Aye Yin Minn, Liew Sylvia, Neo Shermyn Xiumin, Li Wei, Ng Hwee-Lan, Chua Shu-Ting, Zhou Wen-Tao, Au Wing-Lok, Tan Eng-King, Tay Kay-Yaw, Tan Louis Chew-Seng, Xu Zheyu
Department of Neurology, National Neuroscience Institute, Singapore, Singapore.
Parkinson Disease and Movement Disorders Centre, Parkinson Foundation Centre of Excellence, National Neuroscience Institute, Singapore, Singapore.
Front Neurol. 2020 Jun 9;11:502. doi: 10.3389/fneur.2020.00502. eCollection 2020.
Parkinson's disease (PD) is a chronic neurodegenerative disease with complex motor and non-motor symptoms often leading to significant caregiver burden. An integrated, multidisciplinary care setup involving different healthcare professionals is the mainstay in the holistic management of PD. Many challenges in delivering multidisciplinary team (MDT) care exist, such as insufficient expertise among different healthcare professionals, poor interdisciplinary collaboration, and communication. The need to attend different clinics, incurring additional traveling and waiting time for allied health therapies can also make MDT care more burdensome. By shifting MDT care to local community settings and into patients' homes, patient-centered care can be achieved. In Singapore, the National Neuroscience Institute created the Community Care Partners Programme in 2007 to bring the allied MDT team to the community and nurse-led Integrated Community Care Programme for Parkinson's Disease in 2012 to provide care in community and at patient's home. However, attaining MDT care in the community setting is difficult to achieve where there is a shortage of PD-trained professionals. As such, interdisciplinary and transdisciplinary management would be other best practice options to deliver patient-centric care in PD. Telemedicine could be another viable option to bring the MDT closer to the patient.
帕金森病(PD)是一种慢性神经退行性疾病,伴有复杂的运动和非运动症状,常常给照料者带来沉重负担。由不同医疗保健专业人员组成的综合多学科护理模式是帕金森病整体管理的支柱。在提供多学科团队(MDT)护理方面存在诸多挑战,例如不同医疗保健专业人员专业知识不足、跨学科协作和沟通不佳。需要前往不同诊所,接受联合健康治疗时还要额外花费出行和等待时间,这也会使多学科团队护理更加繁重。通过将多学科团队护理转移到当地社区环境并深入患者家中,可以实现以患者为中心的护理。在新加坡,国家神经科学研究所于2007年设立了社区护理伙伴计划,将联合多学科团队带到社区,并于2012年推出了由护士主导的帕金森病综合社区护理计划,在社区和患者家中提供护理。然而,在缺乏经过帕金森病培训的专业人员的地方,很难在社区环境中实现多学科团队护理。因此,跨学科和跨专业管理将是在帕金森病中提供以患者为中心护理的其他最佳实践选择。远程医疗可能是使多学科团队更贴近患者的另一个可行选择。