改善功能性发作患者护理的原则:缩小治疗差距
Toby Winton-Brown1,2, Sarah J Wilson3,4, Kim Felmingham3
1Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia.
The Australian and New Zealand journal of psychiatry
|July 3, 2023
概括
功能性 (非精神发作) 发作会导致严重的残疾,但治疗服务很少. 实施分步护理,分组,综合团队和共享护理可以改善患者的治疗结果.
科学领域:
- 神经学 神经学
- 精神病学是一个精神病学.
- 医疗保健管理的管理
背景情况:
- 功能性 (FS) 呈现显著的残疾,发病率和死亡率,与相似.
- 尽管影响力相似,但FS的治疗服务较少,对病理生理学和基于证据的治疗方法的理解基础较低.
- 高昂的直接和间接成本是由于不充分的FS护理造成的,影响患者,家庭和社会.
研究的目的:
- 确定改善功能性发作患者治疗结果的障碍.
- 探索解决这些障碍的国际模式和专家建议.
- 建议在澳大利亚和新西兰的背景下改善FS护理的框架.
主要方法:
- 审查国际实例和专家建议.
- 分析患者,临床医生和系统级阻碍FS治疗的障碍.
- 开发一个阶段性护理模式,包括分拣,跨学科团队和共享护理.
主要成果:
- 确定了患者层面的障碍:症状异质性,诊断不确定性,家庭因素和心理方面的困难.
- 确定了临床医生层面的障碍:次专业,知识,技能,态度和耻辱的缺乏.
- 识别了系统层面的障碍:医疗保健孤岛,高患病率和融资模式.
- 建议的解决方案包括分步护理,主动选,综合跨学科团队和共享护理.
结论:
- 解决FS需要克服多个患者,临床医生和系统障碍.
- 一个拟议的模型强调分阶段的护理,积极的分拣,综合的跨学科团队和共享护理.
- 实施这些原则为满足澳大利亚和新西兰改善FS护理的迫切需求提供了重要机会.
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