Hulen Elizabeth, Ervin Ayla, Schue Allison, Evans-Young Gina, Saha Somnath, Yelin Edward H, Barton Jennifer L
Center to Improve Veteran Involvement in Care, VA Portland Health Care System, USA.
University of California San Francisco, USA.
Musculoskeletal Care. 2017 Dec;15(4):295-303. doi: 10.1002/msc.1173. Epub 2016 Dec 14.
During the clinical encounter, rheumatoid arthritis (RA) patient goals for care often go unexplored. The aim of the present systematic review was to identify needs, goals and expectations of RA patients in order better to guide systematic elicitation of patient goals in clinical encounters.
An academic librarian searched MEDLINE, PsychINFO and the Cochrane Library using a specialized algorithm developed to identify articles about patient goals for RA care. Investigators screened search results according to prespecified inclusion criteria and then reviewed included articles and synthesized the evidence qualitatively, utilizing an inductive approach.
A total of 909 titles were retrieved in the literature search, of which 871 were excluded after a title/abstract screen. Of the remaining 38, 22 papers were included in the final review. Investigators identified four major themes in the literature: (a) the bodily experience of RA; (b) achieving normalcy and maintaining wellness; (c) social connectedness and support; and (d) interpersonal and healthcare system interactions.
Patients' goals when receiving care for RA are multidimensional and span several facets of everyday life. Goals for RA care should be collaboratively developed between patients and providers, with particular attention to the patient's life context and priorities.
在临床诊疗过程中，类风湿关节炎（RA）患者的护理目标常常未得到探究。本系统评价的目的是确定RA患者的需求、目标和期望，以便更好地指导在临床诊疗中系统地引出患者的目标。
一名学术图书馆员使用专门开发的算法在MEDLINE、PsychINFO和Cochrane图书馆中检索关于RA护理患者目标的文章。研究人员根据预先设定的纳入标准筛选检索结果，然后对纳入的文章进行审查，并采用归纳法对证据进行定性综合。
在文献检索中总共检索到909篇标题，其中871篇在标题/摘要筛选后被排除。在其余的38篇中，22篇论文被纳入最终评价。研究人员在文献中确定了四个主要主题：（a）RA的身体体验；（b）实现正常状态和保持健康；（c）社会联系和支持；（d）人际和医疗保健系统互动。
RA患者接受护理时的目标是多维度的，涵盖日常生活的多个方面。RA护理目标应由患者和提供者共同制定，特别关注患者的生活背景和优先事项。
