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本文引用的文献

1
Emergence of pediatric rare diseases: Review of present policies and opportunities for improvement.儿科罕见病的出现:现行政策回顾与改进机遇
Rare Dis. 2013 Jan 28;1:e23579. doi: 10.4161/rdis.23579. eCollection 2013.
2
How do patients with rare diseases experience the medical encounter? Exploring role behavior and its impact on patient-physician interaction.罕见病患者的就医体验如何?探索角色行为及其对医患互动的影响。
Health Policy. 2012 May;105(2-3):154-64. doi: 10.1016/j.healthpol.2012.02.018. Epub 2012 Mar 29.
3
[High cost drugs for rare diseases in Brazil: the case of lysosomal storage disorders].[巴西治疗罕见病的高成本药物:溶酶体贮积症案例]
Cien Saude Colet. 2010 Nov;15 Suppl 3:3443-54. doi: 10.1590/s1413-81232010000900019.
4
[Health litigation and new challenges in the management of pharmaceutical services].[医疗诉讼与药品服务管理中的新挑战]
Cien Saude Colet. 2010 Aug;15(5):2405-14. doi: 10.1590/s1413-81232010000500015.
5
A comparative study of European rare disease and orphan drug markets.欧洲罕见病和孤儿药市场的比较研究。
Health Policy. 2010 Oct;97(2-3):173-9. doi: 10.1016/j.healthpol.2010.05.017. Epub 2010 Jun 17.
6
Rare childhood diseases: how should we respond?罕见儿童疾病:我们应如何应对?
Arch Dis Child. 2008 Dec;93(12):1071-4. doi: 10.1136/adc.2007.134940. Epub 2008 Aug 6.
7
Parents' concerns about issues related to their children's genetic conditions.父母对与子女遗传状况相关问题的担忧。
J Spec Pediatr Nurs. 2008 Jan;13(1):4-14. doi: 10.1111/j.1744-6155.2008.00129.x.
8
Rare diseases in disabled children: an epidemiological survey.残疾儿童中的罕见病:一项流行病学调查。
Arch Dis Child. 2008 Feb;93(2):115-8. doi: 10.1136/adc.2006.104455. Epub 2007 Oct 17.
9
Why do we need a diagnosis? A qualitative study of parents' experiences, coping and needs, when the newborn child is severely disabled.为什么我们需要诊断?一项关于新生儿严重残疾时父母的经历、应对方式及需求的定性研究。
Child Care Health Dev. 2007 May;33(3):296-307. doi: 10.1111/j.1365-2214.2006.00666.x.
10
[Distortions to national drug policy caused by lawsuits in Brazil].[巴西诉讼对国家药物政策造成的扭曲]
Rev Saude Publica. 2007 Apr;41(2):214-22. doi: 10.1590/s0034-89102007000200007.

根据患者、家属和医护人员的认知看罕见病的诊断与治疗困难

Difficulties in the diagnosis and treatment of rare diseases according to the perceptions of patients, relatives and health care professionals.

作者信息

Lopes Marcos Thomazin, Koch Vera Hermina, Sarrubbi-Junior Vicente, Gallo Paulo Rogério, Carneiro-Sampaio Magda

机构信息

Pediatria, Instituto da Crianca, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, BR.

Saude Materno Infantil, Faculdade de Saude Publica, Universidade de São Paulo, Sao Paulo, SP, BR.

出版信息

Clinics (Sao Paulo). 2018;73:e68. doi: 10.6061/clinics/2018/e68. Epub 2018 Apr 5.

DOI:10.6061/clinics/2018/e68
PMID:29641803
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5866403/
Abstract

OBJECTIVES

The aim of this study is to present a survey of vulnerabilities and to suggest approaches for the treatment of rare diseases according to the perceptions of a group of affected individuals, patient association representatives and health care professionals.

METHODS

The focus group technique was used in interviews with patients and primary caregivers, patient support groups/non-governmental organizations, primary health care professionals and physician specialists.

RESULTS

The transcript analysis focused on thematic units, which were tailored to each group and allowed comparisons in search of concordant views. Unanimity was observed in relation to the physical, emotional and social damage to the life standards of the affected individuals and their families as a result of illness. The Brazilian health system was unanimously classified as inadequate to respond to the needs of patients with rare diseases, and this inadequacy led to unpleasant experiences, such as the seemingly endless referrals among health services to reach a final diagnosis and develop a treatment plan.

CONCLUSIONS

The complex set of health system requirements necessary to support the care of patients with rare diseases represents an obstacle to successfully meeting the needs of patients and their families. Therefore, it is important to develop specific public policies to create referral services, guarantee access to appropriate therapeutic modalities and incorporate technologies that promote research for developing new, affordable therapies.

摘要

目的

本研究旨在根据一组患者、患者协会代表和医疗保健专业人员的看法,对罕见病的脆弱性进行调查,并提出治疗方法。

方法

采用焦点小组技术对患者及其主要照顾者、患者支持团体/非政府组织、初级卫生保健专业人员和专科医生进行访谈。

结果

转录本分析聚焦于主题单元,这些主题单元针对每个群体进行了调整,以便进行比较以寻找一致的观点。大家一致认为,疾病给患者及其家庭的生活水平带来了身体、情感和社会方面的损害。巴西卫生系统被一致认为不足以满足罕见病患者的需求,这种不足导致了不愉快的经历,比如在卫生服务机构之间看似无休止的转诊,以最终确诊并制定治疗方案。

结论

支持罕见病患者护理所需的一系列复杂的卫生系统要求,是成功满足患者及其家庭需求的障碍。因此,制定具体的公共政策以建立转诊服务、确保获得适当的治疗方式并纳入促进研发新的、负担得起的疗法的技术非常重要。