本文關(guān)鍵詞： 部隊 基層軍醫(yī) 全科醫(yī)學(xué) 服務(wù)模式 要素　出處：《第三軍醫(yī)大學(xué)》2008年碩士論文　論文類型：學(xué)位論文

【摘要】： 部隊衛(wèi)生建設(shè)是軍隊現(xiàn)代化建設(shè)中的重要組成部分,基層衛(wèi)生工作處在部隊工作的一線位置,是衛(wèi)生服務(wù)轉(zhuǎn)化為戰(zhàn)斗力的首要環(huán)節(jié)。基層部隊衛(wèi)生機(jī)構(gòu)直接服務(wù)于基層官兵,集預(yù)防、醫(yī)療、保健和康復(fù)等多種工作于一體,其建設(shè)水平的高低直接關(guān)系到平時“保健康”和戰(zhàn)時“打得贏”的問題�；鶎榆娽t(yī)是基層衛(wèi)生工作的主力軍,作為骨干力量的他們是搞好基層衛(wèi)生建設(shè)、提高服務(wù)保障水平的關(guān)鍵。 近半個世紀(jì)以來,全科醫(yī)療服務(wù)、全科醫(yī)學(xué)學(xué)科與全科醫(yī)師隊伍的形成和發(fā)展是醫(yī)療衛(wèi)生事業(yè)中最有意義的歷史事件之一,它顯示了在時代潮流推動下醫(yī)學(xué)模式與衛(wèi)生服務(wù)模式重大變革的世界趨勢。美國家庭(全科)醫(yī)師學(xué)會1984年將全科醫(yī)療定義為“全科醫(yī)療是整合生物醫(yī)學(xué)、行為和社會科學(xué)的�？�,其知識和技術(shù)的核心源自于傳統(tǒng)的開業(yè)醫(yī)師和以家庭為范疇的獨(dú)特領(lǐng)域,而不是以病人的年齡、性別或器官系統(tǒng)的疾病來分科”。簡單地說,全科醫(yī)療是以新醫(yī)學(xué)模式為指導(dǎo),向個人、家庭、社區(qū)提供可及性、持續(xù)性、綜合性、協(xié)調(diào)性、集防、治、保、康一體的基層醫(yī)療保健服務(wù)。 隨著部隊官兵疾病譜的轉(zhuǎn)變以及新時期軍隊現(xiàn)代化建設(shè)的需要,基層軍醫(yī)的功能已完全超越了疾病的診療,軍醫(yī)在與基層部隊官兵的交往中,還需要扮演朋友、教育者、咨詢者、幫助者、代言人等角色,這與社區(qū)衛(wèi)生服務(wù)中的全科醫(yī)生的職責(zé)趨于相似,為了滿足新時期基層官兵的衛(wèi)生服務(wù)需求,基層軍醫(yī)衛(wèi)生服務(wù)工作也需要像全科醫(yī)生一樣開展全科醫(yī)學(xué)服務(wù)的模式,提供全面而連續(xù)的服務(wù)。 本研究采用文獻(xiàn)調(diào)研法、現(xiàn)場調(diào)研法、問卷調(diào)查法、專家咨詢法、優(yōu)序圖法等科學(xué)方法,借鑒全科醫(yī)學(xué)理論的系統(tǒng)研究成果,從了解目前基層官兵關(guān)注的主要衛(wèi)生服務(wù)需求入手,對基層軍醫(yī)衛(wèi)生服務(wù)工作進(jìn)行系統(tǒng)分析研究,并構(gòu)建部隊基層軍醫(yī)全科醫(yī)學(xué)服務(wù)模式的要素模型。研究共分四部分完成。 第一部分:部隊基層官兵衛(wèi)生服務(wù)需求調(diào)查。以我軍西南戰(zhàn)區(qū)部分所屬部隊400名基層官兵為需求調(diào)查對象,自行設(shè)計基層部隊官兵衛(wèi)生服務(wù)需求調(diào)查表,進(jìn)行衛(wèi)生服務(wù)需求調(diào)查。調(diào)查表包含定期體檢、常見病救治及預(yù)防、就近診治、休養(yǎng)病床、定期巡診、指導(dǎo)飲食、指導(dǎo)保健、心理咨詢、傷病護(hù)理、就醫(yī)熱線、健康教育、康復(fù)指導(dǎo)、計生指導(dǎo)、預(yù)防保健、訓(xùn)練保障及傷病關(guān)懷等16項內(nèi)容,分很需要、有時需要、需要、不太需要及不需要五個等級進(jìn)行調(diào)查。了解目前基層官兵的衛(wèi)生服務(wù)需求情況。 第二部分:部隊基層軍醫(yī)衛(wèi)生服務(wù)現(xiàn)狀調(diào)查。以我軍西南戰(zhàn)區(qū)部分所屬部隊180名基層軍醫(yī)為調(diào)查對象,采用描述性與分析性調(diào)查相結(jié)合的方法,根據(jù)研究需要,自行設(shè)計部隊基層軍醫(yī)衛(wèi)生服務(wù)工作現(xiàn)況調(diào)查表,針對基層軍醫(yī)的工作基本情況、考核情況、知識技能掌握情況、地方特殊病處置能力、衛(wèi)生服務(wù)情況及繼續(xù)教育情況等進(jìn)行調(diào)查。 第三部分:部隊基層軍醫(yī)衛(wèi)生服務(wù)工作現(xiàn)狀分析。對應(yīng)我軍基層軍醫(yī)衛(wèi)生服務(wù)現(xiàn)狀從軍醫(yī)的人力結(jié)構(gòu)現(xiàn)狀、專業(yè)素質(zhì)結(jié)構(gòu)現(xiàn)狀以及專業(yè)素質(zhì)影響因素、衛(wèi)生服務(wù)流程瓶頸環(huán)節(jié)進(jìn)行系統(tǒng)分析,提出改善部隊基層軍醫(yī)衛(wèi)生服務(wù)工作現(xiàn)狀的對策。研究認(rèn)為,目前我軍基層衛(wèi)生服務(wù)工作的流程中存在問題較多,整個基層軍醫(yī)的服務(wù)模式不能完全適應(yīng)新時期基層官兵的衛(wèi)生服務(wù)需求,集中體現(xiàn)在缺乏康復(fù)指導(dǎo)、健康教育、傷病關(guān)懷及便捷就醫(yī)等關(guān)鍵環(huán)節(jié)。 第四部分:部隊基層軍醫(yī)全科醫(yī)學(xué)服務(wù)模式構(gòu)建及設(shè)想。通過一系列的環(huán)節(jié)分析,借鑒全科醫(yī)學(xué)的先進(jìn)思想與實(shí)踐經(jīng)驗,發(fā)現(xiàn)軍事社區(qū)與城市社區(qū)的服務(wù)環(huán)境相類似,全科醫(yī)生與全科軍醫(yī)的職責(zé)性質(zhì)也有相同之處,因此提出建立基層軍醫(yī)全科醫(yī)學(xué)服務(wù)模式的構(gòu)想,通過20位專家進(jìn)行專家咨詢并由專家對各要素賦予權(quán)重,最終確立6項一級要素、29項二級要素為主要指標(biāo)的服務(wù)體系。 本研究通過科學(xué)、系統(tǒng)地方法構(gòu)建基層軍醫(yī)全科醫(yī)學(xué)服務(wù)模式,為我軍基層部隊軍醫(yī)的衛(wèi)生醫(yī)療服務(wù)的能力提高提供經(jīng)驗積累,為各級基層衛(wèi)生管理機(jī)構(gòu)提供借鑒和參考;通過實(shí)地調(diào)研,了解目前基層部隊官兵衛(wèi)生服務(wù)需求,了解基層軍醫(yī)衛(wèi)生服務(wù)工作現(xiàn)狀,找出基層部隊軍醫(yī)衛(wèi)生服務(wù)方面存在的不足,建立科學(xué)合理的基層軍醫(yī)服務(wù)模式,更好的為基層軍醫(yī)的工作進(jìn)行督促與改進(jìn),促進(jìn)基層軍醫(yī)不斷學(xué)習(xí)、提高,更好的為基層官兵服務(wù),提高我軍基層軍醫(yī)整體水平,為未來應(yīng)急機(jī)動作戰(zhàn)衛(wèi)勤保障和平時部隊人員的衛(wèi)生服務(wù)提供良好的人力資源保證。
[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 .

【學(xué)位授予單位】：第三軍醫(yī)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2008
【分類號】：R82

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