Wilf-Miron R, Glasser S, Sikron F, Barell V
Pediatric Division, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Pediatrics. 2000 Nov;106(5):1065-9. doi: 10.1542/peds.106.5.1065.
We assessed the extent to which a health concerns checklist (HCC) helps bridge the gap between the reason for encounter (RFE) described by girls entering an adolescent health service and the ultimate diagnosis.
The sample, 547 consecutive 12- to 18-year-old girls visiting an adolescent health service, first underwent a structured intake procedure, including a self-administered form on which they described their RFEs and other health concerns, as well as a psychosocial interview and medical evaluation performed by staff members. The RFEs, HCC items, and diagnoses, grouped into somatic, sexuality-related, and psychosocial categories, were then compared.
Among the 399 girls expressing specific RFEs on entering the clinic, one-third were diagnosed with psychosocial disorders and one-fifth with sexuality-related concerns. Of the patients receiving a sexuality-related diagnosis, 57% presented with a sexuality-related request; another 26% noted it on the checklist. For those diagnosed with psychosocial problems, 22% stated this as the RFE, and another 50% indicated it on the HCC. The contribution of the HCC to the diagnosis was higher among adolescents not stating a specific RFE.
The findings highlight the HCC's contribution in identifying health problems, especially among adolescents who find it difficult to verbalize sensitive issues.
我们评估了一份健康问题清单（HCC）在多大程度上有助于弥合进入青少年健康服务机构的女孩所描述的就诊原因（RFE）与最终诊断之间的差距。
样本为547名连续就诊于青少年健康服务机构的12至18岁女孩，她们首先接受了结构化的接诊程序，包括一份她们自行填写的表格，在表格中她们描述了自己的就诊原因和其他健康问题，以及工作人员进行的社会心理访谈和医学评估。然后对就诊原因、HCC项目和诊断结果进行比较，这些结果分为躯体、性相关和社会心理类别。
在399名进入诊所时表达了特定就诊原因的女孩中，三分之一被诊断为社会心理障碍，五分之一被诊断为性相关问题。在接受性相关诊断的患者中，57%提出了性相关的诉求；另有26%在清单上提到了这一点。对于那些被诊断为社会心理问题的患者，22%将此作为就诊原因，另有50%在HCC上表明了这一点。在未说明特定就诊原因的青少年中，HCC对诊断的贡献更大。
研究结果突出了HCC在识别健康问题方面的贡献，尤其是在那些难以表达敏感问题的青少年中。
