Department of Family Practice, University of British Columbia, Vancouver, BC.
CMAJ. 2011 Sep 6;183(12):E928-32. doi: 10.1503/cmaj.090290. Epub 2010 Jun 14.
Setting priorities is critical to ensure guidelines are relevant and acceptable to users, and that time, resources and expertise are used cost-effectively in their development. Stakeholder engagement and the use of an explicit procedure for developing recommendations are critical components in this process.
We used a modified Delphi consensus process to select 20 high-priority conditions for guideline development. Canadian primary care practitioners who care for immigrants and refugees used criteria that emphasize inequities in health to identify clinical care gaps.
Nine infectious diseases were selected, as well as four mental health conditions, three maternal and child health issues, caries and periodontal disease, iron-deficiency anemia, diabetes and vision screening.
Immigrant and refugee medicine covers the full spectrum of primary care, and although infectious disease continues to be an important area of concern, we are now seeing mental health and chronic diseases as key considerations for recently arriving immigrants and refugees.
确定优先级对于确保指南与用户相关且可接受,并在其开发过程中有效地利用时间、资源和专业知识至关重要。利益相关者的参与以及为制定建议而使用明确的程序是这一过程的关键组成部分。
我们使用改良的德尔菲共识过程选择了 20 项具有高优先级的指南制定条件。照顾移民和难民的加拿大初级保健医生使用强调健康不平等的标准来确定临床护理差距。
选择了九种传染病,以及四种心理健康状况、三种母婴健康问题、龋齿和牙周病、缺铁性贫血、糖尿病和视力筛查。
移民和难民医学涵盖了初级保健的全部范围,尽管传染病仍然是一个重要的关注领域,但我们现在将心理健康和慢性病视为最近移民和难民的主要考虑因素。