Wieringa Thomas H, Sanchez-Herrera Manuel F, Espinoza Nataly R, Tran Viet-Thi, Boehmer Kasey
Department of Medical Psychology, Amsterdam UMC, Amsterdam, Netherlands.
Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, United States.
J Particip Med. 2020 Mar 25;12(1):e13763. doi: 10.2196/13763.
About 42% of adults have one or more chronic conditions and 23% have multiple chronic conditions. The coordination and integration of services for the management of patients living with multimorbidity is important for care to be efficient, safe, and less burdensome. Minimally disruptive medicine may optimize this coordination and integration. It is a patient-centered approach to care that focuses on achieving patient goals for life and health by seeking care strategies that fit a patient's context and are minimally disruptive and maximally supportive. The cumulative complexity model practically orients minimally disruptive medicine-based care. In this model, the patient workload-capacity imbalance is the central mechanism driving patient complexity. These elements should be accounted for when making decisions for patients with chronic conditions. Therefore, in addition to decision aids, which may guide shared decision making, we propose to discuss and clarify a potential workload-capacity imbalance.
约42%的成年人患有一种或多种慢性病，23%的成年人患有多种慢性病。对患有多种疾病的患者进行管理的服务协调与整合，对于实现高效、安全且负担较小的护理至关重要。微干扰医学可优化这种协调与整合。它是以患者为中心的护理方法，通过寻求适合患者情况、干扰最小且支持最大的护理策略，致力于实现患者的生活和健康目标。累积复杂性模型为基于微干扰医学的护理提供了实际指导方向。在该模型中，患者工作量与能力的失衡是驱动患者复杂性的核心机制。在为慢性病患者做决策时应考虑这些因素。因此，除了可能指导共同决策的决策辅助工具外，我们建议讨论并阐明潜在的工作量与能力失衡问题。
