Sorum Paul Clay, Shim Junseop, Chasseigne Gerard, Mullet Etienne, Sastre Maria Teresa Munoz, Stewart Thomas, Gonzalez-Vallejo Claudia
Albany Med Primary Care Network, 724 Watervliet-Shaker Rd, Latham, NY 12110, USA.
J Fam Pract. 2002 Jan;51(1):51-7.
We wanted to discover how parents differ from physicians in making decisions about how to treat a child who may have acute otitis media (AOM).
We used questionnaires that required participants to judge the probability of AOM or choose treatment for 2 sets of 46 paper scenarios of hypothetical children aged 15 months who might have AOM, and they subsequently rated the importance of individual cues and described their attitudes and opinions related to health care and AOM.
Convenience samples of 19 US family physicians, 35 French generalists, 21 French pediatricians, 52 US parents, and 86 French parents were included.
The primary outcomes were the judgment policies-the weights placed on each of the scenario cues when making decisions-that were derived for each individual and each group by multiple linear regression.
The mean judged probabilities of AOM were nearly the same for all groups: 50% for the US physicians, 51% for the US parents, 52.5% for the French physicians, and 52% for the French parents. The percentages of cases treated with antibiotics did not differ: 53% for US physicians, 45% for US parents, 53% for French physicians, and 51% for French parents. All groups gave greatest weight to the physical examination cues for decisions about both diagnosis and treatment. The parents paid little attention to the cues that reflected parental concerns.
US and French parents were very similar to physicians in their judgments and treatment choices regarding AOM. They appear to be able to adopt the physician's point of view and to be selective in the use of antibiotics.
我们想要探究在决定如何治疗可能患有急性中耳炎（AOM）的儿童时，家长与医生有何不同。
我们使用问卷，要求参与者判断AOM的可能性，或为两组共46个关于可能患有AOM的15个月大假想儿童的纸质情景选择治疗方法，随后他们对各个线索的重要性进行评分，并描述他们对医疗保健和AOM的态度及观点。
纳入了19名美国家庭医生、35名法国全科医生、21名法国儿科医生、52名美国家长和86名法国家长的便利样本。
主要结果是判断策略——决策时对每个情景线索的权重——通过多元线性回归为每个个体和每个组得出。
所有组对AOM的平均判断概率几乎相同：美国家庭医生为50%，美国家长为51%，法国医生为52.5%，法国家长为52%。使用抗生素治疗的病例百分比没有差异：美国家庭医生为53%，美国家长为45%，法国医生为53%，法国家长为51%。在诊断和治疗决策方面，所有组都最重视体格检查线索。家长很少关注反映家长担忧的线索。
美国和法国的家长在对AOM的判断和治疗选择上与医生非常相似。他们似乎能够采纳医生的观点，并在抗生素使用上有所选择。
