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 environment
“general practice”, “primary care medicine” Family 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 Doctor
Is 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 hospital
In 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 symptoms
In providing comprehensive and continuing care he will need to interact with his medical and para-medical colleagues. In promoting his patient’s health he will not only treat therapeutically but also educate and counsel his patients
Central values Patient centered care and attention to the doctor-
patient relationship Holistic 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 physician
Looks after people across the whole spectrum of age groups
Look 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 doctor
Primary care : the first contact Continuing care : care of chronic medical problem
requires regular monitoring and care complications that may arise
Comprehensive 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 family
Minimal emphasis on the family – limited the patient only Providing medical information and advice – teaching at
least one family member Providing feelings and support – family member’s
expressions of concerns and feeling related to the patient’s condition
Systematic assessment and planned intervention – engages the family members in a planned family conference or a series of conference
Family 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 rfe
Hanya melihat dan menyelesaikan masalah klinis
Pasien datang untuk berobat
Pemahaman
Hakikat biologikHakikat psikologikHakikat sosiologikHakikat ekologikHakikat medik
Hakikat biologik
Mempunyai kegiatan sebagai makhluk biologis
Prinsip kebugaran biologik dan risiko dalam kehidupan keluarga merupakan komponen jasmani yang esensial
Adanya faktor keturunan, kesehatan keluarga dan reproduksi keluarga
Hakikat psikologik
Mempunyai aktivitas dan tingkah laku yang menentukan penampilan pada perilaku dan kebiasaan
Keluarga merupakan bentuk organisasi sosial yang mempunyai keterkaitan antar anggota keluarga yang erat
Mempunyai keinginan untuk mempertahankan hidupnya dan menjaga hidupnya unyuk lebih baik
Hakikat sosiologik
Orientasi pada penyakit yang berhubungan dengan proses dinamika dalam keluarga
Potensi keluarga yang diperlukan untuk dipahami produksi dan ketrampilan
Kualitas hidup untuk memenuhi kebutuhan hidup
Pendidikan dan lingkungan
Hakikat ekologik
Interaksi dengan sesama, spesies lain dan lingkungan fisik rumah tangganya
Timbulnya penyakit yang disebabkan anggota keluarga lain, faktor biologik, kimia dan fisik lingkungan
Hakikat medik
Pelayanan garis terdepanPergeseran pola perilaku dan penyakit
pengaruhi pola pelayananPraktek dengan pendekatan medik yang
efektif dan efisien
Pendekatan kedokteran keluarga
Serangkaian 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
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