Araja Diana, Krumina Angelika, Nora-Krukle Zaiga, Schneider Marion E, Berkis Uldis, Murovska Modra
Institute of Microbiology and Virology, Riga Stradins University, Riga, Latvia.
Department of Infectology, Riga Stradins University, Riga, Latvia.
Front Neurosci. 2023 Jul 21;17:1202930. doi: 10.3389/fnins.2023.1202930. eCollection 2023.
Theoretical and empirical studies discover that an integrative approach is particularly important in chronic disorders and multiple long-term conditions, such as chronic fatigue. Chronic fatigue syndrome (CFS) is a classic example of a potentially severe, multisystemic illness with a wide diversity of symptoms and the corresponding diagnostic complexity. The prevalence of CFS-like syndromes expanded in the context of the COVID-19 pandemic, increasing the disorder and treatment burden. Thus, this article aimed to draw attention to the possibilities to strengthen the integrative approach to diagnosing and treating chronic disorders and multiple long-term conditions. The main critical success factors identified for integrative approaches were: a holistic approach, that provides a more comprehensive diagnostic and personalized treatment strategy, a multidisciplinary team, and patient engagement. The strengths and weaknesses of these factors were explored and coaching was identified as a potential unifying and reinforcing element. Coaching has a wide spectrum of manifestations clearly representing a holistic approach, that has been successfully used in multidisciplinary team building. Moreover, coaching exposes support addressing the patient engagement issues identified by the Patient Needs-Resources Model (PN-R Model) such as low levels of self-efficacy, optimism, and subjective well-being. Coaching may assist patients to identify and prioritize their goals, becoming aware of their personal resources, developing strategies for managing symptoms, and building skills to increase their self-efficacy and active engagement in the treatment process. Therefore, the authors emphasize coaching as a perspective element of optimization of patient care, that requires additional theoretical and long-term empirical research.
理论和实证研究发现，综合方法在慢性疾病和多种长期病症（如慢性疲劳）中尤为重要。慢性疲劳综合征（CFS）是一种典型的潜在严重多系统疾病，症状多样，诊断复杂。在新冠疫情背景下，类似慢性疲劳综合征的病症患病率有所上升，增加了疾病负担和治疗负担。因此，本文旨在提请关注加强慢性疾病和多种长期病症诊断与治疗综合方法的可能性。确定的综合方法的主要关键成功因素包括：整体方法，可提供更全面的诊断和个性化治疗策略；多学科团队；以及患者参与。探讨了这些因素的优缺点，并确定辅导是一个潜在的统一和强化要素。辅导有广泛的表现形式，清楚地代表了一种整体方法，已成功用于多学科团队建设。此外，辅导提供的支持解决了患者需求-资源模型（PN-R模型）所确定的患者参与问题，如自我效能感、乐观情绪和主观幸福感水平较低。辅导可帮助患者确定目标并确定其优先级，了解自身的个人资源，制定管理症状的策略，以及培养提高自我效能感和积极参与治疗过程的技能。因此，作者强调辅导是优化患者护理的一个重要因素，这需要更多的理论和长期实证研究。
