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Adaptation to Asthma in Children: A Matter of Coping and Stress Control. 儿童对哮喘的适应:应对和压力控制。
Pub Date : 2021-07-07 DOI: 10.1080/24694193.2021.1945707
Cindy Carolina Segura Moreno, Luz Patricia Diaz Heredia

Asthma is the most common chronic lower respiratory disease in childhood throughout the world; it is characterized by bronchial hyperreactivity and variable airway obstruction. Asthma is a disorder involving autonomic nervous system, immunologic, and psychologic factors in individuals. This work sought to describe the relationship among stress, coping, and disease control in children with asthma between 6 and 12 years of age. This was a cross-sectional correlational quantitative study with the participation of 280 children with asthma admitted to outpatient consultation and to a hospitalization service at a tier IV health institution in the city of Bogotá. An inverse correlation was found between stress and coping (r = -0.581; p < .05); between stress and asthma control (r = -0.545¸ p < .05); and a direct correlation between coping and asthma control (r = 0.759; p < .05). The results show that children with low stress levels have greater control of their disease and assume functional coping against their health status. The theory of Adaptation to Chronic Health Conditions permitted analyzing children's conduct and behaviors against a health situation. These findings provide evidence for promoting interventions directly to patients with asthma, focusing on patients, families, and schools. Thus, it is possible to improve the quality of health care and strengthen primary health care.

哮喘是全世界儿童时期最常见的慢性下呼吸道疾病,以支气管高反应性和可变气道阻塞为特征。哮喘是一种涉及自律神经系统、免疫和心理因素的疾病。本研究试图描述 6 至 12 岁哮喘患儿的压力、应对和疾病控制之间的关系。这是一项横断面相关定量研究,波哥大市一家四级医疗机构的 280 名哮喘患儿参加了门诊咨询和住院服务。研究发现,压力与应对之间存在反相关关系(r = -0.581; p < .05);压力与哮喘控制之间存在反相关关系(r = -0.545¸ p < .05);应对与哮喘控制之间存在直接相关关系(r = 0.759; p < .05)。结果表明,压力水平低的儿童对疾病的控制能力更强,并能针对自己的健康状况采取功能性应对措施。适应慢性健康状况理论允许分析儿童在健康状况下的行为和举止。这些研究结果为直接向哮喘患者推广干预措施提供了证据,重点是患者、家庭和学校。因此,提高医疗保健质量和加强初级医疗保健是可能的。
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引用次数: 0
Does a Behavioral Parent Training Program for Parents of ADHD Children Improve Outcomes? A Pilot Project. 针对多动症儿童家长的行为家长培训计划能否改善结果?试点项目。
Pub Date : 2021-06-15 DOI: 10.1080/24694193.2021.1933263
Tracie Clark Morgan, Louise C O'Keefe

Attention Deficit Hyperactivity Disorder (ADHD) is the most common chronic neurobehavioral disorder of childhood. Research suggests increased parent-child conflict exists in families with an ADHD child. The evidence indicates links between child behavior problems and parenting practices. Behavioral Parent Training (BPT) is an evidence-based intervention recommended for the treatment of ADHD. BPT is recommended as first-line treatment in ADHD children under age six and as a combination treatment approach for children older than the age six. BPT programs have demonstrated significant improvement in frequency of the problem behaviors of inattention, hyperactivity, and impulsivity associated with ADHD. Pre- and Post-BPT Parenting Scales and Vanderbilt ADHD Diagnostic Rating Scales for Parents and Teachers were used to evaluate the efficacy of the BPT program. Percent changes for each participant pre- and post-BPT were calculated. The Parenting Scale overall score and overreactivity factor score showed significant improvement post-BPT (p = .05). Participation in a BPT program can affect parenting practices and improve outcomes for ADHD children. BPT programs are effective in reducing negative parenting practices and improving outcomes for this population.

注意力缺陷多动障碍(ADHD)是儿童时期最常见的慢性神经行为障碍。研究表明,在有多动症儿童的家庭中,亲子间的冲突会增加。证据表明,儿童行为问题与父母的养育方式有关。行为父母训练(BPT)是一种基于证据的干预措施,被推荐用于治疗多动症。建议将 BPT 作为六岁以下多动症儿童的一线治疗方法,并作为六岁以上儿童的综合治疗方法。事实证明,BPT 方案能明显改善与多动症相关的注意力不集中、多动和冲动等问题行为。在评估 BPT 计划的疗效时,使用了 BPT 前和 BPT 后家长评分表以及范德比尔特多动症家长和教师诊断评分表。计算了每位参与者在 BPT 前和 BPT 后的百分比变化。父母教养量表总分和过度反应因子分在 BPT 后有显著改善(p = .05)。参加 BPT 计划可以影响父母的养育方式,并改善多动症儿童的治疗效果。BPT 计划能有效减少消极的养育方式,并改善这一人群的结果。
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引用次数: 0
Clinical Features of COVID-19 in Newborns, Infants, and Children: A Systematic Review and Meta-analysis. 新生儿、婴儿和儿童 COVID-19 的临床特征:系统回顾与元分析
Pub Date : 2021-06-14 DOI: 10.1080/24694193.2021.1930288
Leila Taheri, Seyede Fatemeh Gheiasi, Mohammad Taher, Mohammad Hasan Basirinezhad, Zulfiqar Ali Shaikh, Nahid Dehghan Nayeri

Although it was thought that children were not susceptible to 2019-nCoV in the early days of the COVID-19 infection outbreak, there are currently reports of children and even one-day-old newborns being infected by the virus and hospitalized around the world. Recognizing the symptoms of the infection in children is of great value since a large number of children are asymptomatic or have mild symptoms, which may act as facilitators of the virus transmission. This review aimed to identify and summarize the existing evidence on clinical characteristics of COVID-19 in pediatric patients. A systematic search was conducted in the PubMed, Web of Science, Scopus, Google Scholar, and WHO database for eligible publications. The review proposal was registered with the PROSPERO. The quality assessment was done based on JBI Critical appraisal tools. The random-effects model was used to pool clinical features in the meta-analysis. From the identified 256 potentially relevant studies, 32 articles met the predetermined inclusion and exclusion criteria. Twenty-one studies fulfilled the criteria for this meta-analysis. Fever (58%) and cough (48%) were reported as the most common symptoms of infected children. Disease severity was mild in 51% and moderate in 39% of cases. A total of 63% of cases had respiratory and 25% of children had gastrointestinal symptoms, particularly diarrhea and nausea/vomiting. Approximately 24% of patients were asymptomatic. Results demonstrated that fever and cough were the most common symptoms of COVID-19-infected children and the majority of cases had mild-to-moderate disease severity.

尽管在 COVID-19 感染疫情爆发初期,人们认为儿童对 2019-nCoV 病毒并不敏感,但目前世界各地都有儿童甚至刚出生一天的新生儿感染该病毒并住院治疗的报道。由于大量儿童无症状或症状轻微,可能成为病毒传播的诱因,因此识别儿童感染症状具有重要价值。本综述旨在识别和总结有关儿童患者 COVID-19 临床特征的现有证据。我们在 PubMed、Web of Science、Scopus、Google Scholar 和 WHO 数据库中对符合条件的出版物进行了系统检索。综述提案已在 PROSPERO 注册。质量评估根据 JBI 关键评估工具进行。在荟萃分析中,采用随机效应模型汇集临床特征。在确定的 256 项潜在相关研究中,有 32 篇文章符合预定的纳入和排除标准。21项研究符合本次荟萃分析的标准。据报道,发热(58%)和咳嗽(48%)是受感染儿童最常见的症状。51%的病例病情较轻,39%的病例病情较重。63%的病例有呼吸道症状,25%的儿童有胃肠道症状,尤其是腹泻和恶心/呕吐。约 24% 的患者无症状。结果表明,发烧和咳嗽是感染 COVID-19 的儿童最常见的症状,大多数病例的病情为轻度至中度。
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引用次数: 0
An Overview of Adolescents Sexual and Reproductive Health Services Provision in Malaysia. 马来西亚青少年性健康和生殖健康服务提供概况。
Pub Date : 2021-06-01 Epub Date: 2020-05-22 DOI: 10.1080/24694193.2020.1756983
Abdul Hamid Siti Hazariah, Debbie Fallon, Peter Callery

Safer sex provision, including contraception information and services, should be made available to adolescents regardless of their marital status in strategies to reduce the incidence of unintended teenage pregnancies and the spread of STIs. In Malaysia, this information is still not being delivered formally to adolescents even though unintended teenage pregnancies and the practice of "baby dumping" are serious public health issues. The aims of this article are to describe the Malaysian context in terms of the need for comprehensive sexual and reproductive health information and treatment for unmarried adolescents. The article presents the key aspects of Malaysian society and the potential influence on the provision and delivery of sexual and reproductive health information and treatment to unmarried Malaysian adolescents that can be a reference for healthcare professionals especially school health nurses. The article also describes the establishment of sheltered homes, baby hatches and unregulated adoption processes as the initiatives being taken to address the issue of unintended teenage pregnancies. This article suggests that the policy and laws that require parental consent for accessing the services need to be reviewed and revised to ensure that specific services are available to adolescents in a safe environment that maintains confidentiality.

应向青少年提供更安全的性行为,包括避孕信息和服务,无论其婚姻状况如何,以减少少女意外怀孕的发生率和性传播感染的传播。在马来西亚,尽管少女意外怀孕和"弃婴"做法是严重的公共卫生问题,但仍然没有正式向青少年提供这方面的信息。这篇文章的目的是描述马来西亚在需要全面的性健康和生殖健康信息以及未婚青少年治疗方面的情况。文章介绍了马来西亚社会的关键方面,以及对向未婚马来西亚青少年提供和提供性健康和生殖健康信息和治疗的潜在影响,可作为保健专业人员,特别是学校保健护士的参考。文章还描述了建立庇护之家、婴儿舱和不受管制的收养程序,作为解决少女意外怀孕问题的举措。这篇文章建议,需要审查和修订需要父母同意才能获得服务的政策和法律,以确保青少年在保密的安全环境中获得具体服务。
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引用次数: 9
Understanding the Causes of Work-Related Stress among Registered Nurses Working with Children at Home: An Integrative Literature Review. 了解在家照顾儿童的注册护士工作压力的原因:一项综合文献综述。
Pub Date : 2021-06-01 Epub Date: 2020-04-23 DOI: 10.1080/24694193.2020.1745325
Julianne Lee, Sonya Clarke, Fiona Lynn

Work-related stress in nursing is widely acknowledged. This integrative review was undertaken to systematically identify and appraise the causes of work-related stress experienced by registered nurses working with children at home. Ten studies were included, eight of which focused solely on the experiences of nurses providing palliative and end of life care at home for children. One study focused on the experiences of newly qualified nurses and one on the experiences of nurses caring for sick children at home at different stages within their care trajectory. Stress was experienced by nurses caring for children at home and identified and acknowledged within all included studies. Recurrent themes reported in the literature that contributed to work-related stress were, provision of out of hours care, challenge of developing and maintaining skills (clinical and non-clinical), ambiguity of roles and relationships (professional team and child and family), lack of resources, emotional toll, and lack of staff support. The causes of work-related stress highlighted in this review need to be proactively addressed; thus, providing an opportunity to improve the working experiences of nurses improve job satisfaction and overall wellbeing. A recommendation from this integrative review is for workplaces to identify and invest in effective strategies to prevent or reduce work-related stress.

护理工作中的工作压力是公认的。这项综合评价是为了系统地识别和评估在家照顾儿童的注册护士所经历的工作压力的原因。纳入了10项研究,其中8项仅关注护士在家中为儿童提供姑息治疗和临终关怀的经验。一项研究关注新合格护士的经验,另一项研究关注护士在护理轨迹的不同阶段照顾生病儿童的经验。在家里照顾孩子的护士也经历了压力,并且在所有纳入的研究中都得到了确认和承认。文献中反复报道的导致工作压力的主题是,提供非工作时间的护理,发展和保持技能的挑战(临床和非临床),角色和关系的模糊性(专业团队和孩子和家庭),缺乏资源,情感损失和缺乏员工支持。本次审查中强调的工作压力的原因需要积极解决;因此,提供一个改善护士工作经验的机会,可以提高工作满意度和整体幸福感。这项综合审查的建议是,工作场所应确定并投资于有效的策略,以预防或减少与工作有关的压力。
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引用次数: 2
Reducing the Impact of Anti-Vaccine Propaganda on Family Health. 减少反疫苗宣传对家庭健康的影响。
Pub Date : 2021-06-01 Epub Date: 2021-04-30 DOI: 10.1080/24694193.2021.1912988
Edward Alan Glasper

Emeritus Professor Alan Glasper from the University of Southampton discusses strategies to enhance Covid-19 and other vaccine uptake among some families and groups in society who are adversely influenced by so called anti-vaxxers.

来自南安普顿大学的名誉教授艾伦·格拉斯珀讨论了在一些家庭和社会群体中加强Covid-19和其他疫苗接种的策略,这些家庭和群体受到所谓的抗疫苗者的不利影响。
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引用次数: 0
The Challenge of Teaching Emotive Subject Content within the Pre-registration Nursing Program-A Retrospective Review. 在预注册护理课程中教授情感主题内容的挑战——回顾性回顾。
Pub Date : 2021-06-01 Epub Date: 2021-05-11 DOI: 10.1080/24694193.2021.1925074
Bally Sandhu
Undergraduate training of student nurses at each UK higher education institution (HEI) consists of a network of modules interwoven in subjects culminating in a well validated program preparing student nurses to be both competent and confident in their care delivery (Price & McAlinden, 2018; Nursing and Midwifery Council UK, 2018). Pre-registration nursing programs are mostly designed to start with the development of the infant leading to the critically ill child with reference to developing a reasonable understanding in mental and emotional health at some point over the course delivery. The complexities of caring for children require nurses who are fully conversant with the unique needs of this client group. Yet the most emotive and sensitive issues that influence children’s emotional wellbeing remain somewhat understudied within pre-registration nursing due to the challenging nature of the subjects and emotional impact on students learning in the classroom (Mills et al., 2021). Research informs us that young people are willing to engage in understanding much more about their mental health and emotional wellbeing (Omari et al., 2019) despite stigma and discrimination in society. Yet many health-care professionals require support in having confidence in providing a non-judgmental service that is both empathetic and practical (Trainor, 2020). Discrimination remains particularly prevalent toward young people expressing themselves as transgender or non-binary, a minority group whose characteristics and needs (Gender Recognition Act, 2004) should be understood, as well as the mental health needs of Black and Asian children which are overlooked far too often within healthcare (Burton et al., 2014). Along with implementing ethnic-racial socialization (Priest et al., 2014) a deeper exploration of egregious cultural practices of female genital mutilation (Balkozar, 2020), honor-based violence and forced marriages (Gregory et al., 2020), human trafficking (Raker, 2020), or violated mothers modeling aggressive behavior toward their children (Morgan, 2020) remain too often outside the 3-year program. Embedding these emotionally challenging topics within the BSc in Children’s Nursing requires skill, planning, and sensitivity by nurse educators. For many years, performing diagnostics to confirm conditions such as type 1 diabetes or throat infection has become quicker and more accurate (Shatkin, 2015), whereas the lack of accurate testing to determine why a child is exhibiting behaviors of anger, irritability, and withdrawal in the absence of any physical illness remains complex and inexact. Nor is there an exact formula in helping children deal with loss.
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引用次数: 0
Factors Associated with Acute Health Care Use in Children and Adolescents with Asthma. 儿童和青少年哮喘患者急性卫生保健使用的相关因素
Pub Date : 2021-06-01 Epub Date: 2020-04-17 DOI: 10.1080/24694193.2020.1742249
Maha Dardouri, Jihene Sahli, Thouraya Ajmi, Ali Mtiraoui, Jihene Bouguila, Manel Mallouli
ABSTRACT Asthma is a leading cause of acute health care use (AHCU) as defined by hospitalization and emergency department visits (ED). Little was known about factors associated with asthma-related AHCU. This study aimed to identify factors determining AHCU in children and adolescents with asthma. A descriptive study was conducted among children with mild to severe asthma referred to the pediatric outpatient clinic of “Farhat Hached” University Hospital of Sousse (Tunisia) over a period of three months (April–June 2018). We collected data regarding clinical information, the number of hospitalizations and ED visits related to asthma in the past 12 months, asthma management behaviors, and quality of life of children. Multivariable logistic regression was performed using SPSS (20.0). A total of 90 children have participated in the study. The percentage of children aged 7 to 11 years was higher than the percentage of adolescents aged 12 to 17 years (67.8%; 32.2%, respectively). The final logistic regression model demonstrated that asthma severity and inhaler technique increased the odds of AHCU (OR a = 4.6; 95% CI: 1.1–18.1; p = .03, OR a = 2.9; 95% CI: 1.1–7.8; p = .02, respectively). Also, increased quality of life score reduced the odds of AHCU (OR a = 0.6; 95% CI: 0.4–0.9; p = .01). These results suggest that the organization of programs targeting the management of these factors can reduce the workload on hospital services and emergencies.
根据住院和急诊就诊(ED)的定义,哮喘是急性医疗保健使用(AHCU)的主要原因。人们对哮喘相关AHCU的相关因素知之甚少。本研究旨在确定影响哮喘儿童和青少年AHCU的因素。在为期三个月(2018年4月至6月)的突尼斯苏塞“Farhat Hached”大学医院儿科门诊对轻度至重度哮喘患儿进行了描述性研究。我们收集了过去12个月内与哮喘相关的临床信息、住院次数和急诊次数、哮喘管理行为和儿童生活质量等数据。采用SPSS(20.0)进行多变量logistic回归分析。共有90名儿童参与了这项研究。7 ~ 11岁儿童的比例高于12 ~ 17岁青少年的比例(67.8%;分别为32.2%)。最终的logistic回归模型显示,哮喘严重程度和吸入器技术增加了AHCU的几率(OR = 4.6;95% ci: 1.1-18.1;p = .03, OR a = 2.9;95% ci: 1.1-7.8;P = .02)。此外,生活质量评分的提高降低了AHCU的几率(OR a = 0.6;95% ci: 0.4-0.9;P = 0.01)。这些结果表明,针对这些因素的管理组织项目可以减少医院服务和急诊的工作量。
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引用次数: 2
Psychological Well-being and Perceived Parenting Style among Adolescents. 青少年心理健康与父母教养方式的关系。
Pub Date : 2021-06-01 Epub Date: 2020-04-17 DOI: 10.1080/24694193.2020.1743796
Ansu Francis, Mamatha Shivananda Pai, Sulochana Badagabettu

The family of an adolescent assists in shaping the adolescent's behavior and psychological well-being throughout life. In order for the adolescents to maintain an identity, they require security and affection from their parents. To assess the psychological well-being, perceived parenting style of adolescents and to determine the relationship between psychological well-being and perceived parenting style among the adolescents, a correlational survey was conducted in five randomly selected schools in Southern India with 554 adolescents studying in 8th grade to 9th grade. A self-administered perceived parenting scale and a standardized Ryff scale for the assessment of psychological well-being were adopted to collect data, which were analyzed using SPSS. Without gender differences, majority (51%) had a high psychological well-being; 49% revealed low psychological well-being. Majority (95.5%) had a purpose in life and positive relation with others. Most (93.2%) of the adolescents perceived their parents as authoritative. A moderately positive relationship was found between psychological well-being and authoritarian and permissive parenting styles and a negative correlation between psychological well-being and neglectful parenting style. The study concluded that parenting styles will have an influence on adolescents' psychological well-being. Among the four parenting styles, authoritative parenting is warm and steady and hence will contribute to the psychological development of adolescents. They also had maintained a positive relation with others and have a purpose in life. Adolescents who perceived their parents as authoritarian had a decreased autonomy and those who perceived their parents as permissive had a diminished personal growth.

青少年的家庭有助于塑造青少年一生的行为和心理健康。为了让青少年保持一种身份认同,他们需要来自父母的安全和关爱。为了评估青少年的心理健康、感知父母教养方式,并确定青少年心理健康与感知父母教养方式之间的关系,在印度南部随机选择5所学校对554名8年级至9年级的青少年进行了相关调查。采用自填父母感知量表和标准化的Ryff心理健康评估量表收集数据,采用SPSS软件进行分析。没有性别差异,大多数(51%)的心理幸福感较高;49%的人表示心理健康状况不佳。大多数人(95.5%)有生活目标,与他人关系积极。大多数(93.2%)青少年认为父母是权威的。研究发现,儿童的心理健康与专制型和宽容型父母教养方式呈中等正相关,与忽视型父母教养方式呈负相关。该研究得出结论,父母教养方式会对青少年的心理健康产生影响。在四种教养方式中,权威型的教养方式温暖而稳健,有利于青少年的心理发展。他们还与他人保持着积极的关系,并在生活中有目标。认为父母专制的青少年自主性下降,认为父母放任的青少年个人成长减少。
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引用次数: 17
Capacity Building for Health Care Workers and Support Staff in Pediatric Emergency Triage Assessment and Treatment (ETAT) at Primary Health Care Level in Resource Limited Settings: Experiences from Malawi. 在资源有限的情况下,对初级卫生保健人员和辅助人员进行儿科急诊分诊评估和治疗(ETAT)方面的能力建设:马拉维的经验。
Pub Date : 2021-05-24 DOI: 10.1080/24694193.2021.1916127
Maureen Daisy Majamanda, Mtisunge Joshua Gondwe, Martha Makwero, Alfred Chalira, Norman Lufesi, Queen Dube, Nicola Desmond

Primary health care facilities offer an entry point to the health care system in Malawi. Challenges experienced by these facilities include limited resources (both material and human), poor or inadequate knowledge, skills and attitudes of health care workers in emergency management, and delay in referral from primary care level to other levels of care. These contribute to poor outcomes including children dying within the first 24 hours of hospital admission. Training of health care workers and support staff in Emergency Triage Assessment and Treatment (ETAT) at primary care levels can help improve care of children with acute and severe illnesses. Health care workers and support staff in the primary care settings were trained in pediatric ETAT. The training package for health care workers was adapted from the Ministry of Health ETAT training for district and tertiary health care. Content for support staff focused on non-technical responsibility for lifesaving in emergency situations. The primary health care facilities were provided with a minimum treatment package comprising emergency equipment, supplies and drugs. Supportive supervisory visits were conducted quarterly. The training manual for health care workers was adapted from the Ministry of Health package and the support staff training manual was developed from the adapted package. Eight hundred and seventy-seven participants were trained (336 health care workers and 541 support staff). Following the training, triaging of patients improved and patients were managed as emergency, priority or non-urgent. This reduced the number of referral cases and children were stabilized before referral. Capacity building of health care workers and support staff in pediatric ETAT and the provision of a basic health center package improved practice at the primary care level. The practice was sustained through institutional mentorship and pre-service and in-service training. The practice of triage and treatment including stabilization of children with dangerous signs at the primary health care facility improves emergency care of patients, reduces the burden of patients on referral hospitals and increases the number of successful referrals.

在马拉维,初级医疗保健设施是进入医疗保健系统的入口。这些设施所面临的挑战包括:资源(物质和人力资源)有限,医护人员在应急管理方面的知识、技能和态度欠佳或不足,以及从初级保健阶段向其他保健阶段转诊的延误。这些都导致了不良后果,包括儿童在入院后 24 小时内死亡。在基层医疗机构对医护人员和辅助人员进行紧急分诊评估和治疗(ETAT)培训,有助于改善对急重症儿童的护理。对基层医疗机构的医护人员和辅助人员进行了儿科紧急分诊评估和治疗培训。针对医护人员的培训教材改编自卫生部针对地区和三级医疗机构的 ETAT 培训。辅助人员的培训内容侧重于紧急情况下救生的非技术性责任。向初级卫生保健设施提供了最低限度的治疗包,其中包括应急设备、用品和药品。每季度进行一次支持性监督访问。医护人员培训手册是根据卫生部的一揽子计划改编的,辅助人员培训手册则是根据改编后的一揽子计划编写的。共有 87 人接受了培训(336 名医护人员和 541 名辅助人员)。培训结束后,病人的分流工作得到了改善,病人被按急诊、优先或非急诊进行管理。这减少了转诊病例的数量,儿童的病情在转诊前得到了稳定。医护人员和辅助人员在儿科急诊急救方面的能力建设,以及提供基本的保健中心套餐,改善了初级保健层面的实践。通过机构指导以及岗前和在岗培训,这种做法得以持续。在初级卫生保健机构对有危险征兆的儿童进行分诊和治疗,包括稳定病情,这种做法改善了对病人的紧急护理,减轻了病人对转诊医院的负担,并增加了成功转诊的人数。
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引用次数: 0
期刊
Comprehensive child and adolescent nursing
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