Barretto Maria, D'souza Nicole
Parkinson's Disease and Movement Disorder Society, Mumbai, Maharashtra, India.
Ann Indian Acad Neurol. 2023 Jul-Aug;26(4):387-394. doi: 10.4103/aian.aian_366_23. Epub 2023 Jul 28.
Given the rise in the elderly population and predicted increase in age-related diseases like Parkinson's disease, as well as the treatment gaps in Low-and-Middle-Income Countries (LMICs), there is an urgent need to develop a culturally and socioeconomically viable Parkinson's model of care that would be multidisciplinary, replicable, affordable, and accessible to those who need it the most. We present here an outline of a rehabilitation model of care, which incorporates a standardized group therapy format, community-based Parkinson's Support Centers, collaboration with local stakeholders to ensure sustainability, and active engagement of People with Parkinson's (PwPs) and caregivers (CGs) in rehabilitation programs. This model of care incorporates a unique 16-session multi-disciplinary community rehabilitation module for PwPs and CGs which is evidence-based, easily deliverable by non-medical facilitators, relevant to PwPs and CGs, adaptable to different groups, practical and beneficial, and effective in a group - format. This rehabilitation model of care, encompassing the multidisciplinary rehabilitation module, holds promise for implementation in LMICs due to its dynamic nature, cost-effectiveness, community-based approach and easy adaptability to telehealth platforms. We share our experience of developing the model and outline implications for practice and insights about community rehabilitation work in LMICs.
鉴于老年人口的增加以及帕金森病等与年龄相关疾病预计的增长,再加上低收入和中等收入国家(LMICs)存在治疗差距,迫切需要开发一种在文化和社会经济方面可行的帕金森病护理模式,该模式应具备多学科性、可复制性、可负担性,并能让最需要的人获得。我们在此介绍一种康复护理模式的概述,该模式纳入了标准化的团体治疗形式、基于社区的帕金森病支持中心、与当地利益相关者合作以确保可持续性,以及帕金森病患者(PwPs)和护理人员(CGs)积极参与康复计划。这种护理模式为PwPs和CGs纳入了一个独特的为期16节的多学科社区康复模块,该模块基于证据,非医学促进者易于实施,与PwPs和CGs相关,可适应不同群体,实用且有益,并且以团体形式有效。这种康复护理模式包括多学科康复模块,由于其动态性质、成本效益、基于社区的方法以及易于适应远程医疗平台,有望在LMICs中实施。我们分享了开发该模式的经验,并概述了对实践的影响以及对LMICs社区康复工作的见解。