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加强全科医疗中长新冠的管理:一项范围综述

Enhancing the management of long COVID in general practice: a scoping review.

作者信息

Brennan Aimee, Broughan John, McCombe Geoff, Brennan John, Collins Claire, Fawsitt Ronan, Gallagher Joe, Guérandel Allys, O'Kelly Brendan, Quinlan Diarmuid, Lambert John S, Cullen Walter

机构信息

School of Medicine, University College Dublin, Dublin, Ireland.

School of Medicine, University College Dublin, Dublin, Ireland

出版信息

BJGP Open. 2022 Sep 28;6(3). doi: 10.3399/BJGPO.2021.0178. Print 2022 Sep.

Abstract

BACKGROUND

Long COVID is a multifaceted condition, and it has impacted a considerable proportion of those with acute COVID-19. Affected patients often have complex care needs requiring holistic and multidisciplinary care, the kind routinely provided in general practice. However, there is limited evidence regarding GP interventions.

AIM

This study aimed to identify key concepts and knowledge gaps around long COVID by conducting a scoping review of literature on the condition's management by GPs.

DESIGN & SETTING: Arksey and O'Malley's six-stage scoping review framework, with recommendations by Levac , was used.

METHOD

PubMed, Google Scholar, the Cochrane Library, Scopus, and Google searches were conducted to identify relevant peer reviewed and grey literature, and study selection process was conducted according to the PRISMA Extension for Scoping Reviews guidelines. Braun and Clarke's 'Thematic Analysis' approach was used to interpret data.

RESULTS

Nineteen of 972 identified articles were selected for review. These included peer reviewed articles and grey literature spanning a wide range of countries. Six themes were identified regarding GP management of long COVID, these being: (1) GP uncertainty, (2) listening and empathy, (3) assessment and monitoring of symptoms, (4) coordinating access to appropriate services, (5) facilitating provision of continual and integrated multidisciplinary care and (6) need to provide or facilitate psychological support.

CONCLUSION

The findings show that GPs can play and have played a key role in the management of long COVID, and that patient care can be improved through better understanding of patient experiences, standardised approaches for symptom identification and treatment, and facilitation of access to multidisciplinary specialist services when needed. Future research evaluating focused GP interventions is needed.

摘要

背景

长期新冠是一种多方面的病症,它影响了相当比例的急性新冠患者。受影响的患者通常有复杂的护理需求,需要全面的多学科护理,这是全科医疗中常规提供的护理类型。然而,关于全科医生干预措施的证据有限。

目的

本研究旨在通过对全科医生对该病症管理的文献进行范围综述,确定围绕长期新冠的关键概念和知识空白。

设计与背景

采用了阿克西和奥马利的六阶段范围综述框架,并参考了莱瓦克的建议。

方法

通过PubMed、谷歌学术、考克兰图书馆、Scopus和谷歌进行搜索,以识别相关的同行评审文献和灰色文献,并根据范围综述的PRISMA扩展指南进行研究选择过程。采用布劳恩和克拉克的“主题分析”方法来解释数据。

结果

从972篇已识别的文章中选出19篇进行综述。这些文章包括来自广泛国家的同行评审文章和灰色文献。确定了关于全科医生对长期新冠管理的六个主题,分别是:(1)全科医生的不确定性,(2)倾听与同理心,(3)症状评估与监测,(4)协调获得适当服务,(5)促进提供持续和综合的多学科护理,以及(6)提供或促进心理支持的必要性。

结论

研究结果表明,全科医生在长期新冠的管理中可以并且已经发挥了关键作用,通过更好地理解患者经历、采用标准化的症状识别和治疗方法以及在需要时促进获得多学科专科服务,可以改善患者护理。未来需要开展评估针对性全科医生干预措施的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82f0/9680752/d9beee8122d3/bjgpopen-6-0178-f1.jpg

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