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以患者为中心的慢性肾脏病患者自我管理:挑战与意义。

Patient-Centered Self-Management in Patients with Chronic Kidney Disease: Challenges and Implications.

机构信息

School of Nursing, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.

Department of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.

出版信息

Int J Environ Res Public Health. 2020 Dec 16;17(24):9443. doi: 10.3390/ijerph17249443.

Abstract

This review aims to identify attributes of patient-centered self-management (PCSM) in the current literature and explore its implementation in resolving patient obstacles in chronic kidney disease (CKD) treatment and management. A search of relevant articles and literature on PCSM, integrated care, and challenges of CKD management was conducted. Vital attributes of PCSM and current self-management interventions employed to resolve patient obstacles in CKD management were identified from inclusion studies. Findings affirm that PCSM strategies have positive effects on CKD management, but a lack of quality primary study, and long-term evidence presents the need for further development. Future research should focus on the development of a standardized and universal integrated PCSM model and a uniform system of data collection in the clinical setting. The difficulty of CKD management lies in how it is a comorbid and progressive disease. A pure biomedical approach is inadequate. Our review recommends that an integrated PCSM approach with health literacy and information technology intervention, which unifies and integrates patient education, can address the difficulties that are contributing to unsuccessful treatment outcomes. An integrated PCSM model should be implemented systematically and methodologically into future CKD management and health policies.

摘要

本文旨在识别当前文献中以患者为中心的自我管理(PCSM)的属性,并探讨其在解决慢性肾脏病(CKD)治疗和管理中患者障碍方面的应用。对 PCSM、综合护理以及 CKD 管理挑战的相关文章和文献进行了检索。从纳入的研究中确定了 PCSM 的重要属性以及当前用于解决 CKD 管理中患者障碍的自我管理干预措施。研究结果证实,PCSM 策略对 CKD 管理有积极影响,但由于缺乏高质量的原始研究和长期证据,仍需要进一步发展。未来的研究应侧重于开发标准化和通用的综合 PCSM 模型以及在临床环境中统一的数据收集系统。CKD 管理的难点在于它是一种共病和进行性疾病。单纯的生物医学方法是不够的。我们的综述建议采用健康素养和信息技术干预的综合 PCSM 方法,将患者教育统一和整合,以解决导致治疗效果不佳的困难。综合 PCSM 模型应系统地、有条理地纳入未来的 CKD 管理和卫生政策中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/317d/7766278/ff7b54477a8d/ijerph-17-09443-g001.jpg

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