Cooper Helen C, Geyer Robert
Community and Child Health, University of Chester, Chester, UK.
J Eval Clin Pract. 2009 Aug;15(4):761-5. doi: 10.1111/j.1365-2753.2009.01229.x.
Diabetes presents a multifaceted picture with its rapidly rising prevalence associated with changing demographics and increasing levels of obesity in the developed world. Deaths from diabetes are predicted to rise by 25% over the next 10 years. The enormity of this public health challenge has been recognized the world over, but little attention has been paid to the theoretical frameworks underpinning practical management.
This paper aims to introduce complexity theory and discuss its practical application to diabetes, focusing on a single 'tool' to provide an example of how theory can be linked to practice.
Critics have questioned the all inclusive nature of complexity seeing it as an intangible concept that fails to offer anything new to health care. However, few have appraised its practical application to a chronic disease that is currently managed using an outdated, linear, reduce and resolve model which fails to address the multiple interacting systems inherent within this condition.
This article proposes that complexity theory provides an interprofessional perspective for describing and understanding the processes involved, and provides working 'tools' for patients, carers and practitioners that capture the reality of managing this chronic disease in modern life.
糖尿病呈现出多方面的情况，在发达国家，其患病率迅速上升，这与人口结构变化和肥胖水平增加有关。预计在未来10年，糖尿病导致的死亡人数将上升25%。这一公共卫生挑战的严重性已得到全世界的认可，但很少有人关注支撑实际管理的理论框架。
本文旨在介绍复杂性理论，并讨论其在糖尿病管理中的实际应用，重点通过一个单一“工具”举例说明理论如何与实践相联系。
批评者质疑复杂性理论的全面性，认为它是一个无形的概念，未能为医疗保健提供任何新的东西。然而，很少有人评估过它在一种慢性病管理中的实际应用，这种慢性病目前采用的是过时的、线性的、减少和解决问题的模式，无法应对该疾病所固有的多个相互作用的系统。
本文提出，复杂性理论为描述和理解所涉及的过程提供了跨专业视角，并为患者及其家属和从业者提供了实用的“工具”，这些工具反映了在现代生活中管理这种慢性病的实际情况。
