以人为本的精神和合并症护理计划和共同决策

H. Millar, I. Salloum
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引用次数: 1

摘要

鉴于精神疾病人群中身体合并症日益流行的挑战,以人为中心的协调护理的发展至关重要。由于合并症,特别是心血管疾病造成的过多死亡,继续导致有精神健康问题的人的预期寿命大幅缩短。当代的和提出的模型现在可以为这一领域的前进道路提供证据。现在已经制定了实施以人为中心的护理计划的实用指南,以促进一种更加协作和综合的方法,作为解决目前以单一疾病为重点的护理模式的办法,这种模式正在使这一患者群体失败。世卫组织的观点支持这一战略,最近的全球目标概述了应对合并症的主动和预防性战略和干预措施。重点是改造现有系统,采用循证方法,加强整合,以支持为精神障碍和其他共病慢性疾病患者提供更有效和高效的护理。协调、协作、全系统战略包括在预防、早期干预、治疗选择、生活方式管理和药理学合理化方面透明的共同决策。因此,需要采取紧急行动,帮助创造条件,让委托机构、临床医生、患者群体以及自愿提供者和其他社区提供者参与进来,以便在卫生保健系统中提供以人为本的协调护理。当代的合并症护理模式强调,从精神健康问题患者开始治疗起,协调身体健康管理的重要性,以确保更好的结果,改善整体健康状况,延长预期寿命。举例来说,没有更多的资金可用于在英国实施这种护理模式的转变,因此重新设计和重新分配现有资源将是促进这种更加无缝协调的护理系统的关键,以提高这一人口的生活质量和预期寿命。
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PERSON-CENTERED CARE PLANNING AND SHARED DECISION MAKING FOR MENTAL AND COMORBID CONDITIONS
Developments in person-centered coordinated care are essential given the challenges of the growing epidemic of physical comorbidity in the mentally ill population. Excessive deaths due to comorbidity, especially cardiovascular disease, continue to contribute to the significant reduction in life expectancy in people with mental health problems.Contemporary and proposed models are now available to provide evidence for a way forward in this field. Practical guidance on implementation using person-centered care planning has now been developed to promote a more collaborative and integrated approach as a solution to the current single disease focused model of care, which is failing this patient group. The WHO perspective supports this strategy with the recent global objectives outlining proactive and preventative strategies and interventions to tackle comorbidity. The emphasis is on a transformation of current systems using evidence-based approaches for more integration to support the delivery of more effective and efficient care for those with mental disorders and other comorbid chronic diseases.Coordinated, collaborative, system-wide strategies encompass transparent shared decision making in prevention, early intervention, treatment options, lifestyle management and pharmacological rationalization. Hence urgent action is required to help create the conditions to enable the delivery of person-centered coordinated care in health care systems by involving commissioning bodies, clinicians, patient groups along with voluntary and other community providers.Contemporary models of care for comorbidity emphasize the importance of coordination in the management of physical well-being from the onset of treatment of people with mental health problems in order to ensure better outcomes, improved overall well-being, and a longer life expectancy. Illustratively, no further funds are available to implement this shift in the model of care in the United Kingdom, so redesign and redistribution of current resources will be key to promote this more seamless coordinated system of care to improve the quality of life and life expectancy for this population.
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PERSON-CENTERED CARE PLANNING AND SHARED DECISION MAKING FOR MENTAL AND COMORBID CONDITIONS REPORT OF THE FIRST PERUVIAN CONFERENCE ON PERSON-CENTERED MEDICINE SHARED DECISION MAKING FOR OTHER GENERAL CONDITIONS INTERPROFESSIONAL COLLABORATION FOR PERSON-CENTERED CARE SHARED DECISION MAKING IN ONCOLOGY AND PALLIATIVE CARE
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