An Adapted Collaborative Care Model to Manage Co-morbidities of Depression and Chronic Non-Communicable Diseases in Rwanda

M. Mukeshimana, H. DeVon
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Abstract

BackgroundThe 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.PurposeThe purpose of this paper is to describe the process of adaptation and testing of the Collaborative Care Model in the Rwandan healthcare context.MethodsThe 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.ResultsFour 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.ConclusionsInitial evaluation of the Adapted Collaborative Care Model shows promise in Rwanda. Implementation of this model in other Rwandan districts is warranted.Rwanda J Med Health Sci 2023;6(2):154-160
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在卢旺达管理抑郁症和慢性非传染性疾病合并症的适应协作护理模式
背景世界卫生组织建议在所有国家实施协作护理模式,以管理抑郁症和慢性非传染性疾病的合并症。在卢旺达,抑郁症不仅是慢性病患者的主要问题,考虑到卢旺达独特的战争和种族灭绝历史,抑郁症也是普通民众的主要问题。目的本文的目的是描述在卢旺达医疗保健背景下协作护理模式的适应和测试过程。方法大研究采用行动研究设计,混合方法-序贯解释设计。采用研究-实践伙伴关系方法和迭代过程对协同护理模型进行调整和检验。采用定性含量分析法对数据进行分析。结果调整了模型的四个结构组成部分,包括在团队中增加一名注册护士,将模型迁移到地区一级,每3个月咨询一次精神科医生,以及社区卫生工作者的参与。评价结果表明,该模型是适用的、可接受的。对适应式协作式护理模式的初步评估显示,该模式在卢旺达大有前途。有必要在卢旺达其他地区实施这一模式。卢旺达医学卫生科学[J]; 2023;6(2):154-160
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