Cobbing Saul, Hanass-Hancock Jill, Myezwa Hellen
Department of Physiotherapy, Westville Campus, University of KwaZulu-Natal.
Afr J Prim Health Care Fam Med. 2017 Aug 31;9(1):e1-e8. doi: 10.4102/phcfm.v9i1.1374.
People living with HIV (PLHIV) are living longer lives but are at a greater risk of developing disability. South Africa has the largest antiretroviral therapy (ART) programme in the world, shifting HIV from a deadly to a chronic disease. The integration of rehabilitation into chronic care is therefore now crucial to ensure the highest quality of life of PLHIV.
To describe how a home-based rehabilitation (HBR) programme adhered to the fundamental principles of a theoretical model of integrated care developed for the study setting in KwaZulu-Natal, South Africa.
The process and results from the HBR programme were assessed in relation to the model of care to ascertain which principles of the model were addressed with the HBR programme and which elements require further investigation.
The HBR programme was able to apply a number of principles such as evidence-based practice, task shifting to lay personnel, enabling patient-centred care and maximising function and independence of PLHIV. Other elements such as the adoption of a multidisciplinary approach, training on the use of disability screening tools and the use of evidence to influence policy development were more difficult to implement.
It is possible to implement elements of the integrated model of care. Further research is needed to understand how principles that require further training and collaboration with other stakeholders can be implemented. The results of this study provide additional evidence towards understanding the feasibility of the theoretical model and what is required to adjust and test the full model.
感染艾滋病毒的人（PLHIV）寿命延长，但出现残疾的风险更高。南非拥有世界上最大的抗逆转录病毒疗法（ART）项目，使艾滋病毒从一种致命疾病转变为一种慢性病。因此，将康复纳入慢性病护理对于确保PLHIV的最高生活质量至关重要。
描述一项居家康复（HBR）项目如何遵循为南非夸祖鲁 - 纳塔尔省的研究环境开发的综合护理理论模型的基本原则。
根据护理模型评估HBR项目的过程和结果，以确定该模型的哪些原则通过HBR项目得到了落实，哪些要素需要进一步研究。
HBR项目能够应用一些原则，如循证实践、将任务转移给非专业人员、实现以患者为中心的护理以及最大限度地提高PLHIV的功能和独立性。其他要素，如采用多学科方法、残疾筛查工具使用培训以及利用证据影响政策制定等，实施起来则较为困难。
有可能实施综合护理模型的要素。需要进一步研究以了解如何实施那些需要进一步培训并与其他利益相关者合作的原则。本研究结果为理解该理论模型的可行性以及调整和测试完整模型所需的条件提供了更多证据。
