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跨学科类风湿性关节炎研究与患者护理:类风湿性关节炎疾病体验的生物心理社会模型介绍与批判

Interdisciplinary Rheumatoid Arthritis Research and Patient Care: An Introduction and Critique of the Biopsychosocial Model of Disease Experience in Rheumatoid Arthritis.

作者信息

McGarrity-Yoder Maureen, Insel Kathleen, Crane Tracy, Pace Thaddeus

机构信息

College of Nursing, Northern Arizona University, Flagstaff, AZ, USA (MMY).

College of Nursing, The University of Arizona, Tucson, AZ, USA (KI, TP).

出版信息

Am J Lifestyle Med. 2024 Nov 11:15598276241298937. doi: 10.1177/15598276241298937.

Abstract

INTRODUCTION

Rheumatoid arthritis (RA), a debilitating autoimmune disease, affects approximately 78 million people globally. RA is often managed solely by rheumatology providers, but an interdisciplinary approach to RA may be the key to improving health equity and outcomes. An interdisciplinary model is an important step towards this goal. The Biopsychosocial Model of Disease Experience in RA (BDRA) is a conceptual approach that considers individual disease determinants in interdisciplinary research and care.

OBJECTIVE

To introduce and critique the evidence-based, interdisciplinary BDRA.

METHODS

Engel's Biopsychosocial Model of Health (BMH) and the Revised Symptom Management Conceptual Model (RSMCM) were blended in the BDRA. A literature search of articles published prior to December 2021 was completed using "disease exacerbation," "disease improvement," and "disease activity" in RA. Results were categorized as biological, psychological, and social determinants of disease activity in RA. These biopsychosocial factors alter biological function and result in the individual RA experience. Model development and critique were completed using guidelines established by Walker and Avant.

CONCLUSION

The BDRA is a visual depiction of RA biopsychosocial factors, disease activity, and individual experience. This model can guide interdisciplinary research and patient care, in efforts to improve RA health equity and rates of sustained remission.

摘要

引言

类风湿性关节炎(RA)是一种使人衰弱的自身免疫性疾病,全球约有7800万人受其影响。RA通常仅由风湿病专科医生进行管理,但采用跨学科方法治疗RA可能是改善健康公平性和治疗效果的关键。跨学科模式是朝着这一目标迈出的重要一步。类风湿性关节炎疾病体验的生物心理社会模型(BDRA)是一种概念性方法,在跨学科研究和护理中考虑个体疾病决定因素。

目的

介绍并批判基于证据的跨学科BDRA。

方法

恩格尔的健康生物心理社会模型(BMH)和修订后的症状管理概念模型(RSMCM)被融入BDRA。使用“疾病加重”“疾病改善”和“疾病活动”对2021年12月之前发表的关于RA的文章进行文献检索。结果被归类为RA疾病活动的生物、心理和社会决定因素。这些生物心理社会因素会改变生理功能,并导致个体的RA体验。模型的开发和批判是根据沃克和阿凡特制定的指南完成进行的。

结论

BDRA是RA生物心理社会因素、疾病活动和个体体验的直观描述。该模型可指导跨学科研究和患者护理,以提高RA的健康公平性和持续缓解率。

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