为有发育障碍和相关关注行为的儿科病人提供新型护理模式。

IF 1.6 4区 医学 Q2 PEDIATRICS Journal of paediatrics and child health Pub Date : 2024-07-16 DOI:10.1111/jpc.16615
Daryl Efron, James Fowler, Emily Cull, Kirsten Noakes, Claire Wilkin, Ric Haslam
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引用次数: 0

摘要

目的:患有自闭症谱系障碍和/或智力障碍的儿童和青少年在急诊科就诊时经常会出现令人担忧的行为:易怒、攻击和自伤行为。本研究旨在设计、实施和评估一种新的护理模式,为这些患者及其家人提供就诊后的支持,以减少再次就诊的需要:我们为这些患者设计并评估了一种新的护理模式,包括与发育儿科医生和儿童精神科医生会诊、转诊至行为专科服务机构以及由临床护士顾问进行为期 6 周的护理协调。利用质量改进框架,通过一系列 "计划-实施-研究-行动 "周期对该模式进行了反复改进。再次就诊率与对照组患者进行了比较,对照组患者出现了令人担忧的行为,但未被纳入研究。在报名后的 2 周和 6 周,对参与家庭和主治临床医生进行了调查,以收集他们对该模式体验的定性反馈:共有 31 个家庭参与了研究。与对照组相比,3 个月和 6 个月的再次就诊率分别降低了 48.7% 和 36.3%。家庭和临床医生对该模式的定性评价都是积极的。该模式是可行和可接受的。家庭表示感觉自己的意见被倾听和理解,干预措施很有帮助,并提供了一条积极的前进道路:研究结果表明,一个简单的护理模式可以成功实施,并为有令人担忧行为的儿童家庭带来有意义的益处,包括减少以危机为导向的求助。
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A novel model of care for paediatric patients with developmental disabilities and associated behaviours of concern

Aim

Children and adolescents with autism spectrum disorder and/or intellectual disability often present to emergency departments with behaviours of concern: irritability, aggression and self-injurious behaviour. The objective of this study was to design, implement and evaluate a new model of care to support these patients and their families following presentation to reduce the need for re-presentation.

Methods

We designed and evaluated a new model of care for these patients, comprising consultations with a developmental paediatrician and a child psychiatrist, referral to a specialist behavioural service and 6 weeks of care coordination by a clinical nurse consultant. Using a quality improvement framework, iterative improvements were made to the model via a series of plan–do–study–act cycles. Re-presentation rates were compared with a control group of patients who presented with behaviours of concern but were not recruited into the study. Participating families and treating clinicians were surveyed at 2 and 6 weeks post-enrolment to gather qualitative feedback about their experience of the model.

Results

A total of 31 families participated in the study. Three- and 6-month re-presentation rates were 48.7% and 36.3% lower than the control group. Qualitative evaluation of the model by both families and clinicians was positive. The model was feasible and acceptable. Families reported feeling heard and understood, and that the intervention was helpful and provided a positive path forwards.

Conclusions

The findings suggest that a simple model of care can be successfully implemented and provide meaningful benefits for families of children with behaviours of concern, including reduced crisis-oriented help-seeking.

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来源期刊
CiteScore
2.90
自引率
5.90%
发文量
487
审稿时长
3-6 weeks
期刊介绍: The Journal of Paediatrics and Child Health publishes original research articles of scientific excellence in paediatrics and child health. Research Articles, Case Reports and Letters to the Editor are published, together with invited Reviews, Annotations, Editorial Comments and manuscripts of educational interest.
期刊最新文献
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