Community Health Workers as Support for Sickle Cell Care
Community Health Workers as Support for Sickle Cell Care
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DOI：
10.1016/j.amepre.2016.01.016
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发表时间：
2016-07-01
影响因子：
5.5
通讯作者：
Martin, Molly
中科院分区：
文献类型：
--
作者：
Hsu, Lewis L.;Green, Nancy S.;Martin, Molly
社区卫生工作者越来越被认为对改善各种慢性病的卫生保健和健康结果是有用的。社区卫生工作者可以提供社会支持、卫生系统和资源导航以及非专业咨询。社区卫生工作者与其服务人群的社会和文化一致性是社区卫生工作者干预的一个重要方面。虽然社区卫生工作者的干预措施已被证明可以改善服务不足社区以患者为中心的结果，但这些干预措施尚未在镰状细胞病中进行评估。来自其他疾病地区的证据表明，社区卫生工作者的干预对这些患者也是有效的。镰状细胞病是复杂的，在个人，家庭/朋友，临床组织和社区层面的多方面护理需求方面存在一系列障碍。保健服务的提供因保健服务方面的差异而变得复杂：获得、提供、服务以及提供者和家庭之间的文化不匹配。目前的做法不足以解决或提供不完全控制的症状，特别是疼痛，导致生活质量下降和医疗费用高。作者提出，通过社区卫生工作者病例管理、社会支持和卫生系统导航，可以改善镰状细胞病患者的护理和护理结果。本文概述了目前使用的实施策略，以测试社区卫生工作者在各种环境中的镰状细胞病管理。国家为发展镰状细胞病管理社区卫生队伍而开展的医疗和宣传工作可能会促进社区护理这一领域“最佳实践”的进步和发展。(C)2016年美国预防医学杂志。爱思唯尔公司出版
Community health workers are increasingly recognized as useful for improving health care and health outcomes for a variety of chronic conditions. Community health workers can provide social support, navigation of health systems and resources, and lay counseling. Social and cultural alignment of community health workers with the population they serve is an important aspect of community health worker intervention. Although community health worker interventions have been shown to improve patient-centered outcomes in underserved communities, these interventions have not been evaluated with sickle cell disease. Evidence from other disease areas suggests that community health worker intervention also would be effective for these patients. Sickle cell disease is complex, with a range of barriers to multifaceted care needs at the individual, family/friend, clinical organization, and community levels. Care delivery is complicated by disparities in health care: access, delivery, services, and cultural mismatches between providers and families. Current practices inadequately address or provide incomplete control of symptoms, especially pain, resulting in decreased quality of life and high medical expense. The authors propose that care and care outcomes for people with sickle cell disease could be improved through community health worker case management, social support, and health system navigation. This paper outlines implementation strategies in current use to test community health workers for sickle cell disease management in a variety of settings. National medical and advocacy efforts to develop the community health workforce for sickle cell disease management may enhance the progress and development of "best practices" for this area of community-based care. (C) 2016 American Journal of Preventive Medicine. Published by Elsevier Inc.