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Promoting infant and child mental health through support for parenting 通过对父母的支持促进婴幼儿心理健康
Pub Date : 2019-03-01 DOI: 10.1093/MED/9780198788850.003.0010
J. Barlow
Mental health in the early years is underpinned by the capacity of young children for emotion regulation, and the child’s early relational context (i.e. the parenting that they receive) has been identified as being key to the development of this ability. However, many children show signs of regulatory difficulties including sleeping and crying difficulties, and emotional and behavioural problems in the early years; this is as such an important window of opportunity to intervene to optimize parenting, and prevent early parent–child relationship problems using a range of primary and secondary preventive approaches. This chapter provides an overview of the nature and prevalence of early regulatory problems, and some of the main universal and targeted intervention approaches that have been developed to address such problems, alongside the evidence about their effectiveness in improving outcomes for both parents and children.
幼儿早期的心理健康是由幼儿情绪调节能力所支撑的,而儿童早期的关系环境(即他们所受到的养育)已被确定为这种能力发展的关键。然而,许多儿童在早期表现出调节困难的迹象,包括睡眠和哭泣困难,以及情绪和行为问题;这是一个重要的机会窗口,可以通过一系列初级和二级预防方法进行干预,以优化养育方式,并预防早期亲子关系问题。本章概述了早期监管问题的性质和普遍性,以及为解决这些问题而开发的一些主要的普遍和有针对性的干预方法,以及它们在改善父母和儿童结果方面的有效性的证据。
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引用次数: 0
Tobacco, alcohol, and substance use in the perinatal period 围产期的烟草、酒精和物质使用情况
Pub Date : 2019-03-01 DOI: 10.1093/med/9780198788850.003.0006
J. Barlow, N. Axford
This chapter summarizes evidence on (i) the prevalence and effects on the unborn and newborn infant of exposure to teratogenic substances such as tobacco, alcohol, or substances during pregnancy, and (ii) what works during the perinatal period in terms of universal and targeted interventions for smoking cessation, and preventing and treating alcohol and drug misuse. It concludes with recommendations for practice, drawing on the evidence presented and best practice guidance, and focusing on strategies for identification and intervention.
本章总结了以下方面的证据:(1)怀孕期间接触致畸物质(如烟草、酒精或其他物质)的普遍程度及其对未出生婴儿和新生儿的影响,以及(2)围产期普遍和有针对性的戒烟干预措施以及预防和治疗酒精和药物滥用方面的有效措施。报告最后根据所提供的证据和最佳实践指南提出了实践建议,重点是识别和干预战略。
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引用次数: 0
Integrating immunizations into the programme 将免疫接种纳入规划
Pub Date : 2019-03-01 DOI: 10.1093/MED/9780198788850.003.0016
H. Bedford, D. Elliman
Immunization is a highly successful public health intervention providing protection against serious infectious diseases. UK vaccine uptake rates are generally high, although pockets of lower uptake and social inequalities remain which compromise herd protection. The child health programme provides health professionals opportunities to introduce immunization to parents, offer ongoing information and advice, and remind them when vaccines are due. Improving and maintaining high vaccine rates depends on multicomponent strategies. In view of their relationship with families, health visitors are the key professionals to work with them to ensure that children are immunized fully and in a timely fashion, although in practice they now do not usually deliver vaccines.
免疫接种是一项非常成功的公共卫生干预措施,可预防严重传染病。英国的疫苗接种率总体上很高,尽管接种率较低的地区和社会不平等仍然存在,这损害了群体保护。儿童保健方案为保健专业人员提供机会,向父母介绍免疫接种,提供持续的信息和咨询,并提醒他们接种疫苗的时间。提高和保持高疫苗接种率取决于多要素战略。鉴于保健视察员与家庭的关系,他们是与家庭合作的关键专业人员,以确保儿童得到充分和及时的免疫接种,尽管实际上他们现在通常不提供疫苗。
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引用次数: 0
Health for all children: philosophy and principles 所有儿童的健康:哲学和原则
Pub Date : 2019-03-01 DOI: 10.1093/MED/9780198788850.003.0001
A. Emond
The first United Nations Sustainable Development Goal is to ‘ensure that all human beings can fulfil their potential in dignity and equality’. Protecting, promoting, and supporting early childhood development is essential to achieve this goal. The foundations of child health and well-being, and of adult health in later life, are laid down in pregnancy and the early years. So this review of evidence takes a life course approach, starting in pregnancy and extending to the age of 7 years, to include transition into school and to cover the ‘early years’.
联合国可持续发展目标的第一个目标是“确保所有人都能有尊严和平等地发挥自己的潜力”。保护、促进和支持幼儿发展对实现这一目标至关重要。儿童健康和福祉以及成人晚年健康的基础是在怀孕和幼儿时期奠定的。因此,对证据的回顾采用了生命历程的方法,从怀孕开始,一直延伸到7岁,包括进入学校的过渡,并涵盖“早期”。
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引用次数: 1
Health and early years services 保健和幼儿服务
Pub Date : 2019-03-01 DOI: 10.1093/med/9780198788850.003.0030
Susan Soar, M. Malone
An increasing body of evidence around the importance of the first 5 years of life has led to rapid development in recent years in services for children of this age, with a policy emphasis on joint working by health visitors and early years practitioners. This coincided with a large expansion in the number of 2-year-old children accessing free early education across the maintained, private, voluntary, and independent sectors. An integrated health and early education review was introduced to review children’s progress at age 2–2½ years, combining the child health programme review at that key contact point and the statutory early years progress check at age 2 years. Carrying out a joint review has placed new demands on the skillsets of both health and early years practitioners, but implementation and follow-up research studies have highlighted some of the potential benefits of joint working for children and families.
越来越多的证据表明生命最初5年的重要性,这导致近年来为这一年龄的儿童提供的服务迅速发展,政策强调卫生巡视员和早期从业人员的联合工作。与此同时,在公立学校、私立学校、志愿学校和独立学校中,接受免费早期教育的2岁儿童数量大幅增加。实施了一项综合保健和早期教育审查,以审查2 - 2岁半儿童的进展情况,同时在该关键接触点进行儿童保健方案审查,并在2岁时进行法定的早期进展检查。开展联合审查对保健和幼儿从业人员的技能组合提出了新的要求,但实施和后续研究突出了为儿童和家庭联合工作的一些潜在好处。
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引用次数: 1
Enhancements to child health programmes in the UK 加强联合王国的儿童保健方案
Pub Date : 2019-03-01 DOI: 10.1093/MED/9780198788850.003.0032
A. Emond, A. Haynes
Five programmes which offer additional services to enhance the child health programmes for families at risk of poorer maternal and child health and development outcomes are being evaluated. Flying Start is a community-based programme targeted on families with children under 4 years of age living in deprived neighbourhoods in Wales. A Better Start is a place-based programme implemented by local partnerships in English wards with high levels of economic deprivation, providing services and support for all families living in the target wards from pregnancy until a child’s fourth birthday. The Family Nurse Partnership is a structured programme of home visits for first-time young mothers. The Maternal Early Childhood Sustained Home-visiting programme is a structured programme of sustained home visiting delivered by health visitors in pregnancy and the first 2 years. The Trial of Healthy Relationship Initiatives for the Very Early-years is comparing two parenting programmes for women with additional mental health or social support needs in pregnancy with outcomes up to 18 months. Early published results are reviewed and links given to the websites to signpost the reader to up-to-date information on the effectiveness of each programme.
目前正在评估五个方案,这些方案提供额外服务,以加强面向妇幼健康和发展结果较差的家庭的儿童保健方案。“快速启动”是一项以社区为基础的方案,针对的是威尔士贫困社区有4岁以下儿童的家庭。“更好的开始”是一项基于地方的计划,由当地合作伙伴在经济贫困程度很高的英语病房实施,为所有生活在目标病房的家庭提供从怀孕到孩子四岁生日的服务和支持。家庭护士伙伴关系是一个有组织的方案,为第一次做母亲的年轻母亲提供家访。产妇幼儿持续家访方案是一项有组织的方案,由孕期和头两年的保健访视员进行持续家访。早期健康关系倡议试验比较了针对怀孕期间需要额外心理健康或社会支持的妇女的两种育儿方案,其结果长达18个月。对早期公布的结果进行审查,并提供网站链接,以便读者了解有关每个方案有效性的最新信息。
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引用次数: 1
Delivering and managing an effective child health programme across the UK 在全英国提供和管理有效的儿童保健方案
Pub Date : 2019-03-01 DOI: 10.1093/med/9780198788850.003.0033
M. Blair
This chapter describes the evidence base supporting effective implementation of the child health programme at national and local levels. It reviews the contribution of implementation and improvement science. Training accreditation and the use of learning sets and data feedback loops are described. A key organizational mechanism to ensure local quality assurance and accountability is the formation of a local child health programme steering group. The structure and functions of such are described.
本章描述了支持在国家和地方各级有效实施儿童健康规划的证据基础。它回顾了实施和改进科学的贡献。描述了培训认证和学习集和数据反馈循环的使用。确保地方质量保证和问责制的一个关键组织机制是成立地方儿童保健方案指导小组。描述了该系统的结构和功能。
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引用次数: 0
Secondary prevention: principles and good practice/screening tests 二级预防:原则和良好做法/筛选试验
Pub Date : 2019-03-01 DOI: 10.1093/MED/9780198788850.003.0017
D. Elliman
Screening can be a very important means to reduce the morbidity and mortality of conditions that cannot currently be prevented. However, it also has the capacity to do harm by incorrectly labelling people as having a condition, when in reality they do not, thus causing anxiety and sometimes resulting in unnecessary interventions. The UK National Screening Committee recommends national policy on screening on the basis of the evidence of the overall effects of a potential programme and its cost-effectiveness. Once a programme is introduced, it should be carefully monitored to ensure that it lives up to expectations, coverage is appropriately high, the expected outcomes are delivered, and that it does not increase inequality. More detail can be found on the UK National Screening Committee website.
筛查是降低目前无法预防的疾病的发病率和死亡率的一种非常重要的手段。然而,它也有可能造成伤害,因为它错误地将人们贴上患有某种疾病的标签,而实际上他们并没有,从而引起焦虑,有时还会导致不必要的干预。联合王国国家筛查委员会根据潜在方案的总体效果及其成本效益的证据,建议国家筛查政策。一旦实施了一项计划,就应该对其进行仔细监测,以确保其符合预期,覆盖率适当高,实现预期成果,并且不会加剧不平等。更多的细节可以在英国国家审查委员会的网站上找到。
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引用次数: 0
Primary prevention and health promotion in childhood 儿童初级预防和健康促进
Pub Date : 2019-03-01 DOI: 10.1093/MED/9780198788850.003.0008
C. Adams, S. Cowley
This chapter begins by offering some definitions and an explanation of why prevention needs to start with early child development. Then, it considers some of the practicalities of providing primary prevention services, using examples to show the processes of assessing needs and delivering services. Next, key principles and practice approaches that have been found helpful to the preventive effort are explained. Finally, there is a discussion of some effective approaches to health promotion for families and promoting effective parenting.
本章首先提供了一些定义,并解释了为什么预防需要从儿童早期发育开始。然后,它考虑了提供初级预防服务的一些实际情况,并举例说明了评估需求和提供服务的过程。接下来,解释了已发现的有助于预防工作的关键原则和实践方法。最后,讨论了促进家庭健康和促进有效育儿的一些有效方法。
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引用次数: 1
The scope of the review 审查的范围
Pub Date : 2019-03-01 DOI: 10.1093/MED/9780198788850.003.0002
A. Emond
Child health programmes should be based on sound evidence of effectiveness. This chapter summarizes the reasons why an updated review of the evidence is needed in a new edition of Health for all Children, defines the scope of the fifth edition, and explains how the quality and strength of the evidence supporting practice and commissioning have been assessed. The framework for making the evidence-based recommendations for practitioners, managers, and commissioners provided at the end of each chapter is explained. An overview is provided of the book, divided into sections and chapters, with links to online evidence and training resources. The chapter concludes with some overall recommendations applicable to the child health programmes in different countries in the UK.
儿童保健方案应以可靠的有效性证据为基础。本章总结了为何需要在新版《人人享有儿童健康》中对证据进行最新审查的原因,界定了第五版的范围,并解释了如何评估支持实践和委托的证据的质量和强度。对每章末尾提供的为从业人员、管理人员和专员提供循证建议的框架进行了解释。概述提供了这本书,分为部分和章节,链接到在线证据和培训资源。本章最后提出了一些适用于联合王国不同国家儿童保健方案的总体建议。
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Oxford Medicine Online
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