部队基层军医全科医学服务模式的研究

发布时间：2018-02-21 11:12

本文关键词： 部队基层军医全科医学服务模式要素　出处：《第三军医大学》2008年硕士论文　论文类型：学位论文

【摘要】： 部队卫生建设是军队现代化建设中的重要组成部分,基层卫生工作处在部队工作的一线位置,是卫生服务转化为战斗力的首要环节。基层部队卫生机构直接服务于基层官兵,集预防、医疗、保健和康复等多种工作于一体,其建设水平的高低直接关系到平时“保健康”和战时“打得赢”的问题。基层军医是基层卫生工作的主力军,作为骨干力量的他们是搞好基层卫生建设、提高服务保障水平的关键。近半个世纪以来,全科医疗服务、全科医学学科与全科医师队伍的形成和发展是医疗卫生事业中最有意义的历史事件之一,它显示了在时代潮流推动下医学模式与卫生服务模式重大变革的世界趋势。美国家庭(全科)医师学会1984年将全科医疗定义为“全科医疗是整合生物医学、行为和社会科学的专科,其知识和技术的核心源自于传统的开业医师和以家庭为范畴的独特领域,而不是以病人的年龄、性别或器官系统的疾病来分科”。简单地说,全科医疗是以新医学模式为指导,向个人、家庭、社区提供可及性、持续性、综合性、协调性、集防、治、保、康一体的基层医疗保健服务。随着部队官兵疾病谱的转变以及新时期军队现代化建设的需要,基层军医的功能已完全超越了疾病的诊疗,军医在与基层部队官兵的交往中,还需要扮演朋友、教育者、咨询者、帮助者、代言人等角色,这与社区卫生服务中的全科医生的职责趋于相似,为了满足新时期基层官兵的卫生服务需求,基层军医卫生服务工作也需要像全科医生一样开展全科医学服务的模式,提供全面而连续的服务。本研究采用文献调研法、现场调研法、问卷调查法、专家咨询法、优序图法等科学方法,借鉴全科医学理论的系统研究成果,从了解目前基层官兵关注的主要卫生服务需求入手,对基层军医卫生服务工作进行系统分析研究,并构建部队基层军医全科医学服务模式的要素模型。研究共分四部分完成。第一部分:部队基层官兵卫生服务需求调查。以我军西南战区部分所属部队400名基层官兵为需求调查对象,自行设计基层部队官兵卫生服务需求调查表,进行卫生服务需求调查。调查表包含定期体检、常见病救治及预防、就近诊治、休养病床、定期巡诊、指导饮食、指导保健、心理咨询、伤病护理、就医热线、健康教育、康复指导、计生指导、预防保健、训练保障及伤病关怀等16项内容,分很需要、有时需要、需要、不太需要及不需要五个等级进行调查。了解目前基层官兵的卫生服务需求情况。第二部分:部队基层军医卫生服务现状调查。以我军西南战区部分所属部队180名基层军医为调查对象,采用描述性与分析性调查相结合的方法,根据研究需要,自行设计部队基层军医卫生服务工作现况调查表,针对基层军医的工作基本情况、考核情况、知识技能掌握情况、地方特殊病处置能力、卫生服务情况及继续教育情况等进行调查。第三部分:部队基层军医卫生服务工作现状分析。对应我军基层军医卫生服务现状从军医的人力结构现状、专业素质结构现状以及专业素质影响因素、卫生服务流程瓶颈环节进行系统分析,提出改善部队基层军医卫生服务工作现状的对策。研究认为,目前我军基层卫生服务工作的流程中存在问题较多,整个基层军医的服务模式不能完全适应新时期基层官兵的卫生服务需求,集中体现在缺乏康复指导、健康教育、伤病关怀及便捷就医等关键环节。第四部分:部队基层军医全科医学服务模式构建及设想。通过一系列的环节分析,借鉴全科医学的先进思想与实践经验,发现军事社区与城市社区的服务环境相类似,全科医生与全科军医的职责性质也有相同之处,因此提出建立基层军医全科医学服务模式的构想,通过20位专家进行专家咨询并由专家对各要素赋予权重,最终确立6项一级要素、29项二级要素为主要指标的服务体系。本研究通过科学、系统地方法构建基层军医全科医学服务模式,为我军基层部队军医的卫生医疗服务的能力提高提供经验积累,为各级基层卫生管理机构提供借鉴和参考;通过实地调研,了解目前基层部队官兵卫生服务需求,了解基层军医卫生服务工作现状,找出基层部队军医卫生服务方面存在的不足,建立科学合理的基层军医服务模式,更好的为基层军医的工作进行督促与改进,促进基层军医不断学习、提高,更好的为基层官兵服务,提高我军基层军医整体水平,为未来应急机动作战卫勤保障和平时部队人员的卫生服务提供良好的人力资源保证。
[Abstract]:The construction of the army is an important part of the army ' s modernization . The grass - roots health service is the first part of the army ' s work , and it is the primary link of the transformation of health service into combat . The grass - roots military medical institutions are directly related to the problems of " health protection " and " win - win " in wartime . Grass - roots military medicine is the main force of grass - roots health work . As the backbone force , they are the key to improve the construction of grass - roots health and improve the level of service assurance . Since the last half century , the formation and development of general medical service , general medical science and general practitioner team is one of the most significant historical events in medical and health care . With the transformation of the army ' s disease spectrum and the need of military modernization in the new period , the function of the basic military medicine has completely surpassed the diagnosis and treatment of the disease , and the military medicine needs to play a role of friends , educator , consultant , helper and spokesman in the relationship with the army officers and soldiers at the grass - roots level . In order to meet the needs of the health service of the grass - roots soldiers in the new period , the medical service of the grass - roots military medical service also needs to carry out the mode of the general medical service like the general practitioner , and provide comprehensive and continuous service . This research adopts the scientific methods such as documentary investigation , field investigation , questionnaire , expert consultation and superior order graph . Based on the systematic research results of the general medical theory , the paper systematically analyzes the basic health service requirements of the grass - roots military and medical services , and constructs the element model of the medical service model of the basic military medicine of the army . The research is completed in four parts . The first part : Investigation on the demand of health service of troops at the grass - roots level . According to the demand survey of 400 base - level officers and soldiers of the troops in the southwest theater of our army , the survey of health service needs is carried out . The questionnaire includes regular physical examination , common diseases treatment and prevention , medical hotline , health education , rehabilitation guidance , health care , preventive health care , health education , rehabilitation guidance , health care , prevention of health care , training and health care , rehabilitation guidance , health care , prevention of health care , training and health care , rehabilitation guidance , health care , prevention of health care , training and health care , rehabilitation guidance , health care , prevention of health care , training and health care , rehabilitation guidance , health care , prevention of health care , training and health care , rehabilitation guidance , health care , prevention of health care , training and health care , rehabilitation guidance , health care , prevention of health care , training and health care , rehabilitation guidance , health care , prevention of health care , training and health care , rehabilitation guidance , health care , prevention of health care , training and health care , rehabilitation guidance , health care , prevention of health care , training and health care , rehabilitation guidance , health care , prevention of health care , training and health care , rehabilitation guidance , health care , prevention of health care , training and health care , rehabilitation guidance , health care , prevention of health care , training and health care , rehabilitation guidance , health care , prevention of health care , training and health care , rehabilitation guidance , health care , prevention of health care , training and health care , rehabilitation guidance , health care , prevention of health care , training and health care , and disability care . Part Two : Investigation on the status quo of military medical services at the grass - roots level . Based on the research needs , a questionnaire about the status of basic military medical service at the grass - roots level is designed . According to the needs of the research , the investigation is made on the basic situation , the assessment , the knowledge skills , the handling capacity of the local special diseases , the situation of health service and the continuing education . The third part is the analysis of the current situation of the basic military medical service at the grass - roots level in our army . The present situation of the basic military medical service in our army is analyzed , and the countermeasures for improving the current situation of the army medical service in the army are put forward . Part IV : The construction and the idea of medical service model of general medical service in basic military medicine of army . Through a series of link analysis , it is found that the military community is similar to the service environment of the city community , so the concept of establishing the general medical service model of the basic military medicine is put forward , and the experts are consulted by the experts and the weight of each factor is given by the experts , and the service system of six primary elements and 29 secondary elements is established . Through the scientific and systematic method to construct the medical service model of the basic military medical service , the paper provides reference and reference for the medical service of the grass - roots units at the grass - roots level . Through the field investigation , the current situation of the basic medical service of the grass - roots units is understood , the medical service of the grass - roots units is improved , the overall level of the grass - roots military medicine is promoted , the medical service of the grass - roots military medicine is improved , and good human resources guarantee is provided for the future emergency mobile warfare and the health service of the military personnel .

【学位授予单位】：第三军医大学
【学位级别】：硕士
【学位授予年份】：2008
【分类号】：R82

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