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Nursing Science 2025
社区慢病共存病人治疗负担影响因素的研究进展
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Abstract:
多种慢性病合并症难治愈、恢复慢、易复发，多数患者需长期接受药物治疗、康复训练及定期的随访复查，病人往往面临沉重的治疗负担。而共病患者在面对沉重的疾病负担时，多数人会选择在社区卫生服务中心接受治疗，以降低疾病管理负担。本文从社区共病患者治疗负担定义内容及影响因素进行综述，以期为基层医护人员构建临床干预模式提供参考。
Chronic diseases with comorbidities are often characterized by difficulty in cure, slow recovery, and a high likelihood of recurrence. Most patients require long-term pharmacological treatment, rehabilitation training, and regular follow-up visits, which impose a significant treatment burden. To alleviate this burden, many comorbid patients opt for treatment at community health service centers. This paper reviews the definition and influencing factors of the treatment burden on community-dwelling comorbid patients to provide guidance for the development of clinical intervention models for primary care providers.
| [1] | Boyd, C.M. and Fortin, M. (2010) Future of Multimorbidity Research: How Should Understanding of Multimorbidity Inform Health System Design? Public Health Reviews, 32, 451-474. https://doi.org/10.1007/bf03391611 |
| [2] | Chowdhury, S.R., Chandra Das, D., Sunna, T.C., Beyene, J. and Hossain, A. (2023) Global and Regional Prevalence of Multimorbidity in the Adult Population in Community Settings: A Systematic Review and Meta-Analysis. eClinicalMedicine, 57, Article ID: 101860. https://doi.org/10.1016/j.eclinm.2023.101860 |
| [3] | 孙至佳, 樊俊宁, 余灿清, 等. 中国10个地区成年人共病流行特征分析[J]. 中华流行病学杂志, 2021, 42(5): 755-762. |
| [4] | Eton, D., Ramalho de Oliveira, D., Egginton, J., Ridgeway, J., Odell, L., May, C., et al. (2012) Building a Measurement Framework of Burden of Treatment in Complex Patients with Chronic Conditions: A Qualitative Study. Patient Related Outcome Measures, 3, 39-49. https://doi.org/10.2147/prom.s34681 |
| [5] | Duncan, P., Murphy, M., Man, M., Chaplin, K., Gaunt, D. and Salisbury, C. (2018) Development and Validation of the Multimorbidity Treatment Burden Questionnaire (MTBQ). BMJ Open, 8, e019413. https://doi.org/10.1136/bmjopen-2017-019413 |
| [6] | Ong, K., Lee, P. and Lee, E. (2020) Patient-Centred and Not Disease-Focused: A Review of Guidelines and Multimorbidity. Singapore Medical Journal, 61, 584-590. https://doi.org/10.11622/smedj.2019109 |
| [7] | Boyd, C.M., Wolff, J.L., Giovannetti, E., Reider, L., Weiss, C., Xue, Q., et al. (2014) Healthcare Task Difficulty among Older Adults with Multimorbidity. Medical Care, 52, S118-S125. https://doi.org/10.1097/mlr.0b013e3182a977da |
| [8] | Sav, A., Kendall, E., McMillan, S.S., Kelly, F., Whitty, J.A., King, M.A., et al. (2013) “You Say Treatment, I Say Hard Work”: Treatment Burden among People with Chronic Illness and Their Carers in Australia. Health & Social Care in the Community, 21, 665-674. https://doi.org/10.1111/hsc.12052 |
| [9] | 豆丽园, 黄娟, 郭理想. 慢性病共存患者治疗负担相关评估工具研究进展[J]. 中国全科医学, 2020, 23(27): 3440-3443. |
| [10] | Eton, D., Ridgeway, J., Egginton, J., Tiedje, K., Linzer, M., Boehm, D., et al. (2015) Finalizing a Measurement Framework for the Burden of Treatment in Complex Patients with Chronic Conditions. Patient Related Outcome Measures, 6, 117-126. https://doi.org/10.2147/prom.s78955 |
| [11] | Boyd, C.M., Wolff, J.L., Giovannetti, E., Reider, L., Weiss, C., Xue, Q., et al. (2014) Healthcare Task Difficulty among Older Adults with Multimorbidity. Medical Care, 52, S118-S125. https://doi.org/10.1097/mlr.0b013e3182a977da |
| [12] | Rosbach, M. and Andersen, J.S. (2017) Patient-Experienced Burden of Treatment in Patients with Multimorbidity—A Systematic Review of Qualitative Data. PLOS ONE, 12, e0179916. https://doi.org/10.1371/journal.pone.0179916 |
| [13] | 明清, 陶艳玲, 王明珠, 等. 慢性病共病患者治疗负担相关体验的Meta整合[J]. 护理学报, 2024, 31(21): 55-61. |
| [14] | 陈晔, 宋秀娟, 陈倍倍, 等. 温州地区老年期痴呆合并慢性病患者治疗负担的调查研究[J]. 中国卫生统计, 2022, 39(3): 393-396. |
| [15] | 豆丽园, 黄娟, 叶森, 等. 社区老年慢性病共存患者治疗负担现状及影响因素研究[J]. 中国全科医学, 2021, 24(13): 1671-1675. |
| [16] | 赵莹, 王晨, 孙玉倩, 等. 住院老年慢性病病人治疗负担现状及其影响因素研究[J]. 现代预防医学, 2022, 49(6): 1078-1081+1117. |
| [17] | Hounkpatin, H.O., Roderick, P., Harris, S., Morris, J.E., Smith, D., Walsh, B., et al. (2022) Change in Treatment Burden among People with Multimorbidity: A Follow-Up Survey. British Journal of General Practice, 72, e816-e824. https://doi.org/10.3399/bjgp.2022.0103 |
| [18] | 豆丽园, 黄娟, 张振香, 等. 老年慢性病共存患者治疗负担的研究进展[J]. 中国全科医学, 2020, 23(7): 874-879. |
| [19] | Morris, J.E., Roderick, P.J., Harris, S., Yao, G., Crowe, S., Phillips, D., et al. (2020) Treatment Burden for Patients with Multimorbidity: Cross-Sectional Study with Exploration of a Single-Item Measure. British Journal of General Practice, 71, e381-e390. https://doi.org/10.3399/bjgp.2020.0883 |
| [20] | Eton, D.T., Yost, K.J., Ridgeway, J.L., Bucknell, B., Wambua, M., Erbs, N.C., et al. (2024) Development and Acceptability of Pets-Now, an Electronic Point-of-Care Tool to Monitor Treatment Burden in Patients with Multiple Chronic Conditions: A Multi-Method Study. BMC Primary Care, 25, Article No. 77. https://doi.org/10.1186/s12875-024-02316-5 |
| [21] | 曾瑜婷, 李红玉, 张健, 等. 居家慢性病老年人自我感受负担在家庭关怀度与服药依从性间的中介效应[J]. 全科护理, 2024, 22(6): 1002-1006. |
| [22] | 林恺, 姚弥, 陈章, 等. 2型糖尿病治疗负担的概念框架及应对方式: 基于视频记录分析[J]. 中国全科医学, 2023, 26(34): 4302-4307. |
| [23] | Duncan, P., Murphy, M., Man, M., Chaplin, K., Gaunt, D. and Salisbury, C. (2018) Development and Validation of the Multimorbidity Treatment Burden Questionnaire (MTBQ). BMJ Open, 8, e019413. https://doi.org/10.1136/bmjopen-2017-019413 |
| [24] | 吕群, 徐水琴, 孙一勤, 等. 农村老年慢性病病人家庭照顾者心理负担相关因素研究[J]. 护理研究, 2013, 27(23): 2455-2457. |
| [25] | 樊颖珠, 杨瑛. 老年慢性病共病患者心理脆弱现状及其影响因素[J]. 吉林医学, 2024, 45(9): 2277-2282. |
| [26] | 程朝晖, 刘慧慧. 简述我国慢性病的流行现状和应对策略[J]. 中外健康文摘, 2014(6): 56. |
| [27] | 郑琛, 张习禄. 人文关怀视角下慢性病患者治疗负担的质性研究[J]. 医学与哲学, 2019, 40(21): 46-49. |
| [28] | 王梦瑶. 中年慢性病共存患者治疗负担现状及主要影响因素分析[D]: [硕士学位论文]. 大连: 大连医科大学, 2022. |
| [29] | Held, F.P., Blyth, F., Gnjidic, D., Hirani, V., Naganathan, V., Waite, L.M., et al. (2015) Association Rules Analysis of Comorbidity and Multimorbidity: The Concord Health and Aging in Men Project. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 71, 625-631. https://doi.org/10.1093/gerona/glv181 |
| [30] | Dugravot, A., Fayosse, A., Dumurgier, J., Bouillon, K., Rayana, T.B., Schnitzler, A., et al. (2020) Social Inequalities in Multimorbidity, Frailty, Disability, and Transitions to Mortality: A 24-Year Follow-Up of the Whitehall II Cohort Study. The Lancet Public Health, 5, e42-e50. https://doi.org/10.1016/s2468-2667(19)30226-9 |
