The challenges of managing complex lymphoedema/chronic oedema in the UK and Canada
The challenges of managing complex lymphoedema/chronic oedema in the UK and Canada
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DOI：
10.1111/j.1742-481x.2011.00845.x
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发表时间：
2012-02-01
影响因子：
3.1
通讯作者：
Honnor, Amanda
中科院分区：
文献类型：
--
作者：
Morgan, Philip A.;Murray, Susie;Honnor, Amanda
本文探讨了用压迫疗法治疗复杂/严重形式的慢性水肿病/淋巴水肿病患者所面临的专业挑战。举行了四个焦点小组，其中两个在英国，两个在加拿大，以审查从业者在日常实践中面临的挑战。两国的与会者都确定了一些挑战，包括淋巴水肿/慢性水肿的变化情况，以及日益复杂的情况如何超过了服务和基于研究的准则的发展。焦点小组还强调，缺乏公众意识、缺乏专业知识、延误诊断和不适当的治疗对实践有重大影响。其他与实践有关的问题包括从业者对治疗选择的认识不足、缺乏循证实践以及在管理心理社会问题和确保与治疗相一致方面存在困难。在加拿大，与英国相比，服务往往更偏僻和农村，自主专科诊所不那么发达，从业者通常比英国同行更不自信，更容易受到伤害。两国都需要综合的、多学科的服务，改善教育和培训，开发具有成本效益的压迫包扎系统，为应对当代淋巴水肿实践的挑战作出重大贡献。
This article explores the professional challenges of treating patients with complex/severe forms of chronic oedema/lymphoedema with compression therapy. Four focus groups were held, two in the UK and two in Canada, to examine the challenges faced by practitioners in their everyday practice. A number of challenges were identified by participants in both countries and include the changing profile of lymphoedema/chronic oedema and how increasing complexity is outpacing the development of services and research-based guidelines. Focus groups also highlighted a lack of public awareness, poor professional knowledge, delayed diagnosis and inappropriate treatment as having a significant impact on practice. Other practice-related issues include a poor understanding of treatment options among practitioners, a lack of evidence-based practice as well as difficulties associated with managing psychosocial problems and of ensuring concordance with treatment. In Canada, services tend to be more rural and remote than in the UK, autonomous specialist practice is less developed and practitioners were generally less confident and felt more vulnerable than their UK colleagues. There is a need for integrated, multi-disciplinary services in both countries, with improved education and training, as well as the development of cost-effective compression bandaging systems that can make a major contribution to meeting the challenges of contemporary lymphoedema practice.