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帕金森病的治疗能从痴呆症护理中学到什么;将生物-心理-社会方法应用于帕金森病。

What can the treatment of Parkinson's disease learn from dementia care; applying a bio-psycho-social approach to Parkinson's disease.

作者信息

Gibson Grant

机构信息

Faculty of Social Sciences, R G Bomont Building, University of Stirling, Stirling, UK.

出版信息

Int J Older People Nurs. 2017 Dec;12(4). doi: 10.1111/opn.12159. Epub 2017 Jul 7.

Abstract

BACKGROUND

Within contemporary medical practice, Parkinson's disease (PD) is treated using a biomedical, neurological approach, which although bringing numerous benefits can struggle to engage with how people with PD experience the disease. A bio-psycho-social approach has not yet been established in PD; however, bio-psycho-social approaches adopted within dementia care practice could bring significant benefit to PD care.

METHODS

This paper summarises existing bio-psycho-social models of dementia care and explores how these models could also usefully be applied to care for PD. Specifically, this paper adapts the bio-psycho-social model for dementia developed by Spector and Orrell (), to suggest a bio-psycho-social model, which could be used to inform routine care in PD.

RESULTS

Drawing on the biopsychosocial model of Dementia put forward by Spector and Orrell (), this paper explores the application of a bio-psycho-social model of PD. This model conceptualises PD as a trajectory, in which several interrelated fixed and tractable factors influence both PD's symptomology and the various biological and psychosocial challenges individuals will face as their disease progresses. Using an individual case study, this paper then illustrates how such a model can assist clinicians in identifying suitable interventions for people living with PD.

CONCLUSION

This model concludes by discussing how a bio-psycho-social model could be used as a tool in PD's routine care. The model also encourages the development of a theoretical and practical framework for the future development of the role of the PD specialist nurse within routine practice.

IMPLICATIONS FOR PRACTICE

A biopsychosocial approach to Parkinson's Disease provides an opportunity to move towards a holistic model of care practice which addresses a wider range of factors affecting people living with PD. The paper puts forward a framework through which PD care practice can move towards a biopsychosocial perspective. PD specialist nurses are particularly well placed to adopt such a model within routine clinical practice, and should therefore be encouraged within PD services.

摘要

背景

在当代医学实践中,帕金森病(PD)采用生物医学、神经学方法进行治疗,这种方法虽带来诸多益处,但在理解帕金森病患者对疾病的体验方面可能存在困难。生物 - 心理 - 社会方法在帕金森病治疗中尚未确立;然而,痴呆症护理实践中采用的生物 - 心理 - 社会方法可能会给帕金森病护理带来显著益处。

方法

本文总结了现有的痴呆症护理生物 - 心理 - 社会模型,并探讨这些模型如何也能有效地应用于帕金森病护理。具体而言,本文改编了斯佩克特和奥雷尔()提出的痴呆症生物 - 心理 - 社会模型,以提出一个可用于指导帕金森病常规护理的生物 - 心理 - 社会模型。

结果

借鉴斯佩克特和奥雷尔()提出的痴呆症生物心理社会模型,本文探讨了帕金森病生物 - 心理 - 社会模型的应用。该模型将帕金森病概念化为一个轨迹,其中几个相互关联的固定且可处理的因素会影响帕金森病的症状表现以及个体在疾病进展过程中将面临的各种生物和心理社会挑战。通过一个个体案例研究,本文随后说明了这样一个模型如何能够帮助临床医生为帕金森病患者确定合适的干预措施。

结论

本模型最后讨论了生物 - 心理 - 社会模型如何可作为帕金森病常规护理中的一种工具。该模型还鼓励为帕金森病专科护士在常规实践中的角色未来发展建立一个理论和实践框架。

对实践的启示

帕金森病的生物心理社会方法提供了一个机会,以迈向一种整体护理实践模式,该模式能解决影响帕金森病患者的更广泛因素。本文提出了一个框架,通过该框架帕金森病护理实践可迈向生物心理社会视角。帕金森病专科护士在常规临床实践中特别适合采用这样一个模型,因此在帕金森病服务中应予以鼓励。

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