Journal of Pediatric Health Care最新文献

英文中文

Pediatric Expert Research

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2025-01-01 DOI: 10.1016/S0891-5245(24)00350-X

引用次数: 0

Advanced Practice Nursing in Pediatrics and Child Health: A New Hope in Europe 儿科和儿童保健高级实践护理：欧洲的新希望。

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2025-01-01 DOI: 10.1016/j.pedhc.2024.10.003

Sébastien Colson RN, PhD

引用次数: 0

Corrigendum to: Health Equity and Children with Medical Complexity/Children and Youth with Special Health Care Needs: A Scoping Review [Journal of Pediatric Health Care 38/2 (2024) 210–218] 健康公平与医疗复杂性儿童/有特殊健康护理需求的儿童和青少年：范围审查》[《儿科保健杂志》38/2 (2024) 210 - 218]。

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2025-01-01 DOI: 10.1016/j.pedhc.2024.10.020

Elizabeth A. Flasch

引用次数: 0

Take a Closer Look: Considerations for Autism Spectrum Disorder Assessment in Female Children and Adolescents 仔细观察：评估女性儿童和青少年自闭症谱系障碍的注意事项。

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2025-01-01 DOI: 10.1016/j.pedhc.2024.07.008

Daphna Shaw Zack DNP, APRN, CPNP-PC, Bridgette Carroll MS, Amy Magallanes MS, Veronica Bordes Edgar PhD, ABPP

Assessment for autism spectrum disorder (ASD) in the pediatric female population entails unique diagnostic complexities. Females are often misdiagnosed, undiagnosed, or receive an ASD diagnosis at a later age than males. Male bias in ASD, masking behaviors, cultural norms, and overlapping neurodevelopmental comorbidities (such as attention deficit/hyperactivity disorder and intellectual disability) contribute to this phenomenon. The authors present two clinical cases evaluated in an interdisciplinary developmental behavioral pediatrics (DBP) team to highlight these considerations. Cases describe adolescent and school aged females with medical complexity who did not initially appear to have ASD symptoms but later were diagnosed with ASD. Patient anonymity is preserved. Best practice recommendations are discussed. Shared decision making, intentional history taking, thorough observation of behavior and restrictive/repetitive/sensory interests in multiple settings, and attention to social communication in the context of cognitive capacity are essential for ASD assessment in pediatric females.

对儿科女性群体进行自闭症谱系障碍（ASD）评估会带来独特的诊断复杂性。与男性相比，女性经常被误诊、未被诊断或在较晚的年龄才被诊断为自闭症谱系障碍。男性对 ASD 的偏见、掩盖行为、文化规范以及重叠的神经发育合并症（如注意力缺陷/多动障碍和智力障碍）都是造成这种现象的原因。作者介绍了发育行为儿科（DBP）跨学科团队评估的两个临床病例，以强调这些注意事项。病例描述的是患有复杂内科疾病的青少年和学龄女性，她们起初似乎没有 ASD 症状，但后来被诊断为 ASD。患者匿名。讨论了最佳实践建议。共同决策、有意识地采集病史、在多种环境中全面观察行为和限制性/重复性/感官兴趣，以及在认知能力的背景下关注社会交往，这些对于儿科女性 ASD 评估至关重要。

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引用次数: 0

Expanding Our Impact

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2025-01-01 DOI: 10.1016/j.pedhc.2024.10.021

引用次数: 0

Caregiver Willingness to Participate in Pediatric Clinical Research During COVID-19. COVID-19期间护理人员参与儿科临床研究的意愿

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2024-12-30 DOI: 10.1016/j.pedhc.2024.12.001

Crystal S Lim, Dustin E Sarver, Dustin C Brown, Russell McCulloh, Lacy Malloch, Tre D Gissandaner, Robert D Annett

Introduction: Understanding caregiver willingness to participate in pediatric clinical research is needed. We examined caregiver perceptions of pediatric clinical research during COVID-19 and examined research attitudes and sociodemographic factors as predictors of willingness.

Methods: A cross-sectional telephone survey was administered to caregivers of children from August 2020 to April 2021. We examined caregiver willingness to participate in the following research modalities during COVID-19: telehealth, in-person, and vaccine-focused.

Results: Participants included 600 caregivers (52.8% non-Hispanic White; Child Age M = 9.3 years; 50.0% from rural areas). Caregivers reported more willingness to participate in nonvaccine research (64.0% telehealth, 59.4% face-to-face) compared to vaccine research (22.1%). Different predictors were found for caregivers living in rural and nonrural areas and specific research attitudes predicted willingness.

Discussion: Caregiver willingness to participate in pediatric clinical research during COVID-19 differed by modality and research attitudes predicting willingness differed by geography. Surveillance regarding pediatric vaccine and clinical research hesitancy broadly should continue.

引言：了解照顾者参与儿科临床研究的意愿是必要的。我们检查了COVID-19期间护理人员对儿科临床研究的看法，并检查了研究态度和社会人口因素作为意愿的预测因素。方法：于2020年8月至2021年4月对儿童看护人进行横断面电话调查。我们调查了护理人员在COVID-19期间参与以下研究模式的意愿：远程医疗、面对面和以疫苗为重点。结果：参与者包括600名护理人员(52.8%为非西班牙裔白人；儿童年龄M = 9.3岁；50.0%来自农村地区)。与疫苗研究（22.1%）相比，护理人员报告更愿意参与非疫苗研究（64.0%远程医疗，59.4%面对面医疗）。居住在农村和非农村地区的照顾者有不同的预测因子，具体的研究态度预测意愿。讨论：COVID-19期间护理人员参与儿科临床研究的意愿因方式而异，研究态度预测意愿因地理而异。对儿科疫苗和临床研究犹豫不决的监测应继续进行。

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引用次数: 0

Screening for Depression in Caregivers of Children with Developmental Disabilities: A Quality Improvement Initiative 发育障碍儿童照顾者抑郁症筛查：质量改进倡议。

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2024-12-20 DOI: 10.1016/j.pedhc.2024.11.014

Mae Yue Tan MRCPCh, Shang Chee Chong MRCPCh, Amutha Chinnadurai MRCPCh, Sangeetha Guruvayurappan BHMS

Introduction

Screening for depression in caregivers of children with developmental disabilities is not routine, representing missed opportunities for support.

Method

A quality improvement project was initiated in our pediatric clinic. Root causes of limited screening included unclear guidelines for support, caregiver perception that help is unavailable, and lack of a quick screening tool. A clinical pathway was constructed and integrated into existing practice using quality improvement methodology.

Results

Baseline screening rate was 5%–10%. During the 12-week pilot, weekly rates ranged from 46.0% to 91.0% (mean 70.2%). Monthly rates subsequently averaged 55.0%. Approximately 20% had a positive screen; over half were caregivers of children with autism. About 5% had moderate depression, of whom 40% required referral to social workers.

Discussion

Structured depression screening of caregivers of children with developmental disabilities is feasible and sustainable in a busy clinic. Further research is needed to measure the impact on child and family outcomes.

对发育障碍儿童的照料者进行抑郁症筛查并不是常规的，这意味着他们错过了获得支持的机会。方法：在我院儿科门诊开展质量改进项目。筛查有限的根本原因包括支持指南不明确，护理人员认为无法获得帮助，以及缺乏快速筛查工具。构建了临床路径，并使用质量改进方法将其整合到现有实践中。结果：基线筛查率为5% ~ 10%。在12周的试点期间，每周的费率从46.0%到91.0%不等（平均为70.2%）。其后每月平均利率为55.0%。约20%的筛查结果呈阳性；超过一半的人是自闭症儿童的看护人。约5%患有中度抑郁症，其中40%需要转介给社会工作者。讨论：在繁忙的诊所中，对发育障碍儿童的照料者进行结构化的抑郁症筛查是可行和可持续的。需要进一步的研究来衡量对儿童和家庭结果的影响。

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引用次数: 0

Closing Pediatric Asthma Care Gaps Through School-Based Telehealth: A Quality Improvement Initiative. 通过校本远程保健缩小小儿哮喘护理差距：质量改进计划。

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2024-12-14 DOI: 10.1016/j.pedhc.2024.11.003

Amanda K Vickers, Robert Darzynkiewicz, Kelli Garber, Michael Maymi

Background: Uncontrolled pediatric asthma leads to poorer outcomes; school-based telehealth (SBTH) is an opportunity to intervene.

Local problem: The connection rate to primary care after SBTH visits for asthma exacerbations was below organizational goals. Additionally, there was a gap in assessing SBTH's role in providing access to rescue medication.

Method: A 3-month plan-do-study-act design was used to improve SBTH referral rates among SBTH providers. Data was collected via EHR reports and chart reviews.

Interventions: SBTH providers were trained to complete a 3-question checklist on referral orders for all patients treated for an asthma exacerbation.

Results: Chi-square analysis showed a statistically significant increase (p < .001) in the "Connect to PCP" rate, 21% to 71%. Additionally, 86% of eligible participants had access to rescue medication at school, with one-third requiring SBTH to bridge a gap.

Conclusions: PCP connection can be increased; however, automation is needed for sustainability. Additionally, SBTH may increase access to asthma medication.

背景：未经控制的儿童哮喘导致较差的预后；基于学校的远程医疗（SBTH）是一个进行干预的机会。局部问题：哮喘加重SBTH就诊后的初级保健接通率低于组织目标。此外，在评估SBTH在提供救援药物方面的作用方面存在差距。方法：采用为期3个月的计划-研究-行动设计来提高SBTH提供者的转诊率。通过电子病历报告和图表审查收集数据。干预措施：对SBTH提供者进行了培训，以完成所有接受哮喘加重治疗的患者转诊命令的3个问题清单。结果：卡方分析显示，“连接到PCP”的比率增加了21%至71%，具有统计学意义（p < 0.001）。此外，86%的合格参与者在学校获得了救援药物，三分之一的人需要SBTH来弥补差距。结论：PCP连接可增加；然而，可持续发展需要自动化。此外，SBTH可能会增加获得哮喘药物的机会。

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引用次数: 0

The Relationship Between Screen Use and preschoolers' Social-Emotional Problems Among Highly Educated Migrant Families: A One-Year Follow-Up Study 高学历流动家庭屏幕使用与学龄前儿童社会情绪问题的关系：一项为期一年的随访研究。

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2024-12-13 DOI: 10.1016/j.pedhc.2024.11.009

Meixiu Xu MSc, Shaoying Liu PhD, Jingwen Xu MS, Yanqing Zhou BS, Luxin Xu MS

Introduction

The present study investigated the relationship between screen use and social-emotional problems in preschoolers aged 46 to 72 months from migrant families.

Methods

The parents of 427 children completed the Ages and Stages Questionnaire: Social Emotional II (ASQ: SE II) and the survey on screen use at two time points (T1 and T2) with one-year interval.

Results

There were no significant changes in preschoolers' social-emotional problems and screen use over one year. Preschoolers who exceeded 1 hr per day on screens at T1 increased the risk for social-emotional problems at T2. Those who had parental involvement at T1 reduced the risk for social-emotional problems at T2. Those who viewed educational content at T1 reduced the risk for social-emotional problems between T1 and T2.

Discussion

These findings highlight the protective and risk factors of screen use independently predicted children's social-emotional problems from highly educated migrant families.

前言：本研究调查了来自流动家庭的46 ~ 72个月学龄前儿童屏幕使用与社会情绪问题的关系。方法：对427名儿童家长进行年龄阶段问卷：社会情绪II （ASQ: SE II）和T1、T2两个时间点（间隔1年）的屏幕使用情况调查。结果：学龄前儿童的社交情绪问题和屏幕使用在一年内无显著变化。学龄前儿童在第一阶段每天看屏幕超过1小时，在第二阶段出现社交情绪问题的风险会增加。那些在第一阶段有父母参与的孩子在第二阶段出现社交情绪问题的风险降低了。那些在第一阶段观看教育内容的人在第一阶段和第二阶段之间出现社交情绪问题的风险降低了。讨论：这些发现强调了屏幕使用的保护因素和风险因素独立预测了高学历移民家庭儿童的社会情感问题。

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引用次数: 0

Practical Application of Nirsevimab Recommendations for Infants and Toddlers. 婴儿和学步儿童Nirsevimab推荐的实际应用。

IF 2.5 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care

Pub Date : 2024-12-12 DOI: 10.1016/j.pedhc.2024.11.005

Carol Risko Radcliffe, Gabriella Akkawi, Rebecca A Carson

Respiratory syncytial virus (RSV) is a common respiratory tract infection that causes bronchiolitis and pneumonia in infants and children. It is the leading cause of hospitalization of infants in the United States. Nirsevimab is a long-acting monoclonal antibody recommended for the prevention of severe disease in all infants under 8 months of age and certain high-risk toddlers. Recent data demonstrate a 90% protection against hospitalization from severe RSV disease for infants who received nirsevimab in their first RSV season. Providers should understand the mechanism of action, safety, efficacy, and prescribing recommendations for nirsevimab, especially when confronted with caregivers who are hesitant about medications and vaccines. Special circumstances may require nuanced prescribing of nirsevimab to safely provide optimal protection. In these circumstances, and during drug shortages, a lens of health equity should be used to protect the highest risk populations.

呼吸道合胞病毒（RSV）是一种常见的呼吸道感染，可引起婴儿和儿童的毛细支气管炎和肺炎。它是美国婴儿住院的主要原因。Nirsevimab是一种长效单克隆抗体，推荐用于预防所有8个月以下婴儿和某些高危幼儿的严重疾病。最近的数据表明，在第一个呼吸道合胞病毒流行季节接受尼塞维单抗治疗的婴儿，可预防90%因严重呼吸道合胞病毒疾病住院。提供者应了解尼瑟维单抗的作用机制、安全性、有效性和处方建议，特别是当面对对药物和疫苗犹豫不决的护理人员时。特殊情况下，可能需要细致的处方尼西维单抗，以安全提供最佳的保护。在这些情况下，以及在药物短缺期间，应当从卫生公平的角度来保护风险最高的人群。

引用次数: 0

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Journal of Pediatric Health Care

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