[Model of care for the treatment of patients with osteoarthritis from the first to the third level].

Acta ortopedica mexicana Pub Date : 2021-07-01
E Rodríguez-Skewes, M Á Quiñones-Díaz Terán, J Negrete-Corona, G Moralez-Xolalpa, J J Negrete-Camacho, D E Bello-Cárdenas, N Solano-Gutiérrez, Y Camacho-Ruíz, M E Rodríguez-Arellano, N L Martínez-Rodríguez, D X Cruz-Sánchez
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Abstract

Introduction: Osteoarthritis in Mexico is one of the ten most frequent causes of disability. Early diagnosis and detection of risk factors are determinant for treatment. The institutional organization establishes therapeutic guidelines according to each level of care, but effective management is not achieved.

Material and methods: A prospective, pilot, interventional, clinical study was conducted, which included patients diagnosed with different degrees of knee osteoarthritis in the first, second and third level of care, with an integrative model that includes a group of professionals for the intervention of nutritional, physiotherapeutic, social and psychological evaluation from the first level.

Results: The intervention of a multidisciplinary care group allows a correct evaluation and assignment of the level of care, optimizing human and material resources. The participation of different disciplines in nutrition, psychology, social work, physiotherapy and rehabilitation modifies the global lifestyle by involving the patients themselves in their treatment. The intervention group had improvements in the visual analog pain scale, mobility arcs, low body mass index and improvement in the psychological aspect.

Conclusions: The proposed model of care demonstrates that implementation in the institution and in each clinical care unit should be considered to improve outcomes.

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【骨性关节炎患者从一级到三级治疗护理模式】。
骨关节炎在墨西哥是十大最常见的致残原因之一。早期诊断和发现危险因素是治疗的决定性因素。机构组织根据每个级别的护理制定治疗指南,但没有实现有效的管理。材料与方法:前瞻性、先导性、干预性、临床研究,纳入一、二、三级诊断为不同程度膝关节骨性关节炎的患者,采用由一组专业人员从一级进行营养、理疗、社会、心理评价干预的综合模式。结果:多学科护理组的干预可以正确评估和分配护理水平,优化人力和物力资源。营养、心理学、社会工作、物理治疗和康复等不同学科的参与,通过让患者自己参与治疗,改变了全球的生活方式。干预组在视觉模拟疼痛量表、活动弧线、低体重指数和心理方面均有改善。结论:提出的护理模式表明,应考虑在机构和每个临床护理单位实施,以改善结果。
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