integrative health

综合保健
  • 文章类型: Journal Article
    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。
    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.
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  • 文章类型: Journal Article
    综合医疗保健和补充医学被美国人口广泛使用,然而,健康专业学习者通常没有接受足够的教育来指导患者使用这些方法。这种跨专业的标准化患者锻炼(ISPE)为学习者提供了讨论各种医疗保健专业人员在照顾对综合健康策略感兴趣的患者方面的角色的机会。并合作制定护理计划。利用这种ISPE格式符合综合健康的原则,因为它需要跨专业合作来满足患者的多方面需求。
    ISPE的持续时间约为三小时,所有UCSF都需要,第三年牙科,物理治疗,和医学生;二年级护士生,和药学四年级学生。社会工作,营养,牧师的学员也参加了。在4-5名学习者的跨专业团队中工作,团队成员讨论案例信息,单独采访标准化患者(SP),共同制定护理计划,and,与SP讨论该计划。向主持人汇报了经验。
    在2016-17年,520名学习者参加了ISPE。他们一致认为,他们了解了其他医疗保健专业人员的角色(M=5.24,以六点为量表,SD=1.27),并且他们会向其专业的同学推荐ISPE(M=5.25,SD=1.30)。
    学生们欣赏观察来自其他健康专业的学习者与SP互动的能力,以及如何整合不同的观点和专业知识以创建全面的护理计划。该练习可以适应当地卫生专业学习者。
    Integrative health care and complementary medicine are widely used by the U.S. population, yet health professions learners are typically inadequately educated to counsel patients on the use of these approaches. This interprofessional standardized patient exercise (ISPE) provides learners the opportunity to discuss various health care professionals\' roles in caring for a patient interested in integrative health strategies, and to collaborate on a care plan. Utilizing this ISPE format aligns with the principles of integrative health as it requires interprofessional collaboration to address the multifaceted needs of patients.
    The ISPE is approximately three hours in duration, and required of all UCSF, third-year dentistry, physical therapy, and medical students; second-year nurse practitioner students, and fourth-year pharmacy students. Social work, nutrition, and chaplain trainees also participated. Working in interprofessional teams of 4-5 learners, team members discuss case information, interview the standardized patient (SP) individually, jointly formulate a care plan, and, discuss the plan with the SP. The experience is debriefed with a facilitator.
    In 2016-17, 520 learners participated in the ISPE. They agreed that they learned about the roles of other health care professionals (M = 5.24 on a six-point scale, SD = 1.27), and that they would recommend the ISPE to fellow students in their profession (M = 5.25, SD = 1.30).
    Students appreciated the ability to observe learners from other health professions interacting with the SP, and how different perspectives and expertise were integrated to create a comprehensive care plan. The exercise can be adapted to accommodate local health professions learners.
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