Annals of family medicine
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Annals of family medicine · Nov 2004
The biopsychosocial model 25 years later: principles, practice, and scientific inquiry.
The biopsychosocial model is both a philosophy of clinical care and a practical clinical guide. Philosophically, it is a way of understanding how suffering, disease, and illness are affected by multiple levels of organization, from the societal to the molecular. ⋯ We propose a biopsychosocial-oriented clinical practice whose pillars include (1) self-awareness; (2) active cultivation of trust; (3) an emotional style characterized by empathic curiosity; (4) self-calibration as a way to reduce bias; (5) educating the emotions to assist with diagnosis and forming therapeutic relationships; (6) using informed intuition; and (7) communicating clinical evidence to foster dialogue, not just the mechanical application of protocol. In conclusion, the value of the biopsychosocial model has not been in the discovery of new scientific laws, as the term "new paradigm" would suggest, but rather in guiding parsimonious application of medical knowledge to the needs of each patient.
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Annals of family medicine · Sep 2004
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialComfortably engaging: which approach to alcohol screening should we use?
We wanted to compare 2 screening instruments for problem drinking, the CAGE and a single question, assessing frequency of use, patient and clinician comfort, and patient engagement in change. ⋯ Clinicians and patients reported similar comfort with the CAGE questions and the single-question screening tools for problem drinking, and the 2 instruments were equal in their ability to engage the patient. In Missouri, the single question was more likely to be used.
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Annals of family medicine · Sep 2004
The Spirituality Index of Well-Being: a new instrument for health-related quality-of-life research.
Despite considerable interest in examining spirituality in health-related quality-of-life studies, there is a paucity of instruments that measure this construct. The objective of this study was to test a valid and reliable measure of spirituality that would be useful in patient populations. ⋯ The Spirituality Index of Well-Being is a valid and reliable instrument that can be used in health-related quality-of-life studies.
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Annals of family medicine · Sep 2004
ReviewInterpersonal continuity of care and patient satisfaction: a critical review.
We wanted to review the medical literature regarding the relationship between interpersonal continuity of care and patient satisfaction and suggest future strategies for research on this topic. ⋯ Although the available literature reflects persistent methodologic problems, a consistent and significant positive relationship exists between interpersonal continuity of care and patient satisfaction. Future research in this area should address whether the same is true for all patients or only for those who seek ongoing relationships with physicians in primary care.