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首页> 外文期刊>Family medicine >Attitudes and Barriers Encountered in Training Family Medicine Residents in Nursing Home Care: A National Survey of Program Directors: A CERA Study
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Attitudes and Barriers Encountered in Training Family Medicine Residents in Nursing Home Care: A National Survey of Program Directors: A CERA Study

机译：在疗养院中培训家庭医学居民时遇到的态度和障碍：对计划负责人的全国调查：CERA研究

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Background and Objectives: The purpose of this study is to evaluate program director perceptions of influences on resident decisions to practice long-term care (LTC) medicine. Family physicians are well suited to provide nursing home care, but limited available data suggests a decline in the number of family physicians who do so. Family medicine residencies need to address the need for long-term care providers.Methods: We utilized the Council of Academic Family Medicine Educational Research Alliance (CERA) program director survey to (1) query family medicine residency program directors about their programs’ nursing home curriculum and their attitudes toward and perceived barriers to training family medicine residents to practice in nursing homes, (2) assess resident preparedness and barriers to practicing in nursing homes, and (3) estimate the number of family medicine residency graduates practicing in nursing homes.Results: We found that support and perceived preparedness for residency graduates practicing in nursing homes was high. We found that barriers to training were few, with resident interest being the largest barrier. Census region and community size correlated significantly to program directors’ estimates of the percentage of residents to be practicing in nursing homes after graduation.Conclusions: Family medicine residency directors acknowledge the need for family medicine residents to be trained in nursing home care. Further research and policy development are needed to support family physicians in playing key roles in providing care to patients in American nursing homes.(Fam Med 2016;48(4):309-13.)By 2030 there will be roughly 71.5 million people over the age of 65 in the United States, an 88% increase from the year 2008.1 Americans have a 40% lifetime risk of spending some time in a long-term care facility.2 The Institute of Medicine has forecasted a shortage of providers in long-term care facilities in the future.3 In July of 2014 the Institute of Medicine went further, issuing a report advocating for making Medicare funding of graduate medical education “contingent on its demonstrated value and contribution to the nation’s health needs.”4The specialty of family medicine is well poised to meet this need. Family physicians can help patients and their families obtain the care they need at skilled nursing or long-term care facilities. Traditionally, family physicians have provided most of the primary care rendered to elderly patients.5 However, the limited available literature suggests a declining trend in the proportion of family physicians practicing in nursing homes.6-8 Presumably, in response to this decline and to address our nation’s needs, the Accreditation Counsel for Graduate Medical Education (ACGME) added a 2-year longitudinal nursing home experience to family medicine training requirements in 2006.The purpose of this study of family medicine residency program directors is to identify attitudes toward and barriers encountered in implementing this curriculum and training family medicine residents to provide nursing home care. It also sought to determine graduate preparedness and barriers to providing nursing home care, as well as indirectly quantify nursing home practice patterns.Methods
机译：背景与目的：这项研究的目的是评估计划主任对居民决定实施长期护理（LTC）医学的影响的看法。家庭医生非常适合提供疗养院护理，但可用数据有限，表明这样做的家庭医生人数有所减少。方法：我们利用学术家庭医学教育研究联盟理事会（CERA）计划主任调查来调查（1）向家庭医学住院医师计划负责人询问其计划的疗养院。课程及其对培训家庭医学居民在疗养院执业的态度和感知障碍;（2）评估居民的准备情况和在疗养院执业的障碍;（3）估计在疗养院执业的家庭医学住院医师的毕业生人数。结果：我们发现，对在疗养院实习的居住地毕业生的支持和感知准备很高。我们发现培训的障碍很少，居民的兴趣是最大的障碍。人口普查区域和社区规模与计划主任对毕业后在疗养院中执业的居民所占比例的估计值有显着相关。结论：家庭医学住院医师主管承认需要对家庭医学居民进行疗养院培训。需要进一步的研究和政策制定，以支持家庭医生在为美国养老院患者提供护理方面发挥关键作用。（Fam Med 2016; 48（4）：309-13。）到2030年，全球约有7150万人美国的年龄为65岁，比2008年增加了88％。1美国人终生有40％的风险在长期护理机构中度过一段时间。2医学研究院预测， 3 2014年7月，医学研究所走得更远，发表了一份报告，提倡将医疗保险资金用于研究生医学教育的资助“视其对国家医疗需求的证明价值和贡献。” 4家庭的特殊性医学已经准备好满足这种需求。家庭医生可以在熟练的护理或长期护理机构中帮助患者及其家人获得所需的护理。传统上，家庭医生为老年患者提供了大部分的初级保健。5然而，有限的文献表明，在疗养院执业的家庭医生的比例呈下降趋势。6-8可能是由于这种下降和为了满足我国的需求，美国医学研究生教育认证顾问（ACGME）在2006年增加了对家庭医学培训要求的2年纵向疗养院经验​​。本研究对家庭医学住院医师项目负责人的目的是确定对态度和障碍的态度在实施该课程和培训家庭医学居民以提供疗养院护理时遇到的问题。它还试图确定毕业生的准备情况和提供护理之家护理的障碍，以及间接量化护理之家实践模式。

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