Cultura

Medical Workers' Multidisciplinary Collaborative Approaches to Identifying, Assessing, and Intervening on Social Determinants of Health in Integrated Healthcare Settings

VOLUME 21, 2024

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Yassmeen Ibrahim Alnajjar, Nisreen Ghazi Albouq, Noorah Mohammad Alshareef, Turki Mulfi Khelaiwi Alharbi, Bushra Salem Alotuibi, Adel Aqeel Alanezi, Safiah Solaiman Alzhrani, Alaa abdulqader Alahmadi
Enas Mohammed Sokail, Nahid mohamad sokail, Khadijah Mohammed Thani Othman Sokail, Ammar Saud Hodiban Alahmadi, Majed Mustafa Hussein Mimarji, Dalal Saud Alahmadi, Nahla Homud Almowld

Abstract

Social determinants of health (SDOH) significantly influence health outcomes, yet healthcare systems have historically struggled to effectively address these factors within traditional medical models. This article examines how multidisciplinary collaborative approaches among medical workers can enhance identification, assessment, and intervention on SDOH in integrated healthcare settings. Drawing on recent literature and practice examples, the article explores interprofessional collaborative frameworks, role-specific contributions, implementation challenges, and promising intervention models. Findings indicate that effective SDOH-focused collaboration requires intentional team structures, clear role delineation, shared decision-making protocols, and organizational support. Particular attention is given to the integration of social workers within healthcare teams, the development of structured screening and referral processes, and the cultivation of collaborative competencies. The article concludes with recommendations for strengthening multidisciplinary SDOH approaches, including organizational policy changes, educational innovations, and systems-level integration strategies. This comprehensive analysis contributes to understanding how healthcare workers can collaborate more effectively to address the complex social factors influencing patient health and wellbeing.

Keywords : .
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty