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Abstract：
Rationale: There is a need for medicine to deliver more whole-person care. This is a narrative review of several models of whole-person care and studies that illustrate the business case for whole-person models in primary care. Objectives: To provide an overview of what whole-person care models exist and explore evidence to support these models. Study Selection: Representative whole-person care models widely used in the United States are summarized and evaluated. Selected studies focused on outpatient primary care with examples from programs that integrate the delivery of conventional medical care, complementary and alternative medicine, and self-care within the context of social and cultural environments. Methods: Pubmed search conducted December 2020-February 2021. Two iterative searches using terms for \"Whole Health Veterans Administration,\" \"integrative medicine,\" \"integrative health,\" \"complementary and alternative medicine,\" and, as they related to the outcomes, of \"health outcomes,\" \"cost-effectiveness,\" \"cost reduction,\" \"patient satisfaction,\" and \"physician satisfaction.\" Additional studies were identified from an initial search and the authors\' experience of over 50 years. We looked for studies of whole-person care used in general primary care, those not using a single modality and only from United States practices. Results: A total of 125 (out of 1746) studies were found and met our inclusion criteria. We found that whole-person models of primary care exist, are quite heterogeneous in their approaches, and routinely report substantial benefits for improving the patient experience, clinical outcomes and in reducing costs. Conclusions: Evidence for the benefit of whole-person care models exist but definitions are quite heterogenous and unfocused. There is a need for more standardization of whole-person models and more research using whole systems approaches rather than reductionistic attempts using isolated components.
摘要：
理由：需要药物来提供更多的全人护理。这是对全人护理的几种模型的叙述性回顾，并说明了初级护理中全人模型的商业案例。目标：概述存在哪些全人护理模式，并探索支持这些模式的证据。研究选择：总结和评估在美国广泛使用的代表性全人护理模式。选定的研究重点是门诊初级保健，其中包括整合常规医疗服务的计划，补充和替代医学，以及在社会和文化环境中的自我照顾。方法：2020年12月至2021年2月进行Pubmed搜索。使用“全健康退伍军人管理局”的术语进行两次迭代搜索，“”综合医学，综合健康，补充和替代医学，\"和,因为它们与结果相关，“健康结果，“成本效益”，“降低成本”，“\”患者满意度，“和”医生满意度。“从最初的搜索和作者超过50年的经验中确定了其他研究。我们寻找一般初级保健中使用的全人护理的研究，那些不使用单一模式，只来自美国的做法。结果：共找到125项（1746项）研究，符合我们的纳入标准。我们发现存在全人初级保健模式，他们的方法相当不同，并定期报告改善患者体验的实质性好处，临床结果和降低成本。结论：存在有利于全人护理模式的证据，但定义非常异质且没有重点。需要更多的全人模型的标准化和更多的研究使用整个系统的方法，而不是使用隔离组件的简化尝试。
