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自然灾害期间基于社区的慢性病管理解决方案:一项系统综述。

Community-based solutions for chronic disease management during natural disasters: A systematic review.

作者信息

Iyer Aditi, Bookstein Arthur, Kim Giselle, Po Justine

机构信息

Department of Neuroscience, Duke University Trinity College of Arts & Sciences, Durham, North Carolina, United States of America.

Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America.

出版信息

PLOS Glob Public Health. 2025 Aug 1;5(8):e0004997. doi: 10.1371/journal.pgph.0004997. eCollection 2025.

Abstract

Despite rapid increases in both the burden of chronic disease and climate change-driven extreme weather events globally, the need to jointly address these crises remains largely overlooked. Chronic diseases require ongoing and often specialized care, which natural disasters disrupt by increasing physiological stressors and disrupting access to healthcare facilities, food, shelter and medications. Community-based solutions can mitigate these health risks, especially in low-resource settings and among historically underserved populations. This systematic review aimed to identify key recommendations for community-based interventions that aid with chronic disease management during extreme weather events. A comprehensive search strategy was used to yield 46 eligible studies from 266 search results from Embase, PubMed and Google Scholar. Articles were included if they discussed chronic diseases, community-based solutions and natural disasters and excluded if they were not English-language and/or not published in a peer-reviewed journal. Articles were assessed and selected using PRISMA guidelines, and their quality was assessed using the Joanna Briggs Institute Critical Appraisal Tools. The final sample of studies represented 19 countries and consisted of four quantitative, 35 qualitative and seven mixed-method studies. Minimal quantitative data was a key limitation of this review and topic, which requires further research. From the selected studies, a narrative synthesis approach was used to derive nine themes of solutions. Findings reflected the highest number of interventions and recommendations targeting patient education, continuity of medication management, stakeholder collaboration and digital health.

摘要

尽管全球慢性病负担和气候变化引发的极端天气事件都在迅速增加,但共同应对这些危机的必要性在很大程度上仍被忽视。慢性病需要持续且往往是专门的护理,而自然灾害会增加生理压力源并扰乱医疗设施、食物、住所和药物的获取,从而破坏这种护理。基于社区的解决方案可以减轻这些健康风险,尤其是在资源匮乏的环境以及历史上服务不足的人群中。本系统综述旨在确定在极端天气事件期间有助于慢性病管理的基于社区的干预措施的关键建议。采用了全面的检索策略,从Embase、PubMed和谷歌学术搜索结果中的266项研究中筛选出46项符合条件的研究。如果文章讨论了慢性病、基于社区的解决方案和自然灾害,则将其纳入;如果不是英文且未发表在同行评审期刊上,则将其排除。使用PRISMA指南对文章进行评估和筛选,并使用乔安娜·布里格斯研究所的批判性评估工具对其质量进行评估。最终的研究样本代表19个国家,包括四项定量研究、35项定性研究和七项混合方法研究。定量数据极少是本综述及该主题的一个关键局限,这需要进一步研究。从所选研究中,采用叙述性综合方法得出九个解决方案主题。研究结果反映出针对患者教育、药物管理连续性、利益相关者合作和数字健康的干预措施和建议数量最多。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b6c/12316207/b839af50ea3b/pgph.0004997.g001.jpg

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