Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Faculty of Medicine and Health Sciences, Institute of Sport and Exercise Medicine, Stellenbosch University, Cape Town, South Africa.
Glob Heart. 2024 Oct 7;19(1):76. doi: 10.5334/gh.1360. eCollection 2024.
As the burden of chronic disease and multiple long-term conditions is increasing globally, disproportionally affecting those in low-resourced settings, there is an increasing call to action to scale effective models of care that can assist in mitigating the impact of chronic disease on functioning, activity, societal participation, and health-related quality of life. The aim of this paper is to unpack the contextual factors that have been implicitly and explicitly voiced by researchers reporting on rehabilitation interventions used to manage chronic disease in low-resourced settings. We systematically engaged the literature and applied a reflexive qualitative and systems thinking lens to unpack the contextual factors and their interplay. A total of 40 different contextual factors were derived through an iterative analysis of 144 eligible articles. The identified factors could be packaged into nine system elements or subsystems relevant to the scale-up of rehabilitation for people with chronic disease. The complexity identified encourages a focus on innovative and intersectoral approaches to address the rehabilitation needs in low-resourced settings.
随着慢性病和多种长期疾病负担在全球范围内的不断增加，对资源匮乏环境中的人群造成了不成比例的影响，因此越来越需要采取行动，推广有效的护理模式，以减轻慢性病对功能、活动、社会参与和健康相关生活质量的影响。本文旨在剖析研究报告中隐含和明确提到的与在资源匮乏环境中管理慢性病相关的康复干预措施的背景因素。我们系统地查阅文献，并采用反思性定性和系统思维视角来剖析背景因素及其相互作用。通过对 144 篇合格文章的迭代分析，共得出 40 个不同的背景因素。确定的因素可以整合到与慢性病患者康复推广相关的九个系统要素或子系统中。所识别出的复杂性鼓励关注创新和跨部门方法，以满足资源匮乏环境中的康复需求。
