Mayo Chantel D, Farzam-Kia Negar, Ghahari Setareh
Int J MS Care. 2021 Jan-Feb;23(1):37-44. doi: 10.7224/1537-2073.2020-026. Epub 2021 Feb 23.
The symptoms of multiple sclerosis (MS) can be diverse, complex, and progressive, creating a need for frequent and long-standing health care services. The purpose of this scoping review was to identify the barriers people with MS encounter when attempting to access multidisciplinary health services and the reported facilitators for better access to health services.
The MEDLINE, Embase, and CINAHL databases were searched, without date or geographic restrictions, using the following terms: and . After screening based on exclusion criteria, 23 articles were included in the final review.
Five main themes were identified as barriers and facilitators to accessing health services: 1) information (information available to people with MS, health care provider knowledge of and familiarity with MS), 2) interactions (interactions between health care providers and people with MS, social networks and support of people with MS, collaboration among health care providers), 3) beliefs and skills (personal values and beliefs, perceived time to travel to and attend appointments, and self-assessment of symptoms and needs of people with MS), 4) practical considerations (wait times, physical barriers, affordability of services), and 5) nature of MS (complexity and unpredictability of disease symptoms).
People with MS and their health care providers may benefit from structured and comprehensive MS-specific education to address barriers to accessing health care services. The education can ultimately facilitate the process of addressing unmet health care needs and contribute to a greater quality of life for people with MS.
多发性硬化症（MS）的症状可能多种多样、复杂且呈进行性发展，这就需要频繁且长期的医疗保健服务。本范围综述的目的是确定MS患者在尝试获得多学科医疗服务时遇到的障碍，以及报告的有助于更好获得医疗服务的因素。
对MEDLINE、Embase和CINAHL数据库进行检索，不受日期或地理限制，使用以下检索词：[具体检索词缺失]。根据排除标准进行筛选后，最终纳入综述的文章有23篇。
确定了五个主要主题作为获得医疗服务的障碍和促进因素：1）信息（MS患者可获得的信息、医疗保健提供者对MS的了解和熟悉程度），2）互动（医疗保健提供者与MS患者之间的互动、MS患者的社交网络和支持、医疗保健提供者之间的协作），3）信念和技能（个人价值观和信念、前往就诊和参加预约的感知时间、MS患者对症状和需求的自我评估），4）实际考虑因素（等待时间、身体障碍、服务的可承受性），5）MS的性质（疾病症状的复杂性和不可预测性）。
MS患者及其医疗保健提供者可能会从结构化且全面的特定于MS的教育中受益，以解决获得医疗保健服务的障碍。这种教育最终可以促进满足未满足的医疗保健需求的过程，并有助于提高MS患者的生活质量。
