中华护理杂志 ›› 2023, Vol. 58 ›› Issue (16): 2034-2038.DOI: 10.3761/j.issn.0254-1769.2023.16.019
收稿日期:2023-02-02
出版日期:2023-08-20
发布日期:2023-08-14
*通讯作者:
张振香,E-mail:zhangzx6666@126.com作者简介:王丹:女,本科(硕士在读),护士,E-mail:507064029@qq.com
基金资助:
WANG Dan(
), WANG Jiajia, WANG Qian, ZHANG Zhenxiang(
), WANG Wenna
Received:2023-02-02
Online:2023-08-20
Published:2023-08-14
摘要:
阶梯式护理模式作为一种新型卫生保健服务模式,可根据治疗效果及时调整干预策略,一方面提高资源配置,扩大护理服务范围,另一方面根据治疗效果给予个性化护理支持,具有低成本、高效益的优势。该研究阐述了阶梯式护理模式的起源与发展、核心要素、在慢性病健康管理中的应用、应用困境及建议,以期为慢性病防治工作提供参考。
王丹, 王佳佳, 王倩, 张振香, 王文娜. 阶梯式护理模式在慢性病管理中的应用进展[J]. 中华护理杂志, 2023, 58(16): 2034-2038.
WANG Dan, WANG Jiajia, WANG Qian, ZHANG Zhenxiang, WANG Wenna. Application progress of stepped care model in chronic disease health management[J]. Chinese Journal of Nursing, 2023, 58(16): 2034-2038.
| [1] |
熊佳铭, 余红雨, 苏瑾, 等. 老年慢性病患者移动医疗照护体验的Meta整合[J]. 中华护理杂志, 2022, 57(13):1641-1649.
DOI |
| Xiong JM, Yu HY, Su J, et al. Meta-synthesis of qualitative re-search on the experience of elderly patients with chronic disease participating in telemedicine[J]. Chin J Nurs, 2022, 57(13):1641-1649. | |
| [2] |
Miller CK. Adaptive intervention designs to promote behavioral change in adults:what is the evidence?[J]. Curr Diab Rep, 2019, 19(2):7.
DOI |
| [3] |
Wainer AL, Arnold ZE, Leonczyk C, et al. Examining a stepped-care telehealth program for parents of young children with autism:a proof-of-concept trial[J]. Mol Autism, 2021, 12(1):32.
DOI |
| [4] | 姚巧灵, 胡慧, 王凌, 等. 阶梯疗法在抑郁患者中的应用研究进展[J]. 中华护理杂志, 2018, 53(10):1264-1268. |
| Yao QL, Hu H, Wang L, et al. Research progress of stepped care in patients with depression[J]. Chin J Nurs, 2018, 53(10):1264-1268. | |
| [5] | 王利敏, 鲁才红, 胡梦云, 等. 阶梯护理模式在精神障碍患者心理干预中的应用进展[J]. 护理学杂志, 2020, 35(21):109-112. |
| Wang LM, Lu CH, Hu MY, et al. Application of stepped care model in psychological intervention for patients with mental disorders:a literature review[J]. J Nurs Sci, 2020, 35(21):109-112. | |
| [6] | Smith WM. ‘Stepped care:’ treatment toward a specific goal[J]. Urban Health, 1976, 5(3):48,51-53. |
| [7] | Abrams DB. Treatment issues:towards a stepped-care model[J]. Tob Control, 1993, 2(Suppl 1):S17-S29. |
| [8] |
Bower P, Gilbody S. Stepped care in psychological therapies:access,effectiveness and efficiency. Narrative literature review[J]. Br J Psychiatry, 2005, 186:11-17.
DOI URL |
| [9] |
Espie CA. “Stepped care”:a health technology solution for de-livering cognitive behavioral therapy as a first line insomnia treatment[J]. Sleep, 2009, 32(12):1549-1558.
DOI URL |
| [10] |
Norman G, Huang J, Davila EP, et al. Outcomes of a 1-year randomized controlled trial to evaluate a behavioral ‘stepped-down’ weight loss intervention for adolescent patients with obesity[J]. Pediatr Obes, 2016, 11(1):18-25.
DOI PMID |
| [11] |
Liu J, Godino JG, Norman GJ, et al. Planned care for obesity and cardiovascular risk reduction using a stepped-down approach:a randomized-controlled trial[J]. Prev Med, 2018, 114: 223-231.
DOI URL |
| [12] |
Pradhan P, Sharpe L, Menzies RE. Towards a stepped care mo-del for managing fear of cancer recurrence or progression in cancer survivors[J]. Cancer Manag Res, 2021, 13:8953-8965.
DOI PMID |
| [13] |
McKellar J, Austin J, Moos R. Building the first step:a review of low-intensity interventions for stepped care[J]. Addict Sci Clin Pract, 2012, 7(1):26.
DOI |
| [14] | Rapee RM, Lyneham HJ, Wuthrich V, et al. Comparison of step-ped care delivery against a single,empirically validated cognitive-behavioral therapy program for youth with anxiety:a randomized clinical trial[J]. J Am Acad Child Adolesc Psy-chiatry, 2017, 56(10):841-848. |
| [15] | Scogin FR, Hanson A, Welsh D. Self-administered treatment in stepped-care models of depression treatment[J]. J Clin Psy-chol, 2003, 59(3):341-349. |
| [16] |
Wuthrich VM, Rapee RM, McLellan L, et al. Acceptability and feasibility of stepped-care for anxious adolescents in com-munity mental health services:a secondary analysis[J]. Child Psychiatry Hum Dev, 2023, 54(3):806-814.
DOI |
| [17] |
Carels RA, Selensky JC, Rossi J, et al. A novel stepped-care approach to weight loss:the role of self-monitoring and health literacy in treatment outcomes[J]. Eat Behav, 2017, 26:76-82.
DOI URL |
| [18] |
Jakicic JM, Tate DF, Lang W, et al. Effect of a stepped-care intervention approach on weight loss in adults:a randomized clinical trial[J]. JAMA, 2012, 307(24):2617-2626.
DOI PMID |
| [19] |
Anderson DR, Zlateva I, Coman EN, et al. Improving pain care through implementation of the stepped care model at a multisite community health center[J]. J Pain Res, 2016, 9:1021-1029.
PMID |
| [20] |
de Oliveira SD, Pazzinatto MF, Crossley KM, et al. Novel step-ped care approach to provide education and exercise therapy for patellofemoral pain:feasibility study[J]. J Med Internet Res, 2020, 22(7):e18584.
DOI URL |
| [21] |
Vaughan E, Ftanou M, Lewin J, et al. AYA ‘Can-Sleep’ pro-gramme:protocol for a stepped-care,cognitive behavioural therapy-based approach to the management of sleep diffi-culties in adolescents and young adults with cancer[J]. Pilot Feasibility Stud, 2022, 8(1):159.
DOI PMID |
| [22] | Savard J, Ivers H, Savard MH, et al. Efficacy of a stepped care approach to deliver cognitive-behavioral therapy for in-somnia in cancer patients:a noninferiority randomized con-trolled trial[J]. Sleep, 2021, 44(11):66. |
| [23] | Jansen F, Lissenberg-Witte BI, Krebber AMH, et al. Stepped care targeting psychological distress in head and neck cancer and lung cancer patients:which groups specifically benefit? Secondary analyses of a randomized controlled trial[J]. Sup-port Care Cancer, 2019, 27(12):4543-4553. |
| [24] | Tran MJ, Jefford M, Smith B, et al. Study protocol for the eva-luation of fear-less:a stepped-care program for fear of cancer recurrence in survivors with early-stage disease[J]. Pilot Fea-sibility Stud, 2022, 8(1):177. |
| [25] | Kampman M, Broekman T, et al. Stepped-care versus treatment as usual in panic disorder:a rando-mized controlled trial[J]. PLoS One, 2020, 15(8):e237061. |
| [26] |
Krebber AM, Jansen F, Witte BI, et al. Stepped care targeting psychological distress in head and neck cancer and lung cancer patients:a randomized,controlled trial[J]. Ann Oncol, 2016, 27(9):1754-1760.
DOI PMID |
| [27] | 展阳妮, 王斌全, 田俊, 等. 阶梯式心理护理对头颈肿瘤患者焦虑抑郁和生活质量的影响[J]. 护理学杂志, 2019, 34(5):1-4. |
| Zhan YN, Wang BQ, Tian J, et al. Effect of stepped psycho-logical care on anxiety,depression and quality of life in patients with head and neck cancer[J]. J Nurs Sci, 2019, 34(5):1-4. | |
| [28] |
王红, 程青, 李迎新, 等. 急性心力衰竭代偿期患者早期康复活动方案的构建及应用效果[J]. 中华护理杂志, 2020, 55(4):524-528.
DOI |
|
Wang H, Cheng Q, Li YX, et al. Development and evaluation of four-stage early rehabilitation program for patients with acute heart failure in compensatory period[J]. Chin J Nurs, 2020, 55(4):524-528.
DOI |
|
| [29] | Coulton S, Bland M, Crosby H, et al. Effectiveness and cost-effectiveness of opportunistic screening and stepped-care interventions for older alcohol users in primary care[J]. Alco-hol Alcohol, 2017, 52(6):655-664. |
| [30] |
Ebbert JO, Little MA, Klesges RC, et al. Step care treatment for smoking cessation[J]. Health Educ Res, 2017, 32(1):1-11.
DOI PMID |
| [31] |
Nordgreen T, Haug T, Öst LG, et al. Stepped care versus di-rect face-to-face cognitive behavior therapy for social anxiety disorder and panic disorder:a randomized effectiveness trial[J]. Behav Ther, 2016, 47(2):166-183.
DOI PMID |
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