慢性病患者过渡期管理干预的研究进展  

Research progress of transitional care programs on patients with chronic diseases

作　　者：曹晓翼[1] 陈林[1] 石梅[1] 蒋晓莲[2] CAO Xiaoyi;CHEN Lin;SHI Mei;JIANG Xiaolian(Hemodialysis Center,Department of Nephrology,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;School of Nursing,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China)

机构地区：[1]四川大学华西医院肾脏内科,成都610041 [2]四川大学华西医院护理学院,成都610041

出　　处：《华西医学》2018年第8期1037-1041,共5页West China Medical Journal

基　　金：四川省科技厅项目(2014FZ0109)

摘　　要：慢性病患者出院后从医院过渡至家庭的过渡期健康管理面临严峻挑战,如缺乏充分的出院准备度、出院后用药错误增加、自我管理能力不足,无法参与健康照护决策等,这些均可导致出院患者的再入院率增加,危及患者安全。该文对国内外慢性病患者过渡期管理的定义、过渡期管理单成分干预策略、过渡期管理多成分干预策略进行了综述,以期为我国开展安全、有效的慢性病患者过渡期健康管理干预提供参考和借鉴。Patients with chronic diseases usually face severe challenges during their transition from hospital to home, such as poor discharge preparation, the increased incidence of medical errors, insufficient self-care capability, and poor participation in healthcare decision, which can result in increased readmission and poor patient safety. This paper reviews the definition of transitional care, single-element transitional care intervention strategy, and multiple-element transitional care intervention strategy, in order to provide new insights into the development of effective and safe transitional care strategies in China.

关 键 词：慢性病 过渡期管理 文献综述 

分 类 号：R473[医药卫生—护理学]