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盆腔底功能障碍:一项在英国探索当前服务提供情况、跨专业合作和未来管理重点的范围研究。

Pelvic floor dysfunction: a scoping study exploring current service provision in the UK, interprofessional collaboration and future management priorities.

机构信息

Department of Community and Health Sciences, Consortium for Healthcare Research, City University, London, UK.

出版信息

Int J Clin Pract. 2010 Nov;64(12):1661-70. doi: 10.1111/j.1742-1241.2010.02509.x.

Abstract

OBJECTIVE

Pelvic floor dysfunction (PFD) has a significant socioeconomic and healthcare cost. This study aimed to investigate current service provision for PFD in the UK, highlighting any gaps and areas for improvement to inform future service improvement.

METHODS

A three-phase design comprised a scoping literature review, consultation survey with frontline practitioners from four key professional groups and an overarching synthesis. An interpretative analytical framework was informed by the concepts of interdisciplinary and interprofessional collaboration.

RESULTS

Empirical evidence on PFD service provision is limited. No overarching strategic approach to PFD as a single clinical entity in the UK was identified. Two hundred and forty-three medical, nursing and physiotherapy practitioners from different clinical subspecialties participated in the survey. Access and availability to services, models of delivery and individual practice vary widely within and across the disciplines. Time restrictions, mixed professional attitudes, lack of standardisation and low investment priority were identified as major barriers to optimal service provision. Five overlapping areas for improvement are highlighted: access and availability, team working and collaboration, funding and investment, education, training and research, public and professional awareness.

CONCLUSIONS

Current services are characterised by a fragmented approach with asynchronous delivery, limited investment and poor interprofessional integration. An improved service delivery model has the potential to improve outcomes through better interdisciplinary collaboration and efficient use of resources.

摘要

目的

盆底功能障碍(PFD)具有重大的社会经济和医疗成本。本研究旨在调查英国目前 PFD 的服务提供情况,突出任何差距和需要改进的领域,为未来的服务改进提供信息。

方法

采用三阶段设计,包括范围广泛的文献综述、来自四个主要专业群体的一线从业者的咨询调查以及全面的综合。解释性分析框架的依据是跨学科和跨专业合作的概念。

结果

关于 PFD 服务提供的实证证据有限。在英国,没有针对 PFD 作为单一临床实体的总体战略方法。来自不同临床亚专科的 243 名医疗、护理和物理治疗从业者参与了调查。服务的可及性和可用性、交付模式以及个人实践在不同学科和学科之间差异很大。时间限制、混合的专业态度、缺乏标准化和低投资优先级被确定为优化服务提供的主要障碍。突出了五个需要改进的重叠领域:可及性和可用性、团队合作、资金和投资、教育、培训和研究、公众和专业意识。

结论

目前的服务以分散的方式为特征,提供方式不同步,投资有限,跨专业整合不佳。改进的服务交付模式有可能通过更好的跨学科合作和更有效地利用资源来改善结果。

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