METHODS: We developed a longitudinal family systems curriculum, delivered in the third year of a 4-year residency program, and evaluated 2 years of the program using scales to assess self-reported confidence, knowledge and skills. RESULTS: Our curriculum evaluation showed significant improvement in all self-rating scales for all resident participants. CONCLUSIONS: We concluded the curriculum was successful in generating greater appreciation of family systems thinking and increased self-reported knowledge and skills for intervening and supporting families in the clinical setting. Further study is needed to evaluate change in clinical practice and whether these changes will be sustainable.


Assuntos
Competência Clínica , Currículo , Medicina de Família e Comunidade/educação , Família , Internato e Residência , Integração de Sistemas , Educação de Pós-Graduação em Medicina , Docentes , Humanos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...