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新冠疫情期间的急诊与基层医疗协作:快速综述的系统评价

Emergency and primary care collaboration during COVID-19 pandemic: A quick systematic review of reviews.

作者信息

Kumar Raman, Nedungalaparambil Nisanth Menon, Mohanan Nithya

机构信息

World Organization of Family Doctors South Asia Region, Ghaziabad, Uttar Pradesh, India.

Department of Emergency Medicine, AIMS, Thrissur, Kerala, India.

出版信息

J Family Med Prim Care. 2020 Aug 25;9(8):3856-3862. doi: 10.4103/jfmpc.jfmpc_755_20. eCollection 2020 Aug.

Abstract

COVID-19 is one of the deadliest viral infections to have hit the planet. There is urgent need to bridge the gaps in handling this pandemic by methodically synthesising available literature through a unique holistic perspective. A systematic review of articles regarding emergency and primary care during COVID-19 pandemic was carried out. PubMed, Scopus, Science Direct, Web of Science, and Google Scholar were screened for articles and qualitative data across various studies were coded and thematically analyzed. Narrative synthesis was achieved by themes identified from findings of studies. Out of = 953 articles retrieved, we identified and critically appraised = 7 articles of which = 5 were narrative reviews, one was systematic review and one was scoping review from researchers across ten countries. Nine overlapping themes were identified under three broad domains - clinical understanding of the disease, social aspects of the disease, and its contextual implications during pandemic. This narrative synthesis draws up a holistic picture of recent reviews on clinical and social understanding of COVID-19 as a disease and as a pandemic. The overlap among nine themes identified in this review could mean that primary care-level screening, triaging, referral, and emergency care of COVID-19 patients in the backdrop of current clinical understanding of the pandemic are all intertwined. Coping with COVID-19 co-habitation and managing undifferentiated illnesses require a syndromic approach and deft handling at grass root levels. Inclusive health policy empowering inherent holistic specialties like family medicine and emergency medicine could be the prudent way forward during this pandemic.

摘要

新冠病毒病是全球最致命的病毒感染之一。迫切需要通过独特的整体视角,系统地综合现有文献,以弥合应对这一疫情的差距。我们对新冠病毒病大流行期间有关急诊和初级保健的文章进行了系统综述。在PubMed、Scopus、科学Direct、科学网和谷歌学术中筛选文章,并对各项研究中的定性数据进行编码和主题分析。通过研究结果确定的主题进行叙述性综合。在检索到的953篇文章中,我们识别并严格评估了7篇文章,其中5篇是叙述性综述,1篇是系统综述,1篇是来自十个国家研究人员的范围综述。在三个广泛领域下确定了九个重叠主题——对该疾病的临床认识、该疾病的社会层面及其在大流行期间的背景影响。这一叙述性综合勾勒出了近期关于将新冠病毒病作为一种疾病和一场大流行的临床和社会认识的综述的全貌。本综述中确定的九个主题之间的重叠可能意味着,在当前对大流行的临床认识背景下,新冠病毒病患者的初级保健层面筛查、分诊、转诊和急诊护理都是相互交织的。应对新冠病毒病同居情况和处理未分化疾病需要一种综合征方法和基层的灵活处理。在这场大流行期间,赋予家庭医学和急诊医学等固有整体专业权力的包容性卫生政策可能是审慎的前进方向。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f49a/7586530/9a1c140efc30/JFMPC-9-3856-g001.jpg

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