Erwin J, Edwards K, Woolf A, Whitcombe S, Kilty S
Bone & Joint Research Group, Royal Cornwall Hospitals NHS Trust, Truro, UK.
School Healthcare Studies, Cardiff University, Cardiff, UK.
Musculoskeletal Care. 2018 Mar;16(1):48-59. doi: 10.1002/msc.1202. Epub 2017 Jul 26.
The aim of the present study was to identify the competencies that non-specialist community-based nurses and allied health professionals (AHPs) need to enable them to assess, care for and manage arthritis appropriately.
A Delphi survey with an expert panel of 43 rheumatology specialists and expert patients was used to identify the competencies needed by community-based nurses and AHPs to enable them to improve their care of people with arthritis. The process was informed by feedback from focus groups with arthritis patients, community-based nurses and AHPs.
The core competencies in arthritis care needed by non-specialist community-based nurses and AHPs were identified. The key goals identified were to increase the understanding of arthritis and its impact on patients' lives, and to increase the ability to help patients to self-manage their condition and access support. Competencies included an understanding of the pathology underlying inflammatory and non-inflammatory arthritis, the ability to distinguish between the two and the ability to recognize early warning signs, with an emphasis on osteoarthritis (OA), rheumatoid arthritis, gout and septic arthritis. Essential competencies included the ability to engage in shared decision making, goal setting and signposting, to provide patients with education and information and to make appropriate referrals.
Health professionals working in the community commonly encounter arthritis as a presenting problem or as a co-morbidity. The quality of care provided to people with inflammatory arthritis and OA in the community is currently variable. The present study identified the core competencies that all community-based nurses and AHPs should have in relation to OA and inflammatory arthritis.
本研究的目的是确定非专科社区护士和专职医疗人员（AHPs）为能够恰当地评估、护理和管理关节炎所需具备的能力。
对由43名风湿病专科医生和患者专家组成的专家小组进行德尔菲调查，以确定社区护士和AHPs为改善对关节炎患者的护理所需具备的能力。该过程参考了关节炎患者、社区护士和AHPs焦点小组的反馈意见。
确定了非专科社区护士和AHPs在关节炎护理方面所需的核心能力。确定的关键目标是增进对关节炎及其对患者生活影响的了解，以及提高帮助患者自我管理病情和获得支持的能力。能力包括对炎性和非炎性关节炎潜在病理的理解、区分两者的能力以及识别早期预警信号的能力，重点是骨关节炎（OA）、类风湿关节炎、痛风和化脓性关节炎。基本能力包括参与共同决策、设定目标和提供指引的能力，为患者提供教育和信息的能力以及进行适当转诊的能力。
在社区工作的卫生专业人员通常会遇到以关节炎为就诊问题或作为合并症的情况。目前，社区中为炎性关节炎和OA患者提供的护理质量参差不齐。本研究确定了所有社区护士和AHPs在OA和炎性关节炎方面应具备的核心能力。
