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挪威初级卫生保健中 COPD 患者综合性多学科肺康复的组织环境、内容和可及性如何:一项横断面研究。

How is the organisational settings, content and availability of comprehensive multidisciplinary pulmonary rehabilitation for people with COPD in primary healthcare in Norway: a cross-sectional study.

机构信息

Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway

Department of Physiotherapy, Haukeland University Hospital, Bergen, Norway.

出版信息

BMJ Open. 2022 Feb 17;12(2):e053503. doi: 10.1136/bmjopen-2021-053503.

Abstract

OBJECTIVE

To examine the organisational settings, content and availability of comprehensive multidisciplinary pulmonary rehabilitation (PR) programmes for people with chronic obstructive pulmonary disease (COPD) in primary healthcare in Norway.

DESIGN

This was a cross-sectional survey study examining the content, organisational settings and availability of comprehensive multidisciplinary PR for people with COPD.

SETTING AND PARTICIPANTS

When the survey was conducted, Norway had 436 municipalities/primary healthcare services who were invited to participate.

OUTCOME MEASURES

The main outcome was the question related to accessibility to a PR programme in primary healthcare. We also examined in what degree the single interventions which are a part of a PR programme were one of the municipalities services and if there were regional differences regarding PR.

RESULTS

Of the 436 municipalities, 158 answered the survey (36% response rate), and the survey covered for 45% of the total population in Norway. Five per cent of the responders reported having multidisciplinary PR for patients with COPD. The most frequently reported single interventions that can be a part of a multidisciplinary PR programme were reported as follows: group exercise training for all diagnoses (27%), reablement (25%) and home-care treatment by a physiotherapist and/or occupational therapist (24%). Southern-Eastern Norway had a significantly lower number of these interventions than Western Norway, Central Norway, and Northern Norway (p<0.001).

CONCLUSION

Only 5% of the Norwegian primary healthcare services (municipalities) had a multidisciplinary PR programme for patients with COPD. PR is the most important and cost-effective treatment within integrated care of patients with COPD. National strategies are therefore needed to increase the availability of PR for patients with COPD in Norwegian municipalities.

摘要

目的

调查挪威初级卫生保健中针对慢性阻塞性肺疾病(COPD)患者的综合多学科肺康复(PR)计划的组织环境、内容和可及性。

设计

这是一项横断面调查研究,调查了 COPD 患者综合多学科 PR 的内容、组织环境和可及性。

设置和参与者

在进行调查时,挪威有 436 个市/初级卫生保健服务机构受邀参加。

主要结果

主要结果是与初级卫生保健中 PR 计划的可及性相关的问题。我们还检查了作为 PR 计划一部分的单一干预措施在多大程度上是市服务的一部分,以及 PR 是否存在区域差异。

结果

在 436 个市中,有 158 个市回答了调查(回应率为 36%),调查涵盖了挪威总人口的 45%。5%的回应者报告说为 COPD 患者提供多学科 PR。最常报告的可作为多学科 PR 计划一部分的单一干预措施如下:针对所有诊断的团体运动训练(27%)、再能力建设(25%)以及物理治疗师和/或职业治疗师的家庭护理治疗(24%)。与西部、中部和北部挪威相比,东南挪威的这些干预措施数量明显较少(p<0.001)。

结论

挪威只有 5%的初级卫生保健服务机构(市)为 COPD 患者提供多学科 PR 计划。PR 是 COPD 患者综合护理中最重要和最具成本效益的治疗方法。因此,需要制定国家战略,增加挪威市 COPD 患者获得 PR 的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21ca/8860025/b6eb90d0472b/bmjopen-2021-053503f01.jpg

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