Faculty of Medicine and Health Sciences, Research Centre of the CHUS, University of Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada.
Department for Noncommunicable Diseases, World Health Organization, Geneva, Switzerland.
Bull World Health Organ. 2022 Nov 1;100(11):676-688. doi: 10.2471/BLT.22.288105. Epub 2022 Oct 3.
To systematically map the current evidence about the characteristics of health systems, providers and patients to design rehabilitation care for post coronavirus disease 2019 (COVID-19) condition.
We conducted a scoping review by searching the databases: MEDLINE®, Embase®, Web of Science, Cochrane COVID-19 Registry and Cochrane Central Register of Controlled Trials, from inception to 22 April 2022. The search strategy included terms related to (i) post COVID-19 condition and other currently known terminologies; (ii) care models and pathways; and (iii) rehabilitation. We applied no language or study design restrictions. Two pairs of researchers independently screened title, abstracts and full-text articles and extracted data. We charted the evidence according to five topics: (i) care model components and functions; (ii) safe delivery of rehabilitation; (iii) referral principles; (iv) service delivery settings; and (v) health-care professionals.
We screened 13 753 titles and abstracts, read 154 full-text articles, and included 37 articles. The current evidence is conceptual and expert based. Care model components included multidisciplinary teams, continuity or coordination of care, people-centred care and shared decision-making between clinicians and patients. Care model functions included standardized symptoms assessment, telehealth and virtual care and follow-up system. Rehabilitation services were integrated at all levels of a health system from primary care to tertiary hospital-based care. Health-care workers delivering services within a multidisciplinary team included mostly physiotherapists, occupational therapists and psychologists.
Key policy messages include implementing a multilevel and multiprofessional model; leveraging country health systems' strengths and learning from other conditions; financing rehabilitation research providing standardized outcomes; and guidance to increase patient safety.
系统绘制当前有关卫生系统、提供者和患者特征的证据，以设计针对新冠肺炎（COVID-19）后疾病的康复护理。
我们对 MEDLINE®、Embase®、Web of Science、Cochrane COVID-19 注册中心和 Cochrane 对照试验中心数据库进行了范围综述，检索时间从建库至 2022 年 4 月 22 日。检索策略包括与以下内容相关的术语：（i）新冠肺炎后疾病和其他当前已知术语；（ii）护理模式和途径；以及（iii）康复。我们没有对语言或研究设计进行限制。两对研究人员独立筛选标题、摘要和全文文章并提取数据。我们根据五个主题对证据进行图表绘制：（i）护理模式组成部分和功能；（ii）康复的安全提供；（iii）转诊原则；（iv）服务提供环境；以及（v）卫生保健专业人员。
我们筛选了 13753 篇标题和摘要，阅读了 154 篇全文文章，并纳入了 37 篇文章。目前的证据是基于概念和专家意见的。护理模式组成部分包括多学科团队、护理的连续性或协调性、以患者为中心的护理以及临床医生和患者之间的共同决策。护理模式功能包括标准化症状评估、远程医疗和虚拟护理以及随访系统。康复服务整合在从初级保健到三级医院的卫生系统各个层面。在多学科团队中提供服务的卫生保健工作者主要包括物理治疗师、职业治疗师和心理学家。
关键政策信息包括实施多层次多专业模式；利用国家卫生系统的优势并借鉴其他疾病的经验；为提供标准化结果的康复研究提供资金；以及指导以提高患者安全性。
