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医务人员对骨质疏松症、跌倒和骨折风险的看法:系统评价和定性研究的主题综合分析。

Perspectives of healthcare providers on osteoporosis, falls and fracture risk: a systematic review and thematic synthesis of qualitative studies.

机构信息

Faculty of Health and Medicine, School of Public Health, The University of Sydney, Sydney, Australia.

The Institute of Musculoskeletal Health, Sydney, Australia.

出版信息

Arch Osteoporos. 2024 Sep 24;19(1):90. doi: 10.1007/s11657-024-01446-8.

Abstract

OBJECTIVE

Osteoporosis and falls are major risk factors for osteoporotic fractures, with significant detriment to patients' quality of life. We aimed to describe healthcare provider (HCP) perspectives and experiences in the diagnosis, management and prevention of osteoporosis, falls and fractures obtained through primary qualitative research.

METHODS

Thematic synthesis was performed on articles identified through a search of electronic databases (MEDLINE, Embase, PsychINFO and CINAHL), which were searched from inception to May 2023.

RESULTS

Twenty-seven studies including 1662 HCPs, including general practitioners (GPs), physicians, surgeons, physiotherapists (PTs), occupational therapists (OTs), pharmacists and nurses, were included, with identification of six themes: overshadowed as a disease entity, uncertainty in decision making, frustration with interdisciplinary and systemic tension, avoiding medical paternalism, desire for improved care and embracing the responsibility.

CONCLUSION

Osteoporotic fracture and fall prevention in routine clinical care is hampered by inadequate priority and lack of perceived connection with morbidity and mortality, deficits in interdisciplinary collaboration, lack of clinical confidence and health resourcing. However, HCPs acknowledge their role in promoting healthy ageing, thus providing support through appropriate continuing education, resourcing and public health campaigns that are significant future directions, which may improve osteoporotic fracture prevention.

摘要

目的

骨质疏松症和跌倒都是骨质疏松性骨折的主要危险因素,对患者的生活质量有重大影响。我们旨在通过主要的定性研究,描述医疗保健提供者(HCP)在骨质疏松症、跌倒和骨折的诊断、管理和预防方面的观点和经验。

方法

通过对电子数据库(MEDLINE、Embase、PsychINFO 和 CINAHL)的搜索,从研究开始到 2023 年 5 月,对文章进行了主题综合。

结果

共纳入了 27 项研究,包括 1662 名 HCP,包括全科医生(GP)、医生、外科医生、物理治疗师(PT)、职业治疗师(OT)、药剂师和护士,确定了六个主题:作为疾病实体被忽视、决策中的不确定性、对跨学科和系统紧张的沮丧、避免医学家长式作风、渴望改善护理和承担责任。

结论

在常规临床护理中,骨质疏松性骨折和跌倒的预防受到重视不足和缺乏与发病率和死亡率的感知联系、跨学科合作不足、缺乏临床信心和健康资源的阻碍。然而,HCP 承认他们在促进健康老龄化方面的作用,因此通过适当的继续教育、资源和公共卫生运动提供支持是未来的重要方向,这可能会改善骨质疏松性骨折的预防。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/05a1/11420259/349b6657c326/11657_2024_1446_Fig1_HTML.jpg

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