Mukeshimana Madeleine, DeVon Holli A
School of Nursing and Midwifery, College of Medicine and Health Sciences,University of Rwanda, Kigali, Rwanda.
School of Nursing, University of California Los Angeles, United States.
Rwanda J Med Health Sci. 2023 Jul 31;6(2):154-160. doi: 10.4314/rjmhs.v6i2.6. eCollection 2023 Jul.
The World Health Organization has recommended the implementation of the Collaborative Care Model in all countries to manage the comorbidities of depression and chronic non-communicable diseases. In Rwanda depression is major problem not only among patients with chronic illnesses but also in general population considering the unique history of war and genocide in Rwanda.
The purpose of this paper is to describe the process of adaptation and testing of the Collaborative Care Model in the Rwandan healthcare context.
The larger study used the Action Research design with mixed method -sequential explanatory design. A research-practice partnership method and an iterative process was used to adapt and test the Collaborative Care Model. Qualitative content analysis was used to analyse the data.
Four structural components to the model were adapted including the addition of a registered nurse to the team, relocation of the model to the district level, consultation with a psychiatrist every 3 months and involvement of community health workers. The evaluation indicated that the model was applicable and acceptable.
Initial evaluation of the Adapted Collaborative Care Model shows promise in Rwanda. Implementation of this model in other Rwandan districts is warranted.
世界卫生组织建议各国实施协作护理模式，以管理抑郁症和慢性非传染性疾病的合并症。在卢旺达，考虑到该国独特的战争和种族灭绝历史，抑郁症不仅是慢性病患者中的主要问题，也是普通人群中的主要问题。
本文旨在描述协作护理模式在卢旺达医疗环境中的适应和测试过程。
更大规模的研究采用了行动研究设计，采用混合方法——顺序解释性设计。采用研究-实践伙伴关系方法和迭代过程来适应和测试协作护理模式。使用定性内容分析法对数据进行分析。
该模式的四个结构组成部分得到了调整，包括在团队中增加一名注册护士、将模式转移到地区层面、每3个月与精神科医生会诊一次以及让社区卫生工作者参与。评估表明该模式是适用且可接受的。
对适应性协作护理模式的初步评估在卢旺达显示出前景。有必要在卢旺达其他地区实施该模式。
