Journal of Pediatric Health Care最新文献

英文中文

Managing Behavioral Health Concerns in Early Childhood: The Role of Child Psychiatry Access Programs 管理儿童早期的行为健康问题：儿童精神病学访问计划的作用。

IF 1.8 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2026-01-01 DOI: 10.1016/j.pedhc.2025.10.002

Lily Stavisky BA, Grace S. McIlmoyle MPH, Rebecca A. Ferro MA, Meghan Crosby Budinger LCPC, Rheanna Platt MD, Antonia Girard PsyD, Sarah Edwards DO, Dena Appleby LMSW, Shauna P. Reinblatt MD, Kelly Coble LCSW-C, Amie F. Bettencourt PhD

Introduction

Child Psychiatry Access Programs (CPAPs), like Maryland Behavioral Health Integration in Pediatric Primary Care (BHIPP), help address the behavioral health treatment gap. This study examined demographic and clinical characteristics of children aged 0–5 years for whom primary care providers (PCPs) and/or families sought BHIPP services, and recommendations provided by BHIPP.

Method

Descriptive and chi-square statistics were used to examine BHIPP services received, patient demographics, presenting problems, diagnostic impressions, clinical severity, treatments the patient was receiving before BHIPP contact, and BHIPP’s treatment recommendations and referrals from 1,671 unique patient-specific contacts between October 2012 and June 2023.

Results

Older children in this sample presented to BHIPP as more complex and severe. The most common treatment recommendation and referral made by BHIPP were referral to a community behavioral health provider and outpatient psychotherapy, respectively.

Discussion

This study highlights the important role of PCPs in addressing early childhood behavioral health concerns and CPAPs’ role in supporting PCPs and improving access to early childhood behavioral health care.

简介：儿童精神病学访问计划（cpap），如马里兰州儿科初级保健行为健康整合（BHIPP），有助于解决行为健康治疗差距。本研究调查了初级保健提供者（pcp）和/或家庭寻求BHIPP服务的0-5岁儿童的人口统计学和临床特征，以及BHIPP提供的建议。方法：采用描述性和卡方统计方法，对2012年10月至2023年6月1,671名患者接触者的BHIPP服务接受情况、患者人口统计、出现的问题、诊断印象、临床严重程度、患者在接触BHIPP前接受的治疗以及BHIPP的治疗建议和转诊进行分析。结果：本样本中年龄较大的儿童表现为BHIPP更为复杂和严重。BHIPP提出的最常见的治疗建议和转诊分别是转诊到社区行为健康提供者和门诊心理治疗。讨论：本研究强调了pcp在解决儿童早期行为健康问题方面的重要作用，以及cpap在支持pcp和改善儿童早期行为卫生保健方面的作用。

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引用次数: 0

COVID-19 Pandemic Restrictions and Pediatric Emergency Department Attendance for Accidents COVID-19大流行限制和儿科急诊室的事故出勤率。

IF 1.8 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2026-01-01 DOI: 10.1016/j.pedhc.2025.08.010

Alice Boria MD, Ilaria Acquaviva MD, Alessio Correani MSc, PhD, Chiara Monachesi MSc, PhD, Simona Gatti MD, PhD, Elisabetta Fabiani MD, Maria Elena Lionetti MD, PhD

Introduction

From January 2020 to March 2022, Italy implemented stringent public health measures during the COVID-19 state of emergency (EM). This study evaluated their impact on pediatric emergency department (PED) attendances for accidents.

Methods

We retrospectively analyzed 17,852 accident-related visits among patients aged ≤15 years at a regional referral PED between February 2018 and January 2024, comparing prepandemic (PRE-PAN), pandemic emergency (EM-PAN), and postemergency (PostEM-PAN) phases.

Results

Of 107,187 total PED visits, 16.7% were related to accidents. During EM-PAN, accident-related attendances rose to 24.2%, despite a 42.8% decrease in overall visits, and admission abandonment rates declined. In PostEM-PAN, total attendances remained 9.6% lower than PRE-PAN levels, accident-related visits dropped to 8.4%, and the proportion of critical triage codes increased. Visits declined in children aged 0–5 years and rose among adolescents.

Conclusions

Emergency measures during the pandemic significantly affected PED utilization, altering access patterns, clinical severity, and age distribution. While not currently part of the Italian healthcare system, nurse practitioners may be considered in future planning to support changes in pediatric emergency care, especially in contexts of public health strain.

2020年1月至2022年3月，意大利在COVID-19紧急状态期间实施了严格的公共卫生措施。本研究评估其对儿科急诊科（PED）意外出勤率的影响。方法：回顾性分析2018年2月至2024年1月期间，在区域转诊PED中年龄≤15岁的17,852例与事故相关的就诊，比较大流行前（PRE-PAN）、大流行紧急（EM-PAN）和紧急后（PostEM-PAN）阶段。结果：在107187例PED就诊中，16.7%与意外事故有关。在EM-PAN期间，事故相关的出勤率上升至24.2%，尽管总访问量下降了42.8%，住院放弃率也有所下降。在postemp - pan中，总出勤率仍然比PRE-PAN低9.6%，与事故相关的出勤率下降到8.4%，关键分诊代码的比例增加。0-5岁儿童的访问量有所下降，而青少年的访问量有所上升。结论：大流行期间的应急措施显著影响了PED的使用，改变了获取模式、临床严重程度和年龄分布。虽然目前不是意大利医疗保健系统的一部分，但在未来的计划中可能会考虑执业护士，以支持儿科急诊护理的变化，特别是在公共卫生压力的背景下。

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引用次数: 0

Mental Health Care of Children and Youth With Special Health Care Needs Across Four Systems of Care 四种护理系统中有特殊保健需要的儿童和青少年的心理保健。

IF 1.8 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2026-01-01 DOI: 10.1016/j.pedhc.2025.09.006

Valerie Boebel Toly PhD, RN, CPNP-PC, FAAN, Stacee Lerret PhD, RN, CPNP-AC/PC, CCTC, FAAN, Michele Polfuss PhD, RN, CPNP-AC/PC, FAAN, Kathleen J. Sawin PhD, RN, CPNP-PC, FAAN, Laura Grunin PhD, RN, Katherine A. Hinderer PhD, RN, CNE, NEA-BC, Sally S. Cohen PhD, PNP, RN, FAAN

Introduction

Children and youth with special health care needs (CYSHCN) have unique mental health needs. We analyzed issues in mental health care for CYSHCN across four systems (health, education, family, community).

Methods

Narrative review was employed to synthesize and summarize peer-reviewed published literature, national government, and nonprofit organization reports/websites related to mental health of CYSHCN.

Results

Mental health care of CYSHCN is fragmented across the four systems, each with its own set of policies, focus areas, providers, and resources. Mental health of CYSHCN is often overlooked as child health clinicians focus on physical health care needs. Strategies for improving access to screening, evaluation, and treatment in all four systems are presented.

Discussion

Our findings point to ways that child health clinicians might enhance access to mental health care for CYSHCN. Advanced practice registered nurses can play a pivotal role in coordinating care and linking children and families to appropriate resources.

儿童和青少年有特殊的卫生保健需求（CYSHCN）有独特的心理健康需求。我们分析了CYSHCN在四个系统（健康、教育、家庭、社区）中的精神卫生保健问题。方法：采用叙事性综述的方法，综合总结同行评议的已发表文献、国家政府、非营利组织的心理健康相关报告/网站。结果：CYSHCN的精神卫生保健分散在四个系统中，每个系统都有自己的一套政策、重点领域、提供者和资源。由于儿童健康临床医生关注身体健康保健需求，儿童儿童健康网络的心理健康往往被忽视。提出了在所有四个系统中改善获得筛查、评估和治疗的策略。讨论：我们的研究结果指出，儿童健康临床医生可能会增加获得CYSHCN心理健康护理的途径。高级执业注册护士可以在协调护理和将儿童和家庭与适当资源联系起来方面发挥关键作用。

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引用次数: 0

Society Page 社会页面

IF 1.8 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2026-01-01 DOI: 10.1016/S0891-5245(25)00348-7

引用次数: 0

Sexting and Sextortion in Adolescents: Essentials for the PNP 青少年中的性短信和性勒索：PNP要点

IF 1.8 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2026-01-01 DOI: 10.1016/j.pedhc.2025.07.017

Ellen M. Chiocca PhD, CPNP-PC, FAPSAC, Gail Hornor DNP, CPNP, SANE-P, FAPSAC, Rebecca Sidberry DNP, APRN, FNP-C, BA, CDCES

Sexting and sextortion are increasingly common concerns among adolescents, presenting significant challenges for pediatric nurse practitioners (PNPs). Sexting, or digital sharing of self-produced nude or otherwise sexual images, is increasingly seen as a normative part of adolescent sexual exploration, but carries substantial risks, particularly when images are shared non-consensually, by minors, or used as a method of bullying or extortion (“sextortion”). PNPs play a critical role in early identification of any nonconsensual texting and by providing education to adolescents so they may explore their sexuality safely, resist peer pressure, and maintain boundaries.

性短信和性勒索在青少年中越来越普遍，对儿科护士从业人员（PNPs）提出了重大挑战。性短信，或自行制作的裸体或其他性图像的数字共享，越来越被视为青少年性探索的规范部分，但存在重大风险，特别是当图像被未成年人未经同意分享时，或被用作欺凌或敲诈勒索的方法（“性勒索”）。pnp在早期识别任何未经同意的短信方面发挥着关键作用，并为青少年提供教育，使他们能够安全地探索自己的性行为，抵制同伴压力，并保持界限。

引用次数: 0

Second Episode of Rhabdomyolysis: A Case Report. 第二期横纹肌溶解1例。

IF 1.8 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2025-12-31 DOI: 10.1016/j.pedhc.2025.11.027

Mary Jean Ohns, Brooklyn Wolfe

Rhabdomyolysis is a serious medical condition resulting from skeletal muscle breakdown, leading to the release of intracellular contents-most notably myoglobin-into the bloodstream. The accumulation of myoglobin can result in acute kidney injury and electrolyte disturbances. Common etiologies include trauma, strenuous physical activity, infections, genetic predisposition, and certain medications. Clinically, patients may present with muscle pain, weakness, fatigue, dark-colored urine, and decreased urine output. Creatine kinase, an enzyme predominantly located in skeletal muscle, serves as a highly sensitive marker for muscle injury and is a key diagnostic indicator of rhabdomyolysis.

横纹肌溶解是一种由骨骼肌分解引起的严重疾病，导致细胞内内容物（最明显的是肌红蛋白）释放到血液中。肌红蛋白的积累可导致急性肾损伤和电解质紊乱。常见的病因包括创伤、剧烈运动、感染、遗传易感性和某些药物。临床上，患者可表现为肌肉疼痛、无力、疲劳、尿色深、尿量减少。肌酸激酶是一种主要存在于骨骼肌的酶，是肌肉损伤高度敏感的标志物，是横纹肌溶解的关键诊断指标。

引用次数: 0

Expanding Clarity in Competency-Based Education for Pediatric Nurse Practitioners: Response from the Authors. 在儿科护士从业人员的能力为基础的教育扩大清晰度：从作者的回应。

IF 1.8 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2025-12-29 DOI: 10.1016/j.pedhc.2025.11.018

Kristina L Banks, Carol L Savrin

引用次数: 0

Parental Attitudes and Decision Making Toward Routinely Recommended Adolescent Vaccinations: A Qualitative Study Conducted After COVID-19 Vaccine Availability. 父母对常规推荐的青少年疫苗接种的态度和决策：在COVID-19疫苗可用后进行的定性研究

IF 1.8 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2025-12-27 DOI: 10.1016/j.pedhc.2025.11.025

Alexandra Michel, Gary Glauberman, Gregory Zimet, Holly B Fontenot

Introduction: Routine adolescent vaccination rates fluctuate widely and at times fall below public health goals. This study aimed to assess parent perceptions and behaviors around vaccines and to explore potential effects of the pandemic on these parental vaccination decisions.

Method: Between February and March 2022, 64 caregivers of adolescents participated in six text-based online focus groups in which their knowledge and perception regarding routine vaccines were explored.

Results: Participants were predominantly female (84%), White (72%), and college-educated (77%). Their adolescents receiving all recommended vaccines was very important (61%) or important (34%). While caregivers appeared generally supportive of vaccines, knowledge and perception regarding these vaccines varied widely. Postpandemic, health care provider recommendations and vaccine requirements appeared to be a continued driver for obtaining vaccines.

Discussion: Health care providers should continue to apply evidence-based strategies to promote vaccine uptake while addressing misinformation and disinformation.

青少年常规疫苗接种率波动很大，有时低于公共卫生目标。本研究旨在评估父母对疫苗的看法和行为，并探讨大流行对这些父母接种疫苗决定的潜在影响。方法：在2022年2月至3月期间，64名青少年照顾者参加了6个基于文本的在线焦点小组，探讨他们对常规疫苗的知识和认知。结果：参与者主要是女性（84%），白人（72%）和大学学历（77%）。青少年接种所有推荐疫苗非常重要（61%）或重要（34%）。虽然护理人员似乎普遍支持疫苗，但关于这些疫苗的知识和看法差异很大。大流行后，卫生保健提供者的建议和疫苗需求似乎是获得疫苗的持续驱动因素。讨论：卫生保健提供者应继续应用基于证据的战略来促进疫苗接种，同时解决错误信息和虚假信息。

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引用次数: 0

Missing the Malignancy in Primary Care: A Case Study on Pediatric Osteosarcoma. 初级保健忽视恶性肿瘤：儿童骨肉瘤病例研究。

IF 1.8 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2025-12-25 DOI: 10.1016/j.pedhc.2025.11.026

Marissa Chen, Neesha Ramchandani

Osteosarcoma is the most common malignant bone tumor in pediatric and adolescent patients. Typical symptoms include nonspecific localized bone pain often occurring during the adolescent growth spurt. The timing and presentation of symptoms frequently lead primary care providers to associate them with benign conditions such as growing pains or sports-related injuries. As a result, diagnosis is frequently delayed. This case study examines a 14-year-old female whose persistent leg pain was initially misdiagnosed in a primary care setting, resulting in a delayed diagnosis of osteosarcoma. Despite normal initial imaging and examination, the patient later presented with worsening symptoms and neurological deficits, prompting advanced imaging and biopsy that confirmed malignancy. This case highlights the diagnostic challenges in primary care and the need for increased clinical awareness, standardized guidelines, and structured follow-up in pediatric patients presenting with unexplained, unilateral bone pain.

骨肉瘤是儿童和青少年患者中最常见的恶性骨肿瘤。典型症状包括非特异性局部骨痛，通常发生在青春期生长高峰期。症状出现的时间和表现往往导致初级保健提供者将其与良性疾病联系起来，如生长痛或运动相关损伤。因此，诊断常常被延误。本病例研究检查了一名14岁的女性，其持续的腿部疼痛最初在初级保健机构被误诊，导致骨肉瘤的延迟诊断。尽管最初的影像学和检查正常，但患者后来出现症状恶化和神经功能障碍，促使晚期影像学和活检确认恶性肿瘤。本病例强调了初级保健中的诊断挑战，以及提高临床意识、标准化指南和对出现不明原因单侧骨痛的儿科患者进行结构化随访的必要性。

引用次数: 0

Expanding Clarity in Competency-Based Education for Pediatric Nurse Practitioners. 在儿科护士从业人员的能力为基础的教育扩大清晰度。

IF 1.8 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2025-12-18 DOI: 10.1016/j.pedhc.2025.11.019

Iman Nurjaman

引用次数: 0

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全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Journal of Pediatric Health Care

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