Pukapuka HOUPE: Ngā Kaimahi Hauora

He aha ngā Pukapuka HOUPE?

Ko te pukapuka HOUPE he tikanga whakarite hei tuhi mō ngā kaimahi hauora ki te tuhi i te toro atu o te tūroro. He anga hei whakarite i ngā pārongo mai i te tūtakitanga haumanu ki roto i ngā wāhanga e whā, kia puta ai he pūtake tika, kia poto hoki o te āhua o te tūroro me te manaaki i whakawhiwhia.

Ehara tēnei momo tuhi i te mea hou. I whakawhanakehia i ngā tau 1960 e Dr. Lawrence Weed hei wāhanga o te pūnaha o te “pukapuka hauora e aro ana ki ngā raruraru” (POMR) pūtake. Ko tana whāinga kia whakakotahihia ngā pukapuka hauora, kia akiaki hoki i te whakaaro haumanu mārama. I ngā tau maha i muri mai, ko te āhua HOUPE te paerewa koura tonu mō te tuhi hauora i roto i te nuinga o ngā rāngai katoa.

He aha ai te nui o ngā Pukapuka HOUPE?

Ko te piri ki tētahi momo whakarite ka puta he kaha, engari koinei te matua o tōna pai. Koinei ngā take i kore ai e taea te whakakore i ngā pukapuka HOUPE i te ao hauora hou:

• Kia whakapumautia te Tuhi Tūroro Tūrua: Ka whai katoa ngā pukapuka i te ara whakaaro kotahi. Ko te tikanga ka taea e tētahi kaimahi, mai i te kaimāori tinana ki te tākuta tuatahi, te titiro tere ki te pukapuka a te tūroro, kia mārama ai tōna kōrero me te kore e raruraru ki te momo tuhi motuhake.
• Whakanuia te Kōrero i waenga i ngā Kaimahi: Ka kitea te tūroro e te tini o ngā tohunga, ka tino nui ngā pukapuka mārama. Ka whakapumautia e te āhua HOUPE kia kotahi te whakaaro o te katoa o te rōpū manaaki, kia iti ai te tūponotanga o ngā hapa, kia pai ai te mahi tahi.
• Kia Tutuki ai ngā Tono a te Ture me te Inihua: Ko ō pukapuka he tuhinga ture. He mea nui ēnei mō te nama, te utu, me te tiaki i a koe ki te puta he kerēme mahi he. Ko te pukapuka HOUPE pai ka hoatu he pūtake mārama, ka taea te tiaki i te manaaki i whakawhiwhia e koe pūtake.
• Tautoko i te Kounga o te Manaaki: Ko ngā pukapuka whakarite ka akiaki koe ki te whakaaro hōhonu mō te āhua o te tūroro. Mā te wehe i ngā mea e kōrero ana te tūroro i ngā mea e kitea ana e koe, ka taea e koe te hanga i tētahi aromātai tika ake me tētahi mahere whakaora pai ake.

He aha te tikanga o te HOUPE?

Ko te acronym te ngākau o te pūnaha. Kia wetewetehia:

• H - Hono (Subjective)
• O - Ōtaota (Objective)
• U - Uiuinga (Assessment)
• P - Poto (Plan)

Whakaarohia hei kōrero e puta mai ana mārama: ngā mea e kōrero ana te tūroro ki a koe, ngā mea ka kitea e koe, ngā mea e whakaaro ana koe kei te tupu, me ngā mea ka mahia e koe mō tērā.

Me Pēhea te Tuhituhi o Ia Wāhanga o te Pukapuka HOUPE

Kia māramatia ngā tikanga o te hanga pukapuka kounga teitei, wāhanga-wāhanga.

H - Hono: Ngā Mea e Kōrero Ana te Tūroro Ki A Koe

Ko tēnei wāhanga te kōrero a te tūroro, mā ōna ake kupu (arā, ka whakarāpopotohia e koe). Ko ngā mea katoa e pūrongohia ana e ia mō tōna āhua. Ko koe te kaituhi i konei, ehara i te kaiwhakamaori.

Ngā Mea Hei Whakauru:

• Te take matua o te tūroro (CC).
• Te hītori o te mate o nāianei (HPI), he maha tonu te whakamahi i te kaupapa OLDCARTS, OPQRST rānei.
• Te hītori hauora o mua (PMH), te hītori ā-iwi, me te hītori ā-whānau.
• He arotake i ngā pūnaha (ROS).
• Ngā rongoā o nāianei me ngā mate pāwera.

Ngā Tauira o ngā Pārongo Hono:

• “Ko te mamae i tōku turi matau i timata i tēnei toru rā i muri i taku oma.”
• Ka pūrongo te tūroro mō te mamae hōhonu, te ngaua, te 6/10 te taumaha, ā, ka kino haere mā te mārama.
• Ka whakakore i te kirika, te makariri, te ruaki rānei.
• E kii ana ia kua māhī ake ia ki te āwangawanga i te tikanga i te marama kua pahure ake nei.

O - Ōtaota: Ngā Mea Ka Kitea E Koe, Ka Inea Hoki E Koe

Koinei te wāhi ka kuhia ō kitenga haumanu. Ko tēnei wāhanga mō ngā raraunga pakari—ngā meka ka taea te whakahoki, te inea, me te kite. Kia wātea mai i ngā whakaaro whaiaro, i ngā whakamaoritanga rānei.

Ngā Mea Hei Whakauru:

• Ngā pūngao ora (te toto, te ngākau, te pāmahana, me ētahi atu).
• Ngā kitenga o te whakamātautau tinana.
• Ngā hua o ngā whakamātautau taiwhanga, taiwhanga rānei (X-rays, mahi toto, me ētahi atu).
• Ngā mehua haumanu (hei tauira, te kaha o te nekehanga, te whakamātautau kaha).

Ngā Tauira o ngā Pārongo Ōtaota:

• Ngā Pūngao Ora: BP 130/85, HR 78, RR 16, T 98.6°F.
• Te Aromātai Ngākau: RRR, karekau he haruru, he mirimiri, he tangi rānei.
• Turi Matau: Kitea ana te pupuhi māmā me te pupuhi. Mamae ina pā ki te taha o te raina hononga. Ko te whakamātautau Lachman kaore.
• Ko te kaute PHQ-9 ko 14, e tohu ana i te pouri ngāwari.

U - Uiuinga: Tō Aromātai Ngaio

Ko konei koe ka mau ai i tō pātaipara. I runga i ngā pārongo hono me ngā pārongo ōtaota, he aha tō whakaaro haumanu? Ka whakakotahi tēnei wāhanga i ngā raraunga ki tētahi mate, ki tētahi rārangi rānei o ngā mate ka taea.

Ngā Mea Hei Whakauru:

• Te mate matua.
• He aromātai i te mate o te tūroro (hei tauira, “e pai ake ana”, “kei te kino haere”, “kaore e rereke”).

Ngā Tauira o ngā Kōrero Uiuinga:

• 1. Te pakarutanga o te menisuka matau, te turi matau. 2. Te toto toto tiketike, kei te mana pai.
• Te pakarutanga o te mate āwangawanga whānui.
• Ko te mamae o te tuara o raro o te tūroro ka puta pea i te tikanga o te tinana, ā, ka whakakorehia te mate sciatica i runga i te whakamātautau waewae tika karekau.

P - Poto: Te Rautaki Whakaora

Hei te mutunga, ka aha koe mō te tūroro? Ka whakaaturia e te mahere ngā mahi whai muri mō te whakahaere i tō rātou āhua. Kia mārama, kia kawea te mahi.

Ngā Mea Hei Whakauru:

• Ngā rongoā me ngā mahi (ngā rongoā kua tohua, ngā tikanga i mahia).
• Te mātauranga i whakawhiwhia ki te tūroro.
• Ngā tohutoro ki ētahi atu tohunga.
• Ngā korero i tonoa.
• Ngā tohutohu whai muri.

Ngā Tauira o ngā Mahere Whakaora:

• Tohua a Naproxen 500mg BID mō ngā rā e 7.
• I whakangungua te tūroro ki te tikanga RICE (Whakatā, Huka, Mimi, Pungawerewere) mō te mamae o te turi.
• Tohua ki te pokanga wheua mō te aromātai.
• Kia whai muri i te 2 wiki ki te aromātai anō i ngā tohu.
• Ka timatahia ngā tikanga whakaora hinengaro (CBT) mō te whakahaere āwangawanga.

Ngā Tauira Pukapuka HOUPE mā Ia Rāngai

He tino kaha te āhua HOUPE. Anei te ahua o tōna puta i roto i ngā wāhi rerekē:

Tauira Pukapuka HOUPE Kaimāori Tinana

• H: Ka pūrongo te tūroro mō te mamae koi (7/10) i te pakihiwi matau ina toro ake ki runga. E kii ana, “Kare au e taea te whakahoki kohua ki te whare wānanga teitei.”
• O: Ko te kaha o te nekehanga o te pakihiwi matau he 120 nekehanga, ā, kua aukatia e te mamae. Ko ngā whakamātautau Neer me Hawkins-Kennedy positive.
• U: Te mate ngongo pakihiwi matau. Kei te whakaatu te tūroro i te kaha whakaiti i te mahi na te mamae.
• P: Timata ngā mahi whakapakari moka rotator. Whakaakona te whakatikatika tūranga me te whakarerekē mahi. Whakaorangia te ultrasound ki te pakihiwi. Aromātai anō i roto i ngā hui e 2.

Tauira Pukapuka HOUPE Wāhi Mahi Hauora

• H: Ka tae mai te tane 45-tau mō te tirotiro ā-tau. Karekau he amuamu. Ka whakakore i te mamae o te uma, te poto o te manawa, te mamae rānei o te upoko.
• O: Ngā Pūngao Ora: BP 145/92, HR 80, BMI 31. Te whakamātautau karekau he raruraru. Ngā Hua: Te Cholesterol Tapeke 220, LDL 140, A1c 5.9%.
• U: 1. Te Toto Toto Tūrua 2. Te Taumaha toto tiketike. 3. Te mate huka tuatahi.
• P: Tīmata a Lisinopril 10mg ia rā. Korero mō te kai iti te tote me te hiranga o te 150 meneti o te whakapakari tinana ia wiki. Arotake anō i ngā hua me te BP i roto i te 3 marama.

Tauira Pukapuka HOUPE Hauora Hinengaro

• H: Ka pūrongo te kiritaki kua nui haere ngā kare o te raruraru me te karo i ngā tūemi ā-iwi mai i tōna tīmatanga i tētahi mahi hou. E kii ana, “Kei te tino wehi ahau ka kōrero ahau i tētahi mea kuware ka noho ahau ki te kāinga.”
• O: Ka puta te āwangawanga me te whakaiti i te hui. Ko te ngākau ka rite ki te manawa. Ka pūrongo ka moe 4-5 haora ia pō.
• U: Te Mate Āwangawanga Ā-Iwi. E hiahia ana te kiritaki ki te whakaora engari ka uaua ki te whakatinana i ngā tikanga whakaora.
• P: Kia haere tonu te CBT ia wiki. Whakaurua he raupapa whakautu mō ngā tūemi ā-iwi. Whakaakona te manawa diaphragm mō ngā tohu raruraru. Tukua ngā mahi whakaaro.

Ngā Hapa noa hei karo māu i te Tuhituhi Pukapuka HOUPE

Ahakoa ngā kaimahi kōkiri ka he. Anei ētahi wāhi maha hei titiro māu:

• Kia Tino Poto: Ko ngā kōrero pēnei i te “ka pai ake te tūroro” e kore e āwhina. Inehia! Ko te “ka pūrongo te tūroro kua iti iho te mamae mai i te 8/10 ki te 5/10.”
• Te Whakaranu i ngā Pārongo Hono me ngā Pārongo Ōtaota: Ko te “H” ko tā te tūroro e kōrero ai; ko te “O” ko tāu e kitea ai. Kaua e tuhia “kua iti te pupuhi o te tūroro.” Engari, i roto i te wāhanga “O”, tuhia “kua heke te ine o te rekereke mai i te 25cm ki te 22cm.”
• Te Tuhi Kare Nui: Ki te kore koe e tuhituhi, kāore i tupu. Kia tino oti tō mahere me ngā pota, ngā auau, me ngā wā tūrua. Ko tēnei he wāhanga nui o te tuhi tūroro.
• Te Whakamahi i ngā Poto Kare i whakaaetia: Ahakoa ka puta ngā poto, ko te whakamahi i ngā poto rerekē, kāore i whakaaetia ka puta he hapa kino. Piri ki te rārangi whakaaetia a tō wāhi.

Ngā Tikanga Pai mō te Tuhituhi Pukapuka HOUPE Pai

1. Kia Mārama, Kia Poto: Tuhia kia mārama. Aro ki te reo ngāwari ina taea ana. Whakamahia ngā pūtu hei āta whai i te mahere.
2. Whakamahia te Reo Ngaio: Kia mau ki tētahi reo kaore e whaiaro, kia ngaio puta noa i te pukapuka.
3. Tuhia i te Wā tika: Tuhia ō pukapuka i te wawe ka taea i muri i te tūtakitanga kia mārama tonu ai ngā taipitopito kei roto i ō hinengaro. Ka pai ake tēnei i te tika, ā, he mea nui hoki tēnei o te tuhi hauora pai.
4. Kia Mau ki te Muna a te Tūroro: Kia mau tonu ki te HIPAA me te muna o te tūroro, otirā ina whakamahi i ngā pūnaha hiko.
5. Whakamahia te Tika o te Reo Hauora: He mea nui te tika. Ko te whakamahi i ngā kupu anatomical me ngā kupu hauora tika ka whakapumautia karekau he korekore.

Me Pēhea ngā Pukapuka HOUPE e Pai ai te Manaaki Tūroro

Hei te mutunga, ko te tuhi pai he mō te tūroro. Ko te pukapuka HOUPE pai:

• Ka Aroturuki i te Ahunga whakamua i te Wā: Ka hangaia he pūtake mārama, he pūrongo chronological o te haerenga hauora o te tūroro.
• Ka Āwhina i te Mahi Tahi a te Rōpū: Ka taea e te rōpū maha te mahi tahi kia ngāwari.
• Ka Tautoko i ngā Whakataunga i runga i ngā Mātāpono: Ka hoatu ngā raraunga e tika ana hei whakamana i ngā kōwhiringa whakaora me te whakarerekē i te mahere ina hiahiatia.

Pukapuka HOUPE ki Ētahi Atu Tikanga Tuhi

Ahakoa ko HOUPE te tino noa, ka kitea pea e koe ētahi atu momo:

• HOUPE ki ngā Pukapuka DAP: Ko DAP ko Data, Assessment, Plan. Ka whakakotahihia ngā wāhanga Hono me Ōtaota ki tētahi wāhanga “Raraunga”. Ka whakamahia nuitia i roto i te hauora hinengaro, kei reira te wehewehe i waenga i te hono me te ōtaota ka nui ake te ngawari.
• HOUPE ki ngā Pukapuka BIRP: Ko BIRP ko Behavior, Intervention, Response, Plan. Ko tēnei momo ka noa hoki i roto i te hauora hinengaro me te whanonga, ka nui ake te aro ki te ahua o te kiritaki me te urupare ki ngā mahi whakaora.

Ko te momo pai ka whakawhirinaki ki tō rāngai me ngā paerewa a tō wāhi, engari ko ngā mātāpono o te tuhi mārama, o te tuhi whakarite ka noho tonu.

Pukapuka HOUPE Hiko ki te Pepa

Kua mutu ngā rā o te tuhituhi i te pepa. Ko ngā Pukapuka Hauora Hiko (EHRs) te tikanga inaianei.

Ngā Pai o ngā EHR:

• Te Mārama: Karekau he tuhituhi pokepoke hei whakahoki.
• Te Wātea: Ka taea te whai wawe i ngā pukapuka e ngā kaimahi whai mana i ngā wāhi katoa.
• Te Pai o te Mahi: Ka taea e ngā tauira me ngā kupu atamai te tere ake te mahi tuhi.
• Te Whakaurunga Raraunga: Ka taea te tango tika i ngā hua taiwhanga me ngā whakaahua ki roto i te pukapuka pūtake.

Ko ngā pūnaha EHR rongonui pēnei i a Epic, Cerner, me Athenahealth katoa he tauira hanga-roto hei āta whakarite i te tuhituhi pukapuka HOUPE. Ki te neke koe ki te hiko, whāwhā te wā ki te ako i ngā pokatata a tō pūnaha—ka penapena haora koe i te roa.

Ngā Pātai Auau

1. Kia roa ana te roa o ngā pukapuka HOUPE? Kia roa ana te roa, engari kia poto hoki te roa. Ko te whāinga kia tino oti, kia poto hoki. Ko te toro atu mō tētahi raruraru iti ka taea te maha noa iho o ngā raina i ia wāhanga, engari ko te toro atu o tētahi tūroro hou ka nui ake te roa.

2. Ka taea e au te whakamahi i ngā poto? Āe, engari whakamahia anake ngā poto paerewa, ka whakaaetia nuitia e te ao hauora, me ngā poto kua whakaaetia e tō wāhi kia kore ai e raruraru me ngā hapa pea.

3. Kia roa ana te roa o taku pupuri i ngā pukapuka HOUPE? Ka rereke tēnei mā te ture o te whenua me te kaupapa here o te wāhi, engari ko ngā pukapuka hauora ka roa te pupuri mō te iti rawa 7-10 tau i muri i te rā whakamutunga o te ratonga mō ngā pakeke. Tirohia ngā ture motuhake o tō whenua me ngā ture a te kawanatanga mō ngā tono tika.

4. Mehemea ka he ahau? Ki te whakamahi koe i te pepa, tuhia he raina kotahi i te hapa, tuhia “hapa”, ā, tuhia tō hainatanga me te rā. Kaua rawa e whakamahia te muku. I roto i te EHR, ka puta he tikanga motuhake mō te hanga i tētahi atu tuhinga hei whakatika i te pukapuka i te wa e tiaki ana i te tuhinga taketake.

Opaniraa: Te Kaha i ngā Pukapuka HOUPE mō te Pai ake o te Manaaki Tūroro

Ko ngā pukapuka HOUPE he nui ake i te tono; he kōrero rātou mō te hauora o tō tūroro, ā, he whakaatu hoki tēnei i tō kaha haumanu. Mā te kaha ki tēnei anga ngāwari engari kaha, ka pai ake te kōrero, ka tiaki koe i a koe anō i te taha ture, ā, ko te mea nui, ka whai wāhi koe ki ngā hua pai mō ngā tāngata e atawhai ana koe.

Rite ki ētahi atu pukenga, ko te tuhituhi i te tuhi tūroro pai ka hiahia mahi. Nō reira, awhi i te anga, kia tino whai whakaaro koe ki tō tuhituhi, ā, ka kite koe i te pānga o tēnei ki tō mahi haumanu, ā, ka mārama ake tō hinengaro aromātai.

Mō ētahi atu ako, whakaarohia te tirotiro i ngā rauemi mai i ō rōpū ngaio motuhake, pēnei i te American Medical Association (AMA) me te American Physical Therapy Association (APTA).