Minimal buzuvchi tibbiyot

Minimal buzuvchi tibbiyot – bu Carl R May, Victor Montori va Frances Mair tomonidan taklif etilgan surunkali kasalliklarda bemorlarga gʻamxoʻrlik qilish usulidir^[1]. 2009-yilda British Medical Journal jurnalida chop etilgan maqolada ular kasallik yuki, (kasallikning bemorga patofiziologik va psixosotsial taʼsiri) davolanish yuki (sogʻliqni saqlash mutaxassislari tomonidan bemorga yuklangan ish yuki, bu oʻz-oʻzini parvarish qilish va oʻz-oʻzini nazorat qilish, terapevtik sxemalarni boshqarish, shifokorlarning tashriflarini tashkil etish, testlar va sugʻurtalashni oʻz ichiga olishi mumkin)ga ega ekanligini taʼkidladilar. Kasallikka tibbiy javoblar yanada murakkablashgani sababli, davolash yuki oshdi va oʻz foydalanuvchilari tomonidan kundalik hayotga muntazam ravishda kiritilishi kerak boʻlgan tobora murakkab texnikalar va sogʻliqni saqlash texnologiyalarini (masalan, teleparvarish) oʻz ichiga oladi. Minimal buzuvchi tibbiyot – bu bemorlarga yordam koʻrsatishni loyihalashga yondashuv boʻlib, u davolash ishlarining taʼsirini hisobga olishga, xususan, bemorlarning ortiqcha yukini oldini olishga intiladi. May, Montori va Mairning taʼkidlashicha, haddan tashqari yuklamani davolashning tarkibiy jihatdan keltirib chiqarilgan nomuvofiqligiga olib keladi, bunda bemorlar, ayniqsa, koʻp sonli uzoq muddatli holatlar boʻlgan keksa bemorlar uchun terapevtik sxemalar qoʻygan talablarni qondirish tobora qiyinlashadi. Minimal taʼsirchan tibbiyot normalizatsiya jarayoni nazariyasida nazariy asosga ega boʻlib, bu davolanish rejimlari va boshqa kognitiv, xulq-atvor va texnik amaliyotlarning kundalik hayotga muntazam ravishda kiritilishini tushuntiradi^[2]^[3].

Davolash yuklamasi

Davolanish yuklari bemorlar oʻzlariga gʻamxoʻrlik qilish uchun qilayotgan barcha ishlarga bogʻliq qiyinchiliklarni anglatadi^[4]^[5]^[6]^[7]^[8]. Masalan: shifokorga tashriflar, tibbiy koʻriklar, davolanishni boshqarish, turmush tarzini oʻzgartirish.

Surunkali kasalliklar bilan ogʻrigan bemorlar oʻzlarining kundalik hayotida (ish, oilaviy hayot va/yoki boshqa majburiyatlar oʻrtasida) sogʻliqni saqlash muassasasi tomonidan soʻralgan hamma narsani birlashtirishga qiynalishadi. Davolash yuki, kasalliklardan qatʼi nazar, terapevtik yordamga rioya qilish bilan bogʻliq^[9] va shifoxonaga yotqizish va yashovchanlik koʻrsatkichlariga taʼsir qilishi mumkin^[10]. Koʻp sonli surunkali kasalliklar bilan ogʻrigan bemorlarni davolash yuklamasini bemorlar uchun samarali va maqbul boʻlgan davolash taktikasini ishlab chiqishga yordam beradigan, tasdiqlangan vositalar yordamida baholash mumkin^[11].

Manbalar

↑ May, Carl; Montori, Victor M.; Mair, Frances S. (2009-08-11). "We need minimally disruptive medicine" (en). BMJ 339: b2803. doi:10.1136/bmj.b2803. ISSN 0959-8138. PMID 19671932. https://www.bmj.com/content/339/bmj.b2803.
↑ May C, Finch T. Implementation, embedding, and integration: an outline of Normalization Process Theory. Sociology 2009;43:535-54
↑ May C, Mair FS, Finch T, MacFarlane A, Dowrick C, Treweek S, Rapley T, Ballini L, Ong BN, Rogers A, Murray E, Elwyn G, Legare F, Gunn J, Montori VM. Development of a theory of implementation and integration: Normalization Process Theory. Implementation Science 2009;4.
↑ Tran, Viet-Thi; Montori, Victor M; Eton, David T; Baruch, Dan; Falissard, Bruno; Ravaud, Philippe (December 2012). "Development and description of measurement properties of an instrument to assess treatment burden among patients with multiple chronic conditions" (en). BMC Medicine 10 (1): 68. doi:10.1186/1741-7015-10-68. ISSN 1741-7015. PMID 22762722. PMC 3402984. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3402984.
↑ Gallacher, K., et al., Understanding patients' experiences of treatment burden in chronic heart failure using normalization process theory. Ann Fam Med, 2011. 9(3): p. 235-43.
↑ Eton, D. T., et al., Building a measurement framework of burden of treatment in complex patients with chronic conditions: a qualitative study. Patient Related Outcome Measures, 2012. 2012:3: p. 39-49.
↑ Gallacher K, Jani B, Morrison D, Macdonald S, Blane D, Erwin P, May CR, Montori VM, Eton DT, Smith F, Batty DG, Mair FS. Qualitative Systematic reviews of treatment burden in stroke, heart failure and diabetes – Methodological challenges and solutions. BMC Medical Research Methodology 2013;13(10).
↑ Jani B, Blane D, Browne S, Montori V, May C, Shippee N, Mair FS. Identifying treatment burden as an important concept for end of life care in those with advanced heart failure. Current Opinion in Supportive and Palliative Care 2013;7(1):3-7.
↑ Vijan S, Hayward RA, Ronis DL, Hofer TP: Brief report: the burden of diabetes therapy: implications for the design of effective patient-centered treatment regimens. J Gen Intern Med 2005, 20(5):479-482.
↑ Ho PM, Rumsfeld JS, Masoudi FA, McClure DL, Plomondon ME, Steiner JF, Magid DJ: Effect of medication nonadherence on hospitalization and mortality among patients with diabetes mellitus. Arch Intern Med 2006, 166(17):1836-1841.
↑ Tran, V. T., et al., Development and description of measurement properties of an instrument to assess Treatment Burden among patients with multiple chronic conditions. BMC Med, 2012. 10(1): p. 68.

[1] May, Carl; Montori, Victor M.; Mair, Frances S. (2009-08-11). "We need minimally disruptive medicine" (en). BMJ 339: b2803. doi:10.1136/bmj.b2803. ISSN 0959-8138. PMID 19671932. https://www.bmj.com/content/339/bmj.b2803.

[2] May C, Finch T. Implementation, embedding, and integration: an outline of Normalization Process Theory. Sociology 2009;43:535-54

[3] May C, Mair FS, Finch T, MacFarlane A, Dowrick C, Treweek S, Rapley T, Ballini L, Ong BN, Rogers A, Murray E, Elwyn G, Legare F, Gunn J, Montori VM. Development of a theory of implementation and integration: Normalization Process Theory. Implementation Science 2009;4.

[4] Tran, Viet-Thi; Montori, Victor M; Eton, David T; Baruch, Dan; Falissard, Bruno; Ravaud, Philippe (December 2012). "Development and description of measurement properties of an instrument to assess treatment burden among patients with multiple chronic conditions" (en). BMC Medicine 10 (1): 68. doi:10.1186/1741-7015-10-68. ISSN 1741-7015. PMID 22762722. PMC 3402984. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3402984.

[5] Gallacher, K., et al., Understanding patients' experiences of treatment burden in chronic heart failure using normalization process theory. Ann Fam Med, 2011. 9(3): p. 235-43.

[6] Eton, D. T., et al., Building a measurement framework of burden of treatment in complex patients with chronic conditions: a qualitative study. Patient Related Outcome Measures, 2012. 2012:3: p. 39-49.

[7] Gallacher K, Jani B, Morrison D, Macdonald S, Blane D, Erwin P, May CR, Montori VM, Eton DT, Smith F, Batty DG, Mair FS. Qualitative Systematic reviews of treatment burden in stroke, heart failure and diabetes – Methodological challenges and solutions. BMC Medical Research Methodology 2013;13(10).

[8] Jani B, Blane D, Browne S, Montori V, May C, Shippee N, Mair FS. Identifying treatment burden as an important concept for end of life care in those with advanced heart failure. Current Opinion in Supportive and Palliative Care 2013;7(1):3-7.

[9] Vijan S, Hayward RA, Ronis DL, Hofer TP: Brief report: the burden of diabetes therapy: implications for the design of effective patient-centered treatment regimens. J Gen Intern Med 2005, 20(5):479-482.

[10] Ho PM, Rumsfeld JS, Masoudi FA, McClure DL, Plomondon ME, Steiner JF, Magid DJ: Effect of medication nonadherence on hospitalization and mortality among patients with diabetes mellitus. Arch Intern Med 2006, 166(17):1836-1841.

[11] Tran, V. T., et al., Development and description of measurement properties of an instrument to assess Treatment Burden among patients with multiple chronic conditions. BMC Med, 2012. 10(1): p. 68.

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