Van Cleave Jeanne, Leslie Laurel K
Center for Child and Adolescent Health Policy, Massachusetts General Hospital for Children, Boston, Massachusetts, USA.
J Psychosoc Nurs Ment Health Serv. 2008 Aug;46(8):28-37. doi: 10.3928/02793695-20080801-07.
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common chronic conditions of childhood. Although evidence-based treatments for ADHD, including stimulant medication and behavior modification, have long been established, and guidelines for care of ADHD in primary care settings have been developed, adherence to long-term therapy is poor among youth with ADHD. This article proposes use of the Chronic Care Model for Child Health, the purpose of which is to develop informed, activated patients who will interact with a prepared, proactive health care team. Six "pillars" make up the model: decision support, delivery system design, clinical information systems, family and self-management support, community resources and policies, and health care organizations. Each of these is discussed, and an individual example is described. Adopting the Chronic Care Model for Child Health has the potential to improve the quality of care for ADHD.
注意力缺陷多动障碍(ADHD)是儿童期最常见的慢性病之一。尽管针对ADHD的循证治疗方法,包括使用兴奋剂药物和行为矫正,早已确立,并且已经制定了初级保健机构中ADHD的护理指南,但患有ADHD的青少年对长期治疗的依从性较差。本文提议采用儿童健康慢性护理模式,其目的是培养有见识、积极主动的患者,使其能够与有准备、积极主动的医疗团队互动。该模式由六个“支柱”组成:决策支持、服务提供系统设计、临床信息系统、家庭和自我管理支持、社区资源与政策以及医疗机构。本文对每个支柱进行了讨论,并描述了一个具体例子。采用儿童健康慢性护理模式有可能提高ADHD的护理质量。