Multidisciplinary Management of Multiple Sclerosis Symptoms
Multidisciplinary Management of Multiple Sclerosis Symptoms
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DOI：
10.1159/000367620
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发表时间：
2014-01-01
影响因子：
2.4
通讯作者：
Feneberg, Wolfgang
中科院分区：
文献类型：
--
作者：
Gallien, Philippe;Gich, Jordi;Feneberg, Wolfgang
工作背景：多发性硬化症（MS）等多症状慢性疾病的有效管理需要多模式，跨学科的方法。在MS诊所，协调了许多医疗保健专业，为患者提供疾病各个方面的优质临床护理。不同国家/地区的设置和资源可用性可能会有所不同。来自不同欧盟国家的四个具体的专业服务进行了更详细的研究。总结：法国雷恩的多学科神经康复团队提供专业咨询（例如痉挛、尿动力学单元、设备）、住院和门诊强化康复计划以及治疗教育。管理方法是基于患者的损伤程度，如扩展残疾状态量表评估。在西班牙的赫罗纳，神经心理学家对所有MS患者进行评估，作为神经系统方案的一部分。根据损伤程度和患者的特征（例如工作或不工作），认知缺陷可以在家中或神经康复中心治疗。在西班牙巴塞罗那，神经眼科医生参与了MS视力障碍患者的鉴别诊断和随访护理;特别关注患者的视力相关生活质量。位于德国贝格的Marianne Strauss Klinik的疼痛专家开发了一种用于对MS疼痛综合征进行分类并区分MS相关疼痛和非MS相关疼痛的系统。慢性疼痛管理涉及许多学科，需要患者积极参与制定治疗计划。关键信息：MS影响几个身体系统，患者总是需要专业的跨学科支持。深入了解由各种专业提供的服务及其在MS中心的多学科护理模式中的适应性，可能有助于其他地区护理模式的设计或改进。(c)2014 S. Karger AG，巴塞尔
Background: Effective management of multisymptomatic chronic diseases such as multiple sclerosis (MS) requires a multimodal, interdisciplinary approach. At MS clinics, numerous healthcare specialties are coordinated to provide patients with quality clinical care for all aspects of their disease. Settings and resource availability may vary between countries. Four specific specialty services from different EU countries are examined in more detail. Summary: The multidisciplinary neurorehabilitation team in Rennes, France, provides specialized consultations (e.g. spasticity, urodynamic unit, devices), inpatient and outpatient intensive rehabilitation programs and therapeutic education. Management approaches are based on a patient's level of impairment as assessed by the Expanded Disability Status Scale. In Girona, Spain, neuropsychologists perform assessments as part of the neurological protocol for all patients with MS. Depending on the level of impairment and patients' characteristics (e.g. working or not working), cognitive deficits may be treated at home or at a neurorehabilitation center. In Barcelona, Spain, neuro-ophthalmologists are involved in the differential diagnosis and follow-up care of MS patients with visual disturbances; particular attention is given to patients' vision-related quality of life. Pain specialists at the Marianne Strauss Klinik in Berg, Germany, have developed a system for classifying MS pain syndromes and differentiating MS-related pain from non MS-related pain. Chronic pain management involves numerous disciplines and requires active engagement by patients in developing treatment plans. Key Messages: MS affects several body systems and patients invariably require specialized interdisciplinary support. Insight into services provided by various specialties and their fit within multidisciplinary care models at MS centers may facilitate the design or refinement of care models in other locations. (c) 2014 S. Karger AG, Basel