What diagnosis does not tell: the case for a noncategorical approach to chronic illness in childhood.

What diagnosis does not tell: the case for a noncategorical approach to chronic illness in childhood.
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诊断无法说明的内容:对儿童期慢性病采取非明确方法的情况。

DOI:
10.1016/0277-9536(89)90157-3
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发表时间:
1989
期刊:
Social science & medicine (1982)
影响因子:
--
通讯作者:
Jessop,DJ
Jessop,DJ
中科院分区:
--
文献类型:
--
作者:
Stein,RE;Jessop,DJ

文献摘要

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医学培训、实践和研究传统上是围绕身体系统和疾病类别组织的。然而,在临床诊断是否是描述一个患有疾病的人的核心问题上,存在着学科分歧。来自两项研究的数据,一个机构和一个人口为基础的(儿科门诊治疗研究和全国健康检查调查周期II和III),用于测试诊断分组在检查疾病的相关性的有用性。以诊断分组为自变量,以一系列心理、社会和教育指标为因变量的一系列方差分析仅揭示了偶然预期的显着差异的数量。唯一存在显著差异的领域是家庭与保健提供系统的互动。这些结果表明,有更多的变异性诊断组内比他们之间,并建议诊断是不是一个有用的分类在检查的心理和社会变量。虽然社会科学家并不感到惊讶,但这些数据表明,在研究儿童和家庭慢性病引起的心理、社会、康复和预防问题时,需要对研究范式进行重大调整。
Medical training, practice and research are traditionally organized around body systems and disease categories. There is, however, a disciplinary split over the question of whether the clinical diagnosis is the central issue in describing an individual with an illness. Data from two studies, one institutional and one population based (The Pediatric Ambulatory Care Treatment Study and the National Health Examination Survey—Cycles II and III), are used to test the usefulness of diagnostic groupings in examining correlates of illness. A series of analyses of variance with the diagnostic groupings as the independent variable and a range of psychological, social and educational measures as the dependent variables reveal only the number of significant differences expected by chance. The only area in which a pattern of significant differences is found in the family's interaction with the health care delivery system. These results indicate that there is more variability within diagnostic groupings than between them and suggest that diagnosis is not a helpful categorization in the examination of psychological and social variables. While not surprising to social scientists, these data suggest the need for a major reorientation of the research paradigm when examining the psychological, social, rehabilitative and preventive issues raised by chronic illness in children and families.
DOI: --
发表时间: 1984
期刊: Pediatrics
影响因子: 8
作者:
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通讯作者: D. Jessop
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发表时间: 1975
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影响因子: 158.5
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R. Stein
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慢性儿童疾病的非绝对方法。
DOI: --
发表时间: 1982
期刊: Public health reports (1974)
影响因子: --
作者:
R. Stein;D. Jessop
通讯作者: D. Jessop