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    32 views94 pages

    Medicina de Familie in Mileniul 3 PDF

    Uploaded by

    Ana Cozma

    Copyright:

    © All Rights Reserved
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    ALGORITI De vesTiGaRE IN HEDIOINA DE FAMILIE 417 PANTIOULARITATILE D1AGNOsTICE IN MEDICINA De Fane. i 118 EETAPELE DIAGNOSTICULU iN MDICINA DE FaliLie 124 ERORILE DE DIAGNOSTIC. 128 INVENTARIEREA TUTUROA SiMiPTOMELOR 131 ‘ALGORITMIN ELABORAREA DIAGNOSTICULUL IN MEDICINA De FAMILE, 135 ‘TERAPEUTICA IN MEDICINA FAMILIE! 138 ‘ALGORITM IN ABORDAREA PROGRANELOR TERAPEUTICE....t41 PARTICULARITATILE TRATAMENTULU 143 IN MEDICINA DE FAMILIE 148 CCATEGORII DE BOLNAVI CARE NU POT Fi TRATATI DE MEDICINA DE FAMILIE, 143 ‘TERAPI COMPLENENTARE. ae MEDICUL DE FAMILIE $1 OECIZiA'N AGTUL MEDICAL “47 FACTORII CE INFLUENTEAZA DECIZIA MEDICULUI DE FAMILIE 149 CCOMUNICAREA IN MEDICINA DE FAMILIE” 150 AASISTENTA DE URGENTA IN MEDICINA DE FANLIE 153 "ALGORITMUL ACORDAAI [ASISTENTEI MEDICALE DE URGENTA. 158 ETAPELE ACORDARI ASISTENTEI DE URGENTA 184 FENOMENUL MBATRANIRI, 187 INGRUIRILE PALIATIVE 1 TERMNALE IN MEDICINA DE FAMILIE 160 TNGRWIRI PALIATIVE, 160 INGAUIFI TERMINALE. 161 MEDICINA BAZATA PE OOEzi (0) 163 PSIHOSOMATICA IN PRACTICA MEDICULUI DE FAMILIE. 166 INVATAMANTUL MEDICAL SI CERCETAREA, 76 ‘GGHIDURI DE PRACTE. 178 EDUCATIE PENTRU SANATATE. 108 DEONTOLOGIA $i RESPONSABILITATEN IN PRAGTIOA WEDICULUL DE FAME. 197 DEONTOLOGiA MEDICAL 190 ESPONSABILITATEA ACTULU MEDICAL 190 PREVENIREA IATROGENEZELOR, 193 BIELIOGAAFIE 198 MEDICINA DE FAMILIE IN MILENIUL I cna de fa ‘ Mencoperty,recunoscut_ gf integra ip omencind scalar reseed Romana, ssomansior maja stor kami Stag seco 0 ser poat pairs Peon enecta din canh (a ah mmr Ressler rotten sage ssigetos. medal ethtet anna contol oer paras, van fie Morgans iter co sire pont c8 dg unos rests safc do cose el muko of dary te ‘de 9 Sate hwel,at aa rca reveal te cht Go caste ane In oan sere, thas ont aon sont cual be dk utsco al ec ‘rpune vlc oie sist sia de eta Sfe"te do atin oct, compos 9 vara (8 pina amano, ea febloge a pegs doa promiens certs ‘aecnic ones, to Snpem i San age o profual a monitor pao}gi) igurd_ peso 85% dn nevole de esisnj8 medal le Populate opert hiatusuldinre specail) prm caracerl su ine 3 Yara pti. modelearh nll, sitomslr do sind, pro cate ag cote seN la Sate spectaltatecnamied 9 extensive pn cesta cont youu unc pi Gurr compat: 1 sevcor spose speci pi fansana a serl compels de esha rare th coor restunteisisterel’ de sandals god ‘ctr ra ptr do osponesblia a acer sre Redcha [rime Ges “Responesbilttes face parte ces libertatea notes peter cu muller. genre do Gera recsnoayare 6 hopare i rain velar meseale, management freon spot, aman’ gomctre oectia nena Numdrd mare led dofariie I rol medic do ami Hoa stereo ce sanzato, n absnta dein discpine! spilt co Mu ani alanis erat pete, a great Yl gc pent recunoastrea,impunerea emancparea NMG. Ast In 4974, Grp do la Leevenhors 2 dott pararott alscnal 490%, [QMS 2 eleborat o defn, n 1989 Taro Ununt Exzopene au elaborat Doct 82/16 care promora migcarea ibe a modiciorh spa tnetor ‘membre gi detinea 0 paroada abigatre de ste pant acl mormon, In 1998 Gay a elaborat o noua versio, In 1998 OMS ‘labor! Un Fe tatcior apse spell eadete eldectce de Medicina amie lees osu oman nedel emesis fit ste novle ener, enuziem 91 spear, pent & Se eige tial cperjona + sop mora: injtegerea,susiere gl ealzerossehmbari reatzarea devotees und stor rio operafona, formareaechiplor de protein corso cores. Scoput moral. Dervotaresunu Invalamént medial de medina tami cae: ‘8 cusindeforurle socal party promoveres 9 mentinerea ‘taro natal, provers 9\combaeres bow, prt od! bw progat tr domen, ‘siotona mecca co caltta, Subonaroa tuuerprbiemelor asta, motor aporull costa 2 relzal cco mel bun potest, cure acco de ‘medina emi, medi aerator do MP, model tt actos + 8 Gest progame spectico do Inala nut. ghighcs, ‘nrg ope contaoarata mode, ox tar. in aces sors bo impure “organizers nedactnnatoie, @ tvatamaniui do medcna tami ssemansir colrate speci). on angaafe, empcres rosponsabizara. persona ara arte sta modcale Unverataro, cu Morearea trot suelo i resubor p Servolo {nu alter rina compos ft realzarea nut poo do IvslmAn speci la param optim! a caitte 1 aelets ps cures specten, fens modem, eva pote specail cu examnatan oo prt * continuares processus do fvGlSmant spect, pen forme. do seca medal conn cy tematic specie, deineros pent meseu Siar, oboe. de. glad profesional co talc, eoordonsion gi ‘Sxamnator do pol, astra 9 dotrao Inspect rocesul de injelogere, sustinere si realizare a schimbéri procesulul de invajamnt medical de medina fami. “Condi speosconomce 1 cuurala In evolsia lor determing schimberee, Restuturares stom santar a, mpussctmbar gn ‘omencterl specilisior medal cu aparte de spect! nol pntre Care st mecicins do fami, Formarea spociasstuts Io orice speciatato moses nersts ror oy omar eves medal conn Species spec, 0080 oe Impure realzarea schinbéri curiculk Rierae# postunworeare. Cu Iinarea de caledre. wi stu Scrdomee, Go’ specatata. Cunoagora alti, evaluaren 31 ‘conaoarea plsonislor exit, Wonlilarea s ndepsrarea colar Consorvatoare cu itvoduceroa colo no. promessi, permite ceatzaroa ‘Ehmosr intone dmensunie, Schimbarea atest, a mera ‘et ral gre de realza In orice proces de echimbare os n tseauna ‘oneervatoare routes la sctimbaro, de reragee incite trreondijie cunoseuto fondle progrossto do asumare a aru in (togedreanecunosetuh deseoperton giiteduoorea nou gn fal ‘sigurarga pogresu, in relzarea.schimbie.jrle oporaionale sunt: dentearea ‘cavzlo canservatoar, Indeparares lor 9. mlocurea cu elements 1), Progresso, esenfala, ule 91 ecient, Soliilo elaborate vebuess [lose 91 ascoptata de opti, macala de teams plrderi oot do ‘munca sau a prviogiior. lneuorea nou nu tebe reaza pin ‘Bxcderea extort tn completa, Jnana cont 6 impact conta, contnutate gallate; epaqea obstaollr, ‘rdenjrea roalaarir s evolu pce roalzarea srucurlor academies Speates. Teale romines4 evanjazd probleme majre cu cave 3= confunta mein do ami: + "Yecunosstere doar declaratva a speclaltai ‘1 arginalzare 91 cecriminare To ogald| sur In orice medi orice ve din patos redelor co ate special, aulntir gi paclntoe, suninanfare permanent Invatamant medical de medicine famiil fora lpelt de {ond si confinut specifi; ou programe gi curcule alator pst de baza reall Jo invafimint; eu fomatcl ee nu corespund exigentslor spectal; cu evaluator, ru 38 putin or, de o Ina nut academick ‘Gor au ime comin cu spovaitatea de medica fam); cu ovals in ‘Srtonl spect evaluator departs de eureula spocah 1s Praciicen! de _medicind generalifmedicina tamil oplegt de problemele managerial alo cabinet In cont grit ze Go mapo, a e&for una fora do. oducaje. medcald 0 Topezeia Smpozoanele de promovare ce nol medoaments pe Pals Yomnassce, ‘organiza de time prosucatoar, co ado create att Go neces {vari reavzan rect moda 1 peta profesonsle tine do ccor, cu repezontanh i nogecaton po masa, cos! expma aopina aprobare” fla de le Slebwctvol reser Tr aoest context promovarea mescii do tamie, impunerea specaiati 1 Inscneroa sa po era valriorspecaaiey madealo Gn Foména eso asta doa’ uns" un vis rumoe sa poata ft adevarat™ ‘ora marall nosy poo Ea pe cna nu so zara, Az vedom luo" ‘in conclazio, edoparea in Romana & Document Organza Regionale @ Organization Mondale 8 Modeler do Farin (NONCA) 60 care Organize siniee$ pretesonal najonao, va mpasiona § va Sotemea medet do MIME an Romania 8 prmovez, 38 sus 9 8 ‘dervote Mesiona Generalaedeina de Feria no pen ealzarea ‘ meninarea nor standarde ine o calla In edueabo, Insure, orate 9 practea medal, pen face aja provocsnor mien SISTEME DE SANATATE Medicina do famila te pane dn sstomole de sAnatat (nicl ‘medicul do femso tcl un all spodalt ns poate inltdosuna 88 ‘Gaporezo, a aptee, $2 coordoneze i 62 evaluozo sigur sorveilo do ‘sistnya medtala peste neve. Goo ‘permanent, comunicare 9) ‘olborsre) ‘Coaboraroa dint dertlo specialty ue poate raza docat Incacraunul isto do sénstata ‘do eindlale este un aubsisiem al slstemelor. d natate cupinde ugar do soni, boetlat ‘Sistemul 70 fl in menjnerea 9 rlacaroa stb do sdnstate pana a carl ezolvarerbuia 2 Indoplngascs par catego de sor ‘slgurares servicio de sandtate x7 SiMfalgurare sltorl medeaie: 1 mbunatfion ste de senate; Tezuatee ‘obfrite ia grupele cupinso In programele rural pereoaneor cues favorable: Faportl arte porscanao sunt scala nein, lstemulu rapt med: 1 Grape = sage admit tor situ op ia armat: care in ureonare sista. “Tipur de tietme de sanatate: Dezavantale vantale 4 / Stem do sanatate tip Beverige Gratuite (Angi, Sued, Flanaa, Wanda, xhtate Span, Pra a tosctaig {to oo agtopare Droste 2/ asigurate sociale Blamark sleutare (Gomania, Oana, Boa, Frans, Asta). eanewrenia hatd mart rol paciontu ‘enomane pores ‘anja i axe spacial, atte do oiuraf pron, clactao oo case '3/Sitemele do sanatate private (SUA) ‘ndopondonts ‘tome tnaiate de asigura ‘logroa casei oot reat a ‘secesbitat osu rvs excl private tonal coal 44/Sitemul de tat Semacko ‘rautata in ost in comunist| Sccoebitate inane do a bugotl Jo sat onl rmatvat edu hotaator niga reas Subtnanare ‘Sorvel medical speciale cecriinatrt neque MEDICULU! DE FAMILIE CU CASA NATIONALA DE ASIGURARI DE SANATATE Ccablnetul medical de medicina familial furnizor de servicll ‘madicale poate Ih rei confacualo cu cole deasigur de snail, elaile cu casa de asigurr do cara, um de natura cl, 0 stale gl se costgoara po bazd de contact CContracuteadru: ‘rfomeaza taro 9 tigural de servile medical ote oda pblctat ‘nag Sun rei cairo ite de bina gnsonare recieazs clauze cate reglomenioazS conde do patd sore fuizata. poate nogeciat sau moda: Completa cu acto adtonae in cazt moder ezuato cin nogodtar Incheie anual in baza neler metodologine de, apicare care ‘modell do contract, ‘te oauze supieniave nogock. ‘Medicul de faa. In calle do furiaar de aeviclmocicale in relio Corartuais eu catele. de. asguri do saneate ebuo. £3, ‘cunoascd. 98 respecte Giporile cu priv a oblpabie,coptrie 9 atzol sulinenare nga ne pir ia proved lope Obligate caselor de asigurirl de sindtate: Storied termencle de dopunere& creer parr incheireas) nogocieoa eonraclor, ‘comunies funizorlot dunensle AecasaréGonli, norma tole oar, "Soanaz’ procedut. de Netaje sau nega f contoxul ormelr: incele contact ou furor de Servet orto op Ganurica in seria atl reluzncoleleoractlu: {"Geconteaza in Ingle 9. Ta tormence stablflo. if. conrct conravalosfo pestailr medal w ts 16 ereopeu sonqune. © esmenes oP ont sojnu0s ween} sopuCD eaérse sranues 9p wevypuy ve op "jransoube no euio} ul 6 ORY 8p ode od eUoK (ns VINYWOH NI JWNLOV HVAINVS IMNWALSIS VUNLONULS rrnBenuy woweiee gzeanene '6 greeanue> “grbeuepiece ‘ayuofeu eyues eriod preoame we evap enone ona mottos oy uate u gn ten Imes ynuajes up oeotpeu 2oqyoimes WlueUL) OPH" eapou ves evomuny (). pound ehueiise ‘IeRURS op une © creund ohio LeU - YNUAGOW VALV.LAIOOS NI aTTUNVA ‘qd 191 91GaW 10.10% 1S 19901 "eswapurs iostotiod vueace “vayonde em vepuron eu med jrcouou 9 20) 9 80 eayeds. won 9.6 ‘quo eindep i soxiguwoods ‘Boyeoleu no ezbazesoiy 98 ae} ep euaDeUL FOIE u eq pou eran ap KD oul rxIpus aD of arlWv4 3 INIOIGaN vIDOTOGOLaN Is Tn1DaIGO “owomnexo ezopzrevotes sw = "punt eu yrs a0 3% = jewspou guj i 8 8 = "peapou elms 0 = “waned eer ie -aNv4 3g VWI AW NI STHlaIONI . = odo voleonpe ¢ weirs ends emu) = ed cere sone vce oyondn vexed quad aneyoa soputosio’ gzoesoipe os "emir wvanaid "urban pe onmtea ds none nes "eauuepve ott “eud} youu muses ¥ eAvoren ep ewerBOxd ted JoxunUe pavudvaNd qd Uezunus op ewe aagodsn sgn sina 6 main ose emis steers soques jor tp wf2e=1H EINE © ““tintaods ope cstte st eeooevomnBey anya 30 inanoiaaw swloNns ines excnse rnoresoae 2 undo (naan pw 2 PURE 1 num co semen up Su FE) UNI Hee en courapuanas ¥ simigpos juno. op eandus ‘ayuereR® 8 orn “ceoend jies Basu, Un eee ewe) mes (REORLL “ror ever 16 6 ezemdepe oF ‘ruqnse neo tt emu) aS *(elunpvodopit sexed “soue su (990) anne s6d 20 sojuplorep fe) goo) BS 'EGED.- “[emouota fs e1o.one) a2onsep- ‘Yomquaos gunueuod u) AvBtepe educo- aoe oust-on- ‘Co samnede8 jousitoxs ezoucps000 9S ‘meIEPE eNEUPE 1 azawavo rps ‘xebeo0u oedean ih eonos Be "hao! eNO 2) mney ereseoou aeopeu sonoweR elezyee! 16 pereUnp.0cO oqo wd 9) aie luo wayeue seyodes 2yoods ese ues op nuotPeW mnutuoD *gimuad elves ‘pueun 2 ‘gnu, yosedroor & exinadey ‘eneOWeP ood ewes "peaos ood “on ea sojavbuywavesoce nod soyioeds yiege 1 REL ome op apes ogo 26a w mgesvodees eydoidferiuniuca nes obo gujevea 8 wise0e eeP ‘isoppu.isyeoads upon © FeapeW eiavoeerd woud 8 es wSIUND yavinwa yIvolgan viNalsisy v1 VaLvimiais30o¥ "e198 9p osu on en ‘euorowomnou se Jes oro eOpeUs Bletose F.Cae eNUIN} ep MADEN sTivolaaw 1aiNaLSISV ILLYLINNUNOD VaEVENDISY_ ‘evewnpodiio yuna “omgups op Fes wis widea.0d ‘ores no xea100 ff pu WOFEHL0 co0qo.d owsesoxd 8 vob ‘De erase vosewbontndne -punnopue oysdomou atone ‘onus eo9sv02 “aru oo enue povenen f EgUGS op Une WaseyCenexs avon! = Soot nied yoossuore "er peseuurxoorn fen jeuosaqand 8 —— 7 ‘p08 “eawouese “aeualiins soyonau wovenbaest ‘ud earn yivoa 30 vais v7 VLYNYS 30 VauVIS 140 VaHSOaUL Ipipueacp nes exempesoy o3eod 29 snpusuetio jolnsues wiehse gzeauoize 289 wo6oranuabonIe Spe} ef Binoseoejeyandogs, eyzocripand 8 exe efuonosa € vopundoe wruanoad 2 . woud avon ‘BAUNaASUd LiVLIALOV 30 7TNaLL un nes ae "2 naj ai mse woTIuNOSIY VatZONOaU - HLVAVNYS VaEWAONOUA 6 16 — eeuooja capo voroe“jeuyso0H4 axU8UO “zBO08 0 “usu oP . 6 sauna 20une nes —qurua0K ‘eeopewoineeqewenpoul ap M2 > ojeoeoinznae (2 wws6eae (a fuze ne “pounu ap eiveque u vend nes ur 1 jxBojewuoop revo Be seinenotu ‘Sano mmm HHibbe bi i i 3 isha eee 3 i sov onsen soousieoid & wniisise eymdepe aso - Tolls eaeep) f baiopanul no Mes unbiew = 1aniiva 30 YNIoIOaN NE fallwiansnoo aulyavinoWwEve agist al H 3 | isk eggs ‘e020: ongon 09 eusoxd w eves a1 "een rdooe IeapoUL —_, Specie oer sou pent Tog medkao, conta Gi ‘exoWvs post 9% solctaia asia. ‘medio de tami. orm ¢hrstrt n content special: ‘pla lresponsabt xin! ¢ protest apabl $2 rezoWe sngur au in ochps tate probiemele auzomptoat in eveniment ou so impteat eorevszte, cu Impact asupra ‘Solleliant| cu drept de liberS slogere » medieul uni ne cia cc a Tete tne eau reat et mien pre ‘eererortar ip cl, cantly ue ori Soto me soba, sant ‘sislen{2 meccala proven curatva, do gon su curt ‘sooumento medicals irr poclaia Iaborston) Inter (pal, prover, ‘20, cortiat, rete intornat Structure populate: sox) vars, donstat, novel, cuties santara, stat socouconome. nunc ‘cabinet, stajonar, Jamas!” 20 C2DNa, ceme, Ie de mines vet, ‘m cont impropn ‘aglomerate: gtate, ensine rozota tren binevotoror Goto necorarpuneatoare: Improvzape, ‘Umar (sing sau tn ocho) feditard. (Creuto, sprovaionero cu 9p8, uinat, inotlee, Indeprtare ridin): 108 ‘materala. (mobile, aparaiur, aianeriar) Walovalo eanaro, medicaront) ‘ntomatonalaesclatay,to ax, dacuronaio models: ‘rijace de anspor. rm neyo re weitere temas care neci me aca oe aoe emacs Seana St Sa is aoe eats omareees Sarcaenenaiantor ares CARACTERUL MULTIDISCIPLINAR ‘AL CONSULTATIEI DE MEDICINA FAMILIE! 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