为功能性神经障碍者提供最佳专业服务:澳大利亚定性描述研究

IF 2 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Lauren N. Pearce, Peta Prindiville, Charlotte Scroggie, Georgia Taylor, Alice Clarke, Abby Foster, Sarah C. Milne
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引用次数: 0

摘要

功能性神经紊乱(FND)专科门诊正在成为向功能性神经紊乱患者提供最佳治疗的首选方式。然而,围绕最佳治疗路径、服务提供和资源等问题依然存在。本研究旨在确定 (1) 澳大利亚 FND 护理模式的服务特点;(2) 实施 FND 专门服务的障碍和推动因素;以及 (3) 为 FND 患者提供最佳管理的推动因素和障碍。临床医生来自澳大利亚的公立和私立医疗机构,这些机构被认为是为患有 FND 的成年人提供最佳服务的领先机构。临床医生通过电话完成了结构化访谈。采用了描述性内容分析法。在接受访谈的 12 家医疗机构中,有 5 家设有专门的多学科 FND 服务。所有专门的 FND 服务都是门诊项目,但其结构和转诊途径各不相同。提供 FND 服务的机构指出的障碍包括 "资金 "和 "人员与服务的脆弱性",而促进因素包括 "利益相关者的参与 "和明确的 "服务驱动力"。没有 FND 专门服务的机构认为,"诊断延迟 "和 "人员不足 "是实施最佳做法的障碍。尽管专科门诊被认为是为 FND 患者提供护理的实用方法,但在澳大利亚仅有少数几家专科门诊在运营。及时、有针对性的诊断以及由神经病学、物理治疗和心理学组成的跨学科团队是 FND 服务的核心支柱。需要进一步开展工作,建立临床和经济上有效的服务模式,以便为 FND 患者提供最佳护理服务。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Delivering a Specialised Best Practice Service for People with Functional Neurological Disorder: An Australian Qualitative Descriptive Study

Specialised functional neurological disorder (FND) clinics are emerging as the preferred way of providing best practice care to people with FND. However, questions remain around optimal care pathways, service provision, and resources. This study aimed to identify (1) service characteristics of Australian FND models of care; (2) barriers and enablers to implementing a specialised FND service; and (3) enablers and barriers to providing best practice management for people living with FND. Clinicians were recruited from Australian public and private healthcare organisations identified as leading best practice for adults with FND. Clinicians completed a structured interview via phone. A descriptive content analysis was used. Five out of 12 healthcare organisations interviewed had a specialised multidisciplinary FND service. All specialised FND services were outpatient programs, but the structure and referral pathways varied. Barriers identified by organisations with an FND service included “funding” and “staff and service fragility,” while enablers included “engaging stakeholders” and having a clear “service driver.” “Diagnosis delay” and “insufficient access to staff” were identified as barriers to implementing best practice by organisations without a specialised FND service. Despite specialised clinics being recognised as a practical way to deliver care to people with FND, only a few services operate in Australia. Timely and educated diagnosis and access to an interdisciplinary team consisting of neurology, physiotherapy, and psychology are central pillars for FND services. Further work to establish clinically and economically effective delivery models is required to facilitate the provision of best practice care for people living with FND.

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来源期刊
CiteScore
4.50
自引率
8.30%
发文量
423
期刊介绍: Health and Social Care in the community is an essential journal for anyone involved in nursing, social work, physiotherapy, occupational therapy, general practice, health psychology, health economy, primary health care and the promotion of health. It is an international peer-reviewed journal supporting interdisciplinary collaboration on policy and practice within health and social care in the community. The journal publishes: - Original research papers in all areas of health and social care - Topical health and social care review articles - Policy and practice evaluations - Book reviews - Special issues
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