Family Medicine Nendyah Roestijawati

Kasus Seorang anak usia 8 tahun, kelas 3 SD, dibawa ibunya ke dokter. Ia sering mengeluh sakit kepala pada hari-hari tertentu, bahkan beberapa kali tidak masuk sekolah. Dokter melakukan anamnesis singkat, pemeriksaan fisik dan memberikan obat analgesik dan penenang

Family Medicine A discipline concerned with the provision of personal, primary, comprehensive and continuing health care of the individual in relation to his family, community and his environmentgeneral practice, primary care medicineFamily medicine is preferred to emphasize the family as the sociological unit providing support to the individual as well as to reiterate the importance of the family in the cause and effect of health and disease

Family DoctorIs a qualified medical practitioner who provides personal, primary, comprehensive and continuing health care to his patients in relation to their families, the community and their environment. He may attend to his patients in his clinic, in their homes or sometimes in the hospitalIn treating his patients the medical practitioner must take into consideration the whole person, their psyche as well as their body systems and must not treat just the signs and symptomsIn providing comprehensive and continuing care he will need to interact with his medical and para-medical colleagues. In promoting his patients health he will not only treat therapeutically but also educate and counsel his patients

Central valuesPatient centered care and attention to the doctor-patient relationshipHolistic approach to the patient and his problems that recognizes contributions to ill-health and well-being come from not only physical disease but equally if not from social and psychological dimensions in the patient (the bio-psycho-social model of ill-health)Emphasis on preventive medicine that has greater long term impact on health status than curative medicine

Looks after health problems that may be initially unclear in terms of seriousness the ability to deal with initially uncertain symptoms is important in the makeup of the family physicianLooks after people across the whole spectrum of age groupsLook after the patient not only in the consulting room, also in the home and other setting as well

Terms Personal care : close rapport between patient and doctorPrimary care : the first contactContinuing care : care of chronic medical problem requires regular monitoring and care complications that may ariseComprehensive care : (a) cares for all age groups, (b) promotive, preventive, curative, rehabilitative, palliative care, (c) physical, social, psychological problem

Levels of physician involvement an the familyMinimal emphasis on the family limited the patient onlyProviding medical information and advice teaching at least one family memberProviding feelings and support family members expressions of concerns and feeling related to the patients conditionSystematic assessment and planned intervention engages the family members in a planned family conference or a series of conferenceFamily therapy ability to handle intense emotions in families and self and maintain neutrality in the face of strong pressure from family members of other professionals

Reason for encounter (rfe)Idea : alasan kedatanganConcern : menjadi perhatianAnxiety : kecemasanExpected : harapan

Kesalahan penilaian rfeHanya melihat dan menyelesaikan masalah klinisPasien datang untuk berobat

Pemahaman Hakikat biologikHakikat psikologikHakikat sosiologikHakikat ekologikHakikat medik

Hakikat biologikMempunyai kegiatan sebagai makhluk biologisPrinsip kebugaran biologik dan risiko dalam kehidupan keluarga merupakan komponen jasmani yang esensialAdanya faktor keturunan, kesehatan keluarga dan reproduksi keluarga

Hakikat psikologikMempunyai aktivitas dan tingkah laku yang menentukan penampilan pada perilaku dan kebiasaanKeluarga merupakan bentuk organisasi sosial yang mempunyai keterkaitan antar anggota keluarga yang eratMempunyai keinginan untuk mempertahankan hidupnya dan menjaga hidupnya unyuk lebih baik

Hakikat sosiologikOrientasi pada penyakit yang berhubungan dengan proses dinamika dalam keluargaPotensi keluarga yang diperlukan untuk dipahami produksi dan ketrampilanKualitas hidup untuk memenuhi kebutuhan hidupPendidikan dan lingkungan

Hakikat ekologikInteraksi dengan sesama, spesies lain dan lingkungan fisik rumah tangganyaTimbulnya penyakit yang disebabkan anggota keluarga lain, faktor biologik, kimia dan fisik lingkungan

Hakikat medikPelayanan garis terdepanPergeseran pola perilaku dan penyakit pengaruhi pola pelayananPraktek dengan pendekatan medik yang efektif dan efisien

Pendekatan kedokteran keluargaSerangkaian kegiatan pelayanan kesehatan yang terencana, terarah, untuk menggali, meningkatkan, dan mengarahkan peran serta keluarga agar dapat memanfaatkan potensi yang ada guna menyembuhkan dan menyelesaikan masalah keluarga