以初级保健为基础的骨关节炎护理模式;一个范围审查
Joice Cunningham1, Frank Doyle2, Jennifer M Ryan3
1School of Physiotherapy, Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin, Ireland.
Seminars in arthritis and rheumatism
|June 16, 2023
概括
关节骨炎 (OA) 管理的初级保健模式在改善护理质量方面表现有前途,但临床结果是混合的. 未来的研究应侧重于个性化,利益相关者参与和行为改变策略,以更好地遵守.
科学领域:
- 类风湿病学 类风湿病学
- 初级医疗保健医学 一级医疗保健医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 骨关节炎 (OA) 管理通常涉及复杂的护理途径.
- 越来越多的初级保健机构正在探索提供OA干预措施.
- 标准化的护理模式 (MoCs) 旨在提高OA管理的效率和有效性.
研究的目的:
- 系统地识别和描述基于初级保健的骨关节炎护理模式.
- 描述这些模型的范围,性质,特征和影响.
- 综合了有关OA MoCs在初级保健中的发展和评估的发现.
主要方法:
- 从2010年到2022年5月,在六个电子数据库中进行了全面的文献搜索.
- 从相关研究中提取和综合使用叙事方法的数据.
- 包括的研究描述了骨关节炎护理的离散模型.
主要成果:
- 在13个国家确定了37个不同的MOC,主要是在高收入国家,目标是部/膝盖OA.
- 模型包括OA管理计划 (62%),增强初始咨询 (11%) 和综合护理途径 (27%).
- 常见的组成部分是全科医生领导的护理和多学科团队,但模型往往缺乏个性化;尽管护理质量得到了改善,但临床结果是混合的.
结论:
- 在全球范围内,基于证据的非手术初级保健OA管理模式正在出现.
- 未来的研究应该优先考虑实施科学,利益相关者参与,提供者培训,治疗个性化和行为改变策略.
- 整合和协调整个护理连续性的服务对于长期的坚持和自我管理至关重要.
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