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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 patients 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 members expressions of concerns and feeling related to the patients 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 kedatangan
Concern : menjadi perhatian Anxiety : kecemasan Expected : harapan

Kesalahan penilaian rfe


Hanya melihat dan menyelesaikan masalah

klinis Pasien datang untuk berobat

Pemahaman
Hakikat biologik
Hakikat psikologik Hakikat sosiologik Hakikat ekologik Hakikat 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 terdepan
Pergeseran pola perilaku dan penyakit

pengaruhi pola pelayanan Praktek 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