Miranda J Jaime, Moscoso Miguel G, Yan Lijing L, Diez-Canseco Francisco, Málaga Germán, Garcia Hector H, Ovbiagele Bruce
CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.
CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
J Neurol Sci. 2017 Apr 15;375:309-315. doi: 10.1016/j.jns.2017.02.027. Epub 2017 Feb 15.
Stroke is a major cause of death and disability, with most of its burden now affecting low- and middle-income countries (LMIC). People in rural areas of LMIC who have a stroke receive very little acute stroke care and local healthcare workers and family caregivers in these regions lack the necessary knowledge to assist them. Intriguingly, a recent rapid growth in cell-phone use and digital technology in rural areas has not yet been appropriately exploited for health care training and delivery purposes. What should be done in rural areas, at the community setting-level, where access to healthcare is limited remains a challenge. We review the evidence on improving post-stroke outcomes including lowering the risks of functional disability, stroke recurrence, and mortality, and propose some approaches, to target post-stroke care and rehabilitation, noting key challenges in designing suitable interventions and emphasizing the advantages mHealth and communication technologies can offer. In the article, we present the prevailing stroke care situation and technological opportunities in rural Peru as a case study. As such, by addressing major limitations in rural healthcare systems, we investigate the potential of task-shifting complemented with technology to utilize and strengthen both community-based informal caregivers and community healthcare workers.
中风是导致死亡和残疾的主要原因，目前其造成的负担大多影响着低收入和中等收入国家（LMIC）。低收入和中等收入国家农村地区的中风患者很少能得到急性中风护理，这些地区的当地医护人员和家庭护理人员缺乏帮助他们的必要知识。有趣的是，农村地区近期手机使用和数字技术的迅速增长尚未被适当地用于医疗保健培训和服务目的。在农村地区社区层面，在医疗保健可及性有限的情况下该如何做仍是一项挑战。我们回顾了关于改善中风后预后（包括降低功能残疾、中风复发和死亡风险）的证据，并提出了一些针对中风后护理和康复的方法，指出了设计合适干预措施时的关键挑战，并强调了移动医疗（mHealth）和通信技术所能带来的优势。在本文中，我们以秘鲁农村地区为例，介绍了当地普遍的中风护理情况和技术机遇。因此，通过解决农村医疗系统中的主要限制因素，我们研究了任务转移辅以技术手段以利用和加强社区非正式护理人员和社区医护人员的潜力。
