Family Medicine

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Family Medicine Nendyah Roestijawati

Transcript of Family Medicine

Page 1: Family Medicine

Family Medicine Nendyah Roestijawati

Page 2: Family Medicine

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

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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

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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

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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

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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

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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

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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

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Reason for encounter (rfe)

Idea : alasan kedatanganConcern : menjadi perhatianAnxiety : kecemasanExpected : harapan

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Kesalahan penilaian rfe

Hanya melihat dan menyelesaikan masalah klinis

Pasien datang untuk berobat

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Pemahaman

Hakikat biologikHakikat psikologikHakikat sosiologikHakikat ekologikHakikat medik

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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

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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

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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

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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

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Hakikat medik

Pelayanan garis terdepanPergeseran pola perilaku dan penyakit

pengaruhi pola pelayananPraktek dengan pendekatan medik yang

efektif dan efisien

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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