[Counselling our patients to stop smoking: why,when, and how?].
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Biomedical subjects
Publications and source records attributed to M González Díaz.
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OBJECTIVE: To establish the relative weight of the various kinds of primary health care (PHC) research collected in the IME (Spanish medical index), In order to determine their possible relationships with Spain's PHC model. DESIGN: Bibliometric analysis. PARTICIPANTS: PHC documents (1971-1994) from the IME data base (CD-ROM), subdivided by years, journals, themes and Autonomous Communities (AC). RESULTS: 3,015 studies were published, with a first phase (1970s) of under 10 documents per year, a second (1980s) with a big increase and a third (1990s) of stagnation. Of the 117 journals containing studies, Atención Primaria gave a home to almost 58% (60% after 1984). CONCLUSIONS: PHC research production has stagnated recently, though the journal Atención Primaria has maintained its undisputed leadership position. The clinical model predominant in Spanish medicine is generally followed.
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OBJECTIVE: To analyse Primary Health Care (PHC) research in Murcia between 1988 and 1992, looking at the possible influence of regional PHC conferences (RC) on the production of scientific work, which might be presented to RC, national conferences (NC) or national reviews (NR), as well as the impact of personal factors. DESIGN: A crossover, retrospective and descriptive study. PARTICIPANTS: Publications in NR and presentations at Murcia PHC RC and at NC between 1988 and 1992. 176 works were analysed. There were two sources of information: a) documents on PHC done in the region, articles, editorials or letters to the editor in NR collected in the IME (Spanish Medical Index), or as oral contributions, papers or posters in PHC RC or NC; b) personal and professional data of the authors. MEASUREMENTS AND MAIN RESULTS: Documents: title, authors, sources, date, theme, type, work centre and describer. Authors: sex, age, work activity, work situation, place of work and number of jobs. Statistical treatment: Chi squared and variance analysis. Between 1988 and 1992 works presented to RC duplicated (16 to 39) and increased by six to NC (1 to 6) and NR (2 to 13). Health Centres (62% of studies) made the greatest scientific contribution. CONCLUSIONS: The celebration of RC has a positive impact on the number of articles sent to NR, but not on the presentation of work in NC. Increase in the number of PHC research works (18 in 1988 and 52 in 1992) does not imply higher proportional collaboration of nonmedical health staff.
OBJECTIVE: Given both the limited experience of Undergraduate Teaching in Primary Health Care (PHC) and the lack of contact between different teaching centres, we sought to identify the minimum contents of a potential Syllabus. We made a distinction between items of knowledge required and skills students would have to develop. DESIGN: We undertook a Delphi study, which was longitudinal, prospective and observational. PARTICIPANTS: We defined three groups of experts among groups with PHC teaching experience. 20 Associate Lecturers at Undergraduate level, attached to Health centres; 20 postgraduate PHC teachers, and 7 University staff members involved with Public Health and Preventive and Community Medicine teaching. MAIN MEASUREMENTS AND RESULTS: The reply rate from the three questionnaires was about 60%. There was a high level of agreement. Of the items of knowledge which scored highest, we noted: the doctor-patients relationship, the Promotion of Health and Health education, Integrated Health Programmes, Prevention of Disease and Care of Risk-Groups. Of the skills, we pointed to the Clinical Interview, the construction of a Clinical History at the PHC level, Detection of Risk factors and Physical Examination. CONCLUSIONS: The most valued items of knowledge are those related to the overall Conception of Health, Promotion and Prevention. The most highly-scored skills are those concerning the Doctor-Patient relationship. Questions relating to the Individual are prioritised over those concerning Family and Community. There is a high level of agreement that the acquisition of the necessary theoretical knowledge must be accompanied by the ability to put them into practice.
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