The problem-oriented approach (POA) is a ratio- nal method to manage clinical cases globally adopted in the medical practice. The centre of this me- thod is the ‘problem’, which becomes the goal of the medical path aimed to the resolution of this evidence. Additionally, the medical record build around the ‘problem’ (POMR, problem oriented medical record) becomes an effective means to follow the evolution of this condition and it allows a persuasive management of the patient. The following scheme is develop to describe the medical action: data base collection, to arrange the initial database of patient’s problems; list of problems, where the meaning for problem is “anything that has, does, or may require health care management, and that has or could significantly affect a patient’s well-being”1, and it should be formulated by pro- gressive refinements until becomes a short list of master problems; plan formulation, including a dia- gnostic plan to verify and localize the problem and then to look for both its pathophysiologic mecha- nism and cause, and a therapeutic plan incorporating a specific, supportive, symptomatic and palliative treatment. Based on this scheme prognostic consi- deration and supplying an effective client education could be formulated. Finally, the medical action path is completed with progress notes including: subjective (S) and objective (O) data collected from the patien- t’s follow-up or monitoring, problem assessment (A) which is then re-evaluated and further diagnostic or therapeutic plan (P) revised and up-dated (the so-called SOAP). The POA is really useful to the application of the evidence-based medicine.
Le basi fondamentali per sviluppare un corretto “approccio orientato al problema” per la gestione dei casi clinici
VEZZOSI, TOMMASO;LUBAS, GEORGE;
2012-01-01
Abstract
The problem-oriented approach (POA) is a ratio- nal method to manage clinical cases globally adopted in the medical practice. The centre of this me- thod is the ‘problem’, which becomes the goal of the medical path aimed to the resolution of this evidence. Additionally, the medical record build around the ‘problem’ (POMR, problem oriented medical record) becomes an effective means to follow the evolution of this condition and it allows a persuasive management of the patient. The following scheme is develop to describe the medical action: data base collection, to arrange the initial database of patient’s problems; list of problems, where the meaning for problem is “anything that has, does, or may require health care management, and that has or could significantly affect a patient’s well-being”1, and it should be formulated by pro- gressive refinements until becomes a short list of master problems; plan formulation, including a dia- gnostic plan to verify and localize the problem and then to look for both its pathophysiologic mecha- nism and cause, and a therapeutic plan incorporating a specific, supportive, symptomatic and palliative treatment. Based on this scheme prognostic consi- deration and supplying an effective client education could be formulated. Finally, the medical action path is completed with progress notes including: subjective (S) and objective (O) data collected from the patien- t’s follow-up or monitoring, problem assessment (A) which is then re-evaluated and further diagnostic or therapeutic plan (P) revised and up-dated (the so-called SOAP). The POA is really useful to the application of the evidence-based medicine.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
