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多民族贫困社区儿童的医疗服务提供情况、超重及相关风险变量

Provider practice, overweight and associated risk variables among children from a multi-ethnic underserved community.

作者信息

Hamilton Joni L, James Frederick W, Bazargan Moshen

机构信息

Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, California, USA.

出版信息

J Natl Med Assoc. 2003 Jun;95(6):441-8.

Abstract

Two hundred and eight medical records subdivided into two age groups, < 2 years (n = 49), and two to 17 years (n = 159) were used to assess providers' practice of documentation and intervention for overweight and associated risk variables, among children from a multi-ethnic inner-city population. The Body Mass Index (BMI) and/or weight to height ratio > or = 90th percentile for age and sex were used to define overweight, or at risk for overweight. Documentation for excessive weight and intervention, resident-physician training level, demographics, blood pressure, and cholesterol values were recorded. Overweight was identified in 36% of the pediatric patients. Twenty-nine percent of the affected children were documented, and all but two had an intervention. Exercise, nutritional and/or behavioral counseling were prescribed with nutritional counseling being the most frequent. Blood pressure and cholesterol levels were measured more frequently in overweight children than in normal weight children. Children < two years of age with BMI or weight/height ratios > or = 90th percentile had no documentation or intervention for suspected overweight. We conclude that childhood overweight was highly prevalent, and under-recognized as determined by medical record documentation. Further study is needed to determine effective provider education programs for preventing, detecting and managing overweight during childhood.

摘要

208份病历被分为两个年龄组,即2岁以下(n = 49)和2至17岁(n = 159),用于评估来自多民族市中心城区儿童的医疗服务提供者对超重及相关风险变量的记录和干预情况。根据年龄和性别,体重指数(BMI)和/或体重与身高之比大于或等于第90百分位数被用来定义超重或有超重风险。记录了超重和干预情况、住院医师培训水平、人口统计学信息、血压和胆固醇值。36%的儿科患者被确定为超重。29%的患病儿童有记录,除两名儿童外,其他所有儿童都接受了干预。开出了运动、营养和/或行为咨询的医嘱,其中营养咨询最为常见。超重儿童的血压和胆固醇水平比正常体重儿童测量得更频繁。BMI或体重/身高比大于或等于第90百分位数的2岁以下儿童,对于疑似超重情况没有记录或干预。我们得出结论,儿童超重非常普遍,而根据病历记录,超重情况未得到充分认识。需要进一步研究以确定有效的医疗服务提供者教育项目,用于预防、检测和管理儿童期超重。

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