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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.

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。

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