Concept Of Medicine Research Articles

Mind-body-medicine in oncology-from patient needs to tailored programs and interventions: a cross-sectional study.

National and international guidelines recommend early integration of evidence-based multimodal interventions and programs, especially with a focus on relaxation techniques and other Mind-Body-based methods to maintain the quality of life of oncology patients, improve treatment tolerability, and promote healthy lifestyle behaviors. Consequently, we aim to understand what drives patients and how they navigate integrative medicine to best advise them. This study aimed to detect possible topics of particular interest to patients and identify the patient groups that could benefit most from further programs. Furthermore, we aimed to investigate if patients are open-minded toward integrative oncology concepts and learn about their motivational level to maintain or change behavior. Between August 2019 and October 2020 we surveyed patients undergoing oncological therapy in a university oncological outpatient center using a custom-developed questionnaire based on established Mind-Body Medicine concepts. We included 294 patients with various cancers. More than half reported problems sleeping through (61%) and 42% felt stressed frequently, invariably rating this as detrimental to their health. Moreover, a slight majority (52%) felt physically limited due to their disease and only 30% performed defined exercise programs. Women were significantly more likely to feel stressed and reported with alarming frequency that they often feel "everything was up to them." The 40-65-year-olds reported significantly less restful sleep, more stress and were more dissatisfied with their situation. However, this group already used natural remedies most frequently and was most often motivated to use relaxation techniques in the next 6 months. The lower the perceived individual energy level (EL), the less frequently patients did sport, the more frequently they felt their disease impaired their activity, mostly feeling stressed and tense. We also found significant associations between negative emotions/thoughts and the variables "sleep," "use of relaxation techniques," "personal stress perception," and "successful lifestyle modification." Mind-Body programs that focus on patient's individual resources, with tools to explore impairing patterns of self-perception and cognitive biases, can be a valuable resource for oncology patients and should therefore be part of an integrative medical treatment concept.

Building Public Health Imagination in Controlling NCDs through Integrative Medicine - A Narrative Synthesis Scoping Review on its Challenges & Future in India

Background: India is amidst an epidemiological transition with the country’s health system being tested to manage the dual burden of communicable and Non-Communicable Diseases (NCDs) and it is prudent that policy bearers should ensure stratification of data collected through large-scale surveys like NFHS & NSS for better understanding of NCDs in India and AYUSH users for NCDs. The subject scoping review focuses on the uptake of the AYUSH system of medicines in the backdrop of NCDs in India, systems approach to healthcare, the concept of integrative medicine and the challenges it faces in terms of scalability and mass adoption. Design & Method: Through a comprehensive literature review exercise, and nationally representative NFHS data on health, the qualitative research work presents an analysis to comprehend the evident prevalence of NCDs in India and the usage of the AYUSH system of medicine to restrain these chronic conditions with mechanisms like integrative medicine. Results: Out of the 1087 articles validated, 27 were finalised for a detailed review with respect to the identified thematic analysis. The selected articles assimilated through multiple themes and theories include the theory of the classical model of epidemiological and demographic transition and its inference in Indian settings with essential data on diseases (communicable and NCDs) in India, usage of Complementary and Alternative Medicines (CAM/ AYUSH) in global/ Indian context and its mainstreaming with biomedicine, systems approach to healthcare and global innovations in digital health.

Comparative analysis of the current state of regulatory and legal regulation of health care in Ukraine and Hungary

The article provides a comparative analysis of the current state of legal regulation of health care in Ukraine and Hungary. The importance of public health issues has led to their elevation to the level of one of the most important state tasks, an internal function of the modern state, and this requires not only effective public administration, but also the formation and implementation of state policy in this area. This article is devoted to the formation and implementation of the state policy of legal regulation of the healthcare sector in Ukraine and Hungary. In the process of writing it, the author studied the system of legal relations and state bodies that perform the relevant functions and tasks in the formation and implementation of state health policy, analyzed the system of legislation that regulates them and the practice of its application in both countries. The article defines the place and role of the Verkhovna Rada in relation to health policy in comparison with the role of the Hungarian State Assembly, the Cabinet of Ministers, and the system of executive authorities of both countries in its implementation.
 The article, like most modern scientific developments in this field, covers the problems of three scientific disciplines - medicine, management and law. In the process of preparing this article, the author has processed a significant amount of medical literature, on social medicine and health care organization, and thoroughly researched their scientific issues both in Ukraine and Hungary. However, he tried to cover the issues and problems arising in this area from the standpoint of legal and administrative law. Therefore, in this work the main attention is focused not on the categories and concepts of social medicine and health care organization, but on the actual legal categories and concepts - legal mechanisms for the implementation of state medical and health programs, ensuring the human right to medical care, health care and health insurance guaranteed by the Constitution of Ukraine and the Basic Law of Hungary guaranteed level of free qualified medical care.

DYNAMICS OF ELEMENTSOFNATIONAL CONSCIOUSNES ONTHE EXAMPLEOF ALCHEMICAL ASPECTS IN TAOISM

The article examines the influence of alchemical aspects in Taoist medicine on the national consciousness of China during its historical development and in the modern context. The main focus of the article is directed towards exploring the stages of evolution of alchemical concepts in Chinese medicine, investigating moments of significant qualitative changes and transformations of key research objects, as well as studying the vectors of development of medical culture in China as a whole. In the early stages of alchemical practice in China, alchemists based their teachings on philosophical foundations, which manifested in the rapid development of alchemical medicine. The result was new medicines, treatment methods, and tools. Discussions unfolded, and institutions created were associated with alchemical medical practice. The intersection of external and internal alchemy in practices such as Taoist massage and psychotherapy, where religious and magical elements correlate with physical procedures, is noted. For this stage, it is important to define the specificity of Taoism, which became the environment where medical culture in China actively developed through alchemy. A particular emphasis is placed on the interaction of alchemical aspects with political power, specifically the support and utilization of Taoist medical ideas by the Communist Party. It is noted that this contributed to the survival and popularization of Taoist medicine in China, and Taoist concepts found their reflection in the ideology of communism, allowing them not only to survive but also to firmly establish themselves in the mass consciousness of the Chinese citizens. In contemporary society, the medical culture of China is closely linked to everyday life. In particular, the general attitude towards health, expressed in preventive measures and the use of traditional medicine, is emphasized. Taoist concepts, such as the connection of emotions with health, continue to play a key role in the culture of treatment and health maintenance among the population. In conclusion, the article reveals the multifaceted contribution of alchemical aspects of Taoist medicine to the formation of China's national consciousness, their evolution throughout history, and their significant role in the modern medical landscape of China.

Trends of Medicinal Plant Use over the Last 2000 Years in Central Europe.

Medicinal plant knowledge in Central Europe can be traced back from the present to antiquity, through written sources. Approximately 100 medicinal plant taxa have a history of continuous use. In this paper, we focus on use patterns over time and the link between historical and traditional uses with the current scientific evidence. We discuss our findings against the backdrop of changing eras and medicinal concepts. Based on use-records from totally 16 historical, popular and scientific herbals, we analyze how use categories of 102 medicinal plant taxa developed over time. Overall, 56 of the 102 taxa maintained continuous use throughout all time periods. For approximately 30% of the continuous uses, scientific evidence supporting their use exists, compared to 11% for recently added uses and 6% for discontinuous uses. Dermatology and gastroenterology are use categories that are relevant across all time periods. They are associated with a high diversity of medicinal taxa and continuously used medicinal species with scientific evidence. Antidotes, apotropaic (protective) magic, and humoral detoxification were important use categories in the past. New applications reflecting biomedical progress and epidemiological challenges are cardiovascular and tonic uses. Changes in medicinal concepts are mirrored in plant use and specifically in changes in the importance of use categories. Our finding supports the concept of social validation of plant uses, i.e., the assumption that longstanding use practice and tradition may suggest efficacy and safety.

Paradigm transformation from structural meridians to functional meridians：a hypothesis of "the brain controls the meridians"

The "meridian" is the core concept of acupuncture medicine. It can be said that almost all the theories and clinical practice of acupuncture and moxibustion in traditional Chinese medicine are based on this concept. However, up to now, scientists have failed in finding the "meridian" described in Chinese classic textbooks and fall into the dilemma of the meridian essence research. In fact, the meridian is independent of currently known anatomical tissues. Nevertheless, researches obtained highly valuable outcomes of life science through long-term studies, especially the cerebral science endowed the meridian theory with new connotations. The modern meridian theory is composed of new knowledge and traditional meridian knowledge. In the present paper, we put forward a new hypothesis that "the brain controls the meridians", and a new academic paradigm, that is, the meridians research should turn from looking for the structure of meridian to exploring the functions of meridian, which can be realized with the help of brain function.

Whole-exome sequencing identifies a set of genes as markers of hepatocellular carcinomaearly recurrence.

Hepatocellular carcinoma (HCC) is characterized by a high recurrence rate and poor prognosis. In recent years, the therapeutic regimen of programmed cell death protein 1 (PD-1) antibody combined with multi-targeted tyrosine kinase inhibitors (mTKIs) has achieved better results in the clinical application of hepatocellular carcinoma. Whole-exome sequencing can reflect the mutational characteristics of patients' exons and guide the clinical selection of molecular targeting drugs more accurately, which is in line with the concept of precision medicine. We performed exome sequencing on 63 patients with HCC treated with radical surgery at our hospital and collected their clinical indexes and postoperative follow-up data. Using machine learning, a prediction model for recurrence within 1year was constructed and the model was presented in a nomogram. Patients treated with PD-1 antibodies in combination with mTKIs after relapse were grouped by prognosis, and the valuable mutated genes were screened according to whole-exome sequencing data. The tumor tissue immune cells were analyzed using the UCSC Xena database. The expressions of target proteins were verified by Polymerase Chain Reaction (PCR) and Immunohistochemistry (IHC), respectively, on commercial HCC cell lines and pathological specimens of hepatocellular carcinoma collected clinically. The proportion of patients who relapsed within a year was 41% and the prognosis of those patients was poor. The characteristic exon mutation profile with a high frequency of variants in multiple mucin genes was present in Chinese HCC patients. Multiple nidi and 30 exon variants were brought into the prediction model with an area under the curve (AUC) = 0.94. MUC6 gene mutation was obvious in patients with an early recurrence, and MUC3A and MUC4 gene mutations were evident in patients with poorer responses to PD-1 antibodies combined with mTKIs. Those three mucins were negatively correlated with immune infiltrating cells. We depicted the exon characteristics of hepatocellular carcinoma in the Chinese population and established a predictive model for recurrence within 1year after radical surgical treatment. Moreover, we found that mucins were worthy targets of hepatocellular carcinoma.

Helical Hyperbolic Magnetic Field in Nerves, when they Act as Current Conductors

Knowledge of the magnetic field of a nerve is of interest for the application of external electromagnetic therapy to regenerate injured nerves. The aim of this work is to the theoretical study of the magnetic field generated in the nerves when they act as current conductors and thus determine how their hyperbolic curves are, within the concept of hyperbolic medicine. Using Internet search engines and various databases (Medline, Google Scholar, Researchgate, Scielo), a bibliographic review of scientific papers related to the electromagnetic field generated in the nerves, when they act as current conductors, has been carried out. For this work we use, theoretically, the right-hand rule in electromagnetism. So, we apply it to a model nerve, to determine what its hyperbolic magnetic field is like. The conclusions are: a) Hyperbolic curves are very common in nature and human physiology. The lines of force of an electromagnetic field act on human physiology through hyperbolic curves. b) Human physiology and a nerve can be divided into smaller fragments like a magnet do and maintain their same characteristics. c) A nerve fragment is a conducting wire of electric current that generates a transversal magnetic field, according to the right-hand rule in electromagnetism. That magnetic field has hyperbolic lines of force that follow a counterclockwise helical path.

Drill; A Solution to Reduce Mistriage in Prehospital Emergency Setting

Background: Triage is used as one of the main concepts in the emergency medicine to differentiate between critically ill patients or patients in a non-emergency situation. Miss-triage occurs if the prioritization of patients or injured is not done correctly for any reason. Miss-triage occurs in two forms of over and under triage. According to studies, the incidence of miss-triage is high worldwide. Exercising is one of the ways to reduce the amount of miss-triage. Objectives:. This two-group pretest post-test intervention study aimed to investigate the effect of drilling on the miss-triage of emergency medical service personnel. Methods: The tools used in this study included: demographic information form questionnaire, Triage Decision Making Inventory (TDMI), and designed START/jump START triage scenarios. After collecting the required data, these data were analyzed by appropriate parametric and non-parametric statistical tests, including mean and standard deviation, independent t-test, paired t-test, K-square. Results: Results showed that the Miss-triage rate decreased from (34.1%) before the intervention to (9.1%) after the intervention in the experimental group. Moreover, after drill, the score of triage decision-making power increased from (121) to (136.91). However, in the control group, no statistically significant change was observed in the amount of miss-triage and triage decision-making power in emergency medical service personnel at the end of the study (p>.05). Conclusion: The findings of the present study revealed the effectiveness of this exercise method in reducing miss-triage in participants. Thus, this method could be used in emergency medical service personnel training and preparation programs.

Neobaicalein Inhibits Th17 Cell Differentiation Resulting in Recovery of Th17/Treg Ratio through Blocking STAT3 Signaling Activation

Huangqin is the dried root of Scutellaria baicalensis Georgi, which has been widely utilized for heat-clearing (Qingre) and dewetting (Zaoshi), heat-killed (Xiehuo) and detoxifying (Jiedu) in the concept of Traditional Chinese Medicine and is used for treating inflammation and cancer in clinical formulas. Neobaicalein (NEO) is of flavonoid isolated from Huangqin and has been reported to possess prominent anti-inflammatory effects in published work. Th17/Treg balance shift to Th17 cells is an essential reason for autoimmune inflammatory diseases. However, the role NEO plays in Th17 and Treg and the underlying mechanism has not been elucidated yet. Network pharmacology-based study revealed that NEO predominantly regulated IL-17 signaling pathway. Moreover, our result shown that NEO (3-30 μmol/L) down-regulated Th17 differentiation and cellular supernatant and intracellular IL-17A level and tumor necrosis factor α production in a concentration-dependent manner. The further mechanism research revealed that NEO also specifically inhibited phosphorylation of STAT3(Tyr725) and STAT4 (Y693) without influence on activation of STAT5 and STAT6 in splenocytes. Immunofluorescence results illuminated that NEO effectively blocked STAT3 translocated into nucleus. Interestingly, NEO at appreciated dose could only inhibit Th17 cell differentiation and have no effect on Treg differentiation. The present study revealed that NEO effectively inhibited Th17 cell differentiation through specifically blocking the activation of STAT3 signaling without inactivation of STAT5 and STAT6. Additional inhibitory effect on activation of STAT4 by NEO also suggested the potential for antagonism against Th1 differentiation. All work suggested that NEO may be a potential candidate for immunoregulation and treating autoimmune inflammatory diseases through inhibiting immune cell viability and T cell differentiation.

Catalysis medicine: Participating in the chemical networks of living organisms through catalysts

We are investigating catalytic approaches to participating in the chemical networks of living organisms. Catalysts that enable us to do so activate stable molecules with high selectivity under physiological conditions and will form the basis of a new area of medicine, catalysis medicine. Additionally, our research will contribute to progress in both physical and life sciences based on catalysis. In this Perspective, we provide a general overview of the concept of catalysis medicine, with examples of our recent achievements in chemical catalyst-promoted synthetic epigenetics in living cells and amyloid degradation in Alzheimer's disease model mice. This Perspective postulates the potential for catalysis research to act as a foundation from which to tackle important interdisciplinary problems.

The PrU: Development and validation of a measure to assess personal utility of genomic results

PurposePeople report experiencing value from learning genomic results even in the absence of clinically actionable information. Such personal utility has emerged as a key concept in genomic medicine. The lack of a validated patient-reported outcome measure of personal utility has impeded the ability to assess this concept among those receiving genomic results and evaluate the patient-perceived value of genomics. We aimed to construct and psychometrically evaluate a scale to measure personal utility of genomic results—the Personal Utility (PrU) scale. MethodsWe used an evidence-based, operational definition of personal utility, with data from a systematic literature review and Delphi survey to build a novel scale. After piloting with 24 adults, the PrU was administered to healthy adults in a Clinical Sequencing Evidence-Generating Research Consortium study after receiving results. We investigated the responses using exploratory factor analysis. ResultsThe exploratory factor analysis (N = 841 participants) resulted in a 3-factor solution, accounting for 74% of the variance in items: (1) self-knowledge (α = 0.92), (2) reproductive planning (α = 0.89), and (3) practical benefits (α = 0.91). ConclusionOur findings support the use of the 3-factor PrU to assess personal utility of genomic results. Validation of the PrU in other samples will be important for more wide-spread application.

Precision medicine: The use of tailored therapy in primary immunodeficiencies.

Primary immunodeficiencies (PID) are rare, complex diseases that can be characterised by a spectrum of phenotypes, from increased susceptibility to infections to autoimmunity, allergy, auto-inflammatory diseases and predisposition to malignancy. With the introduction of genetic testing in these patients and wider use of next-Generation sequencing techniques, a higher number of pathogenic genetic variants and conditions have been identified, allowing the development of new, targeted treatments in PID. The concept of precision medicine, that aims to tailor the medical interventions to each patient, allows to perform more precise diagnosis and more importantly the use of treatments directed to a specific defect, with the objective to cure or achieve long-term remission, minimising the number and type of side effects. This approach takes particular importance in PID, considering the nature of causative defects, disease severity, short- and long-term complications of disease but also of the available treatments, with impact in life-expectancy and quality of life. In this review we revisit how this approach can or is already being implemented in PID and provide a summary of the most relevant treatments applied to specific diseases.

Aquaporins: A new target for traditional Chinese medicine in the treatment of digestive system diseases.

Aquaporins (AQPs) are a family of transmembrane proteins expressed in various organ systems. Many studies have shown that the abnormal expression of AQPs is associated with gastrointestinal, skin, liver, kidneys, edema, cancer, and other diseases. The majority of AQPs are expressed in the digestive system and have important implications for the physiopathology of the gastrointestinal tract as well as other tissues and organs. AQP regulators can prevent and treat most gastrointestinal-related diseases, such as colorectal cancer, gastric ulcer, and gastric cancer. Although recent studies have proposed clinically relevant AQP-targeted therapies, such as the development of AQP inhibitors, clinical trials are still lacking and there are many difficulties. Traditional Chinese medicine (TCM) has been used in China for thousands of years to prevent, treat and diagnose diseases, and is under the guidance of Chinese medicine (CM) theory. Herein, we review the latest research on the regulation of AQPs by TCMs and their active components, including Rhei Radix et Rhizoma, Atractylodis macrocephalae Rhizoma, Salviae miltiorrhizae Radix et Rhizoma, Poria, Astragali radix, and another 26 TCMs, as well as active components, which include the active components include anthraquinones, saponins, polysaccharides, and flavonoid glycosides. Through our review and discussion of numerous studies, we attempt to explore the regulatory effects of TCMs and their active components on AQP expression in the corresponding parts of the body in terms of the Triple Energizer concept in Chinese medicine defined as "upper energizer, middle energizer, and lower energizer,"so as to offer unique opportunities for the development of AQP-related therapeutic drugs for digestive system diseases.

A Review of State-of-the-Art on Enabling Additive Manufacturing Processes for Precision Medicine

Abstract Precision medicine is an emerging healthcare delivery approach that considers variability between patients, such as genetic makeups, in contrast to the current one-size-fits-all approach that is designed to treat the average patient. The White House launched the Precision Medicine Initiative in 2015, starting an endeavor to reshape healthcare delivery. To translate the concept of precision medicine from the bench to practice, advanced manufacturing will play an integral part, including the fabrication of personalized drugs and drug delivery devices and drug screening platforms. These products are highly customized and require robust yet flexible manufacturing systems. The advanced manufacturing field has rapidly evolved in the past five years. In this state-of-the-art review, products manufactured for precision medicine will be introduced, followed by a brief review of processing materials and their characteristics. A review on different manufacturing processes applicable to those aforementioned products is provided. The current status of the development of regulatory submission and quality control considerations are also discussed. Finally, this paper presents a future outlook on manufacturing processes used for precision medicine.

Corneal neovascularization associated with a novel PDGFRB gene variant: Implications for precision medicine treatment

AbstractPurpose: To identify the genetic cause of aggressive corneal neovascularization arising in otherwise healthy children in one family. Further, to study molecular consequences associated with the identified variant and implications for possible precision medicine treatment.Methods: Sanger sequencing of the candidate gene PDGFRB was performed in affected individuals. HeLa cells were transduced with wild type PDGFRB and the identified variant. Cells were treated with tyrosine kinase inhibitors (TKIs). ELISA and immunoblot analysis were used to detect phosphorylation of PDGFRβ and downstream signalling proteins.Results: A novel variant in PDGFRB was found in affected family members. HeLa cells transduced with this variant did not have increased baseline levels of phosphorylated PDGFRb. However, upon stimulation with ligand, excessive activation of PDGFRb was observed in these cells compared to cells transduced with the wild type variant. Inhibition with some TKIs in vitro successfully prevented upregulation of PDGFRβ and its downstream signalling.Conclusions: A novel substitution in PDGFRB was found in family members with isolated corneal neovascular overgrowth. Cells transduced with the variant showed increased phosphorylation upon ligand stimulation. While the examined TKIs had various effects in preventing such overactivation, this introduces the concept of precision medicine in preventing childhood blindness in these patients.

Exploratory Analysis of the Sasang Constitution by Combining Network Analysis and Information Entropy.

Sasang constitutional medicine is a unique concept in Korean medicine that can provide valuable insights into personalized healthcare and disease treatment. In this study, we combined network analysis and information entropy to systematically investigate the related information of Sasang constitutional (SC) types. A feature network was constructed using SC type and clinical information. The SC type-associated features and feature classes were identified using statistical analysis and entropy ranking. The patient network was constructed based on SC-type-associated features. We found that the feature network was closely connected within the features of the same classes and between several feature class pairs, including the symptom class. Most of the separation values between the feature classes, including the symptom class, were negative. In addition, we found 42 clinical features related to the SC type, and two important classes -personality and cold/heat- that increase the entropy ranking of the SC type. In the patient network, we found sparsely connected modules between SC types and a positive separation value between the Taeeumin-Soeumin and Taeeumin-Soyangin pairs. Our data-driven approach provides a deeper understanding of modernized forms of SC types and suggests that SC type is a practically useful concept for stratified healthcare and personalized medicine.

Sickness Absence in the Kursk Nuclear Power Plant Workers as an Element of the Digital Twin Concept in Occupational Medicine

Introduction: A multifactorial analysis of the causes of morbidity and preventive measures provides an opportunity to build a risk prediction model for sickness absence in the working population, thereby reducing production and healthcare costs. Objective: A retrospective analysis of sickness absence in workers of the Kursk Nuclear Power Plant exposed to a combination of occupational risk factors in the year 2020. Materials and methods: We analyzed sickness absence rates in the workers in terms of the ICD-10 nomenclature based on data of the Russian Statistical Observation Form No. 16-VN and established the number of episodes of sickness absence per employee as a relative indicator independent of the size of the groups under study. Results: The highest sickness absence rates per 100 employees were estimated for workers of the Training Center and Design and Technology Department (73.1 episodes each), the Hydroshop (68.6) and Transportation Department (65.5). In the Radioactive Waste Treatment Shop and the first and second Reactor Shops, these rates were 53, 43.9, and 33.9 per 100 employees, respectively. The mean duration of an episode of sickness absence in all divisions of the nuclear power plant was 13–15.4 days and its most frequent causes were, similar to the Kursk Region and the Russian Federation as a whole, diseases of the respiratory and musculoskeletal systems, injuries and poisonings. Conclusions: It is important to develop a risk-based approach in occupational medicine. To establish a cause-and-effect relationship for loss of health among nuclear industry workers, we propose to create a digital platform (a digital twin of an employee) enabling prediction of the time, cause, risk of a disease and/or disability, and prerequisites for its mitigation.

Development of Enhanced Recovery After Surgery (ERAS) protocols in veterinary medicine through a one-health approach: the role of anesthesia and locoregional techniques.

Enhanced Recovery After Surgery (ERAS) is a new and emerging concept in human medicine that involves rethinking the preoperative, intraoperative, and postoperative periods. The ultimate, overarching aim is to improve patient outcome following surgery and, thus, return to a normal daily routine as soon as possible. The development and implementation of locoregional anesthetic techniques in humans is one of the key elements driving these protocols. In veterinary medicine, we are no exception: the rapidly growing interest, development, and refinement of these techniques in our veterinary species is changing the way we think of anesthesia and analgesia. The potential real benefits are yet to be determined, as this concept is implemented into our veterinary hospitals in general, and our surgical patients in particular, in a more systematic and routine way. In this article, we will introduce the reader to the concept of ERAS protocols and the role of regional anesthesia in some common surgical procedures.

Integrative Medicine and Holistic Care for the Post-pandemic Era

<p>臺灣在高齡化的情況下，多重疾病、衰弱與失能變得普遍，多重用藥與高醫療耗用的問題隨之浮現。照顧高齡衰弱病人，應重視健康促進與功能維持，將目標由治癒轉向照顧，因此需要跨領域團隊合作進行全人照護，並將照護場域由醫療機構延伸至社區居家。這樣的照護就是整合醫學的核心理念，根據本人意願，以價值為導向，提供全人、全程、全家、全團隊、全社區的五全照護模式。 在這背景下，各國的醫療體系開始面臨重整，包括減少治療疾病的急性病床、擴增以功能回復為目標的急性後期或是回復期病床、也提升在宅醫療的量能。疫情導致的就醫障礙，更使遠距與居家醫療的趨勢獲得普遍重視。後疫情時代的醫院整合醫學照護模式，應有專責病房來照顧多重疾病、高醫療耗用、身心失能的病人，並強化社區連結、建立在宅醫療團隊、提升遠距醫療能力，以提供病人從醫院到社區的全程健康照護服務。</p> <p> </p><p>In Taiwan, the multimorbidity, frailty, and disability associated with population aging have aggravated the problem of polypharmacy and resulted in high medical resource consumption. The care for patients who are frail and in an advanced age must emphasize health promotion and function maintenance, focusing on the provision of care rather than the curing of a disease. This requires an interdisciplinary team capable of extending the holistic care provided in medical institutions to patients’ homes. This is a type of care that embodies the core concepts of integrative medicine, namely a value-oriented health care that involves the patient, the medical treatment, the patient’s family, the medical team, and the community based on the patient’s own free will.To meet this requirement, medical systems worldwide are in the process of reorganization, and the measures taken include reducing the number of acute care beds, increasing the number of beds for post-acute and rehabilitative care, and enhancing the capacity for home health care. The barriers to medical access, which are induced by the COVID-19 pandemic, have also turned global attention to telemedicine and home health care. To provide patients with a holistic care that extends from hospital to community, post-pandemic medical institutions must apply integrative medicine; establish dedicated wards for patients with polypharmacy, high medical resource consumption, and physical and mental impairment; strength their ties with local communities; create medical teams proficient in home health care; and improve their abilities in telemedicine.</p> <p> </p>