将儿童健康保健带入21世纪：一种利用计算机化教程提高家长知识水平的新颖有效方法。

Taking well-child care into the 21st century: a novel, effective method for improving parent knowledge using computerized tutorials.

作者信息

Sanghavi Darshak M

机构信息

Department of Cardiology, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA.

出版信息

Arch Pediatr Adolesc Med. 2005 May;159(5):482-5. doi: 10.1001/archpedi.159.5.482.

DOI:10.1001/archpedi.159.5.482

PMID:15867124

Abstract

BACKGROUND

Despite expert panel recommendations, few pediatric providers administer sufficient anticipatory guidance and educational counseling during well-child visits, largely owing to lack of time.

OBJECTIVES

To design a waiting room educational kiosk that uses interactive, self-guided, computerized tutorials to give anticipatory guidance to parents at the 6-week and 4-month well-child visits, and assess impact on parent knowledge. The intervention required no additional provider time, and automatically printed a summary for the medical record.

SETTING

A government-funded hospital serving Navajo patients in New Mexico.

METHODS

After a well-child visit, knowledge regarding issues such as fever management, dental care, sleep position, nutrition, and car seat use was tested in a group of parents receiving standard care (control), and a group using the computerized tutorials in addition to standard care (intervention).

RESULTS

Fifty-two parents in the control group and 49 parents in the intervention group completed the knowledge assessment. Ninety-five percent of intervention subjects completed the computerized tutorial without clinic staff involvement. Compared with the control group, the intervention group had superior knowledge in all tested areas. The percentage of correct responses to all questions was higher for the intervention group in the following categories: car seat use (49% vs 31%, P<.01), dental care (80% vs 27%, P<.001), and nutrition (43% vs 21%, P<.001). Among parents of 6-week-old infants, a greater number of parents in the intervention group identified fever as 100.4 degrees F or higher (86% vs 50%, P<.001), and fewer replied that they would give antipyretics to a febrile child younger than 3 months old without consulting a provider (52% vs 100%, P<.001). The percentage of parents with a perfect score or only one question wrong on the 21-item test was 17-fold higher in the intervention group (P<.001).

CONCLUSION

Computerized anticipatory guidance at well-child visits increases knowledge over printed materials alone and is usable by the majority of parents.

摘要

背景

尽管有专家小组的建议，但很少有儿科医疗服务提供者在儿童健康检查期间提供足够的预期指导和教育咨询，这主要是由于时间不足。

目的

设计一种候诊室教育信息亭，利用交互式、自主引导的计算机化教程，在6周和4个月的儿童健康检查时为家长提供预期指导，并评估对家长知识的影响。该干预措施不需要额外的医疗服务提供者时间，并会自动打印一份病历摘要。

地点

新墨西哥州一家为纳瓦霍族患者服务的政府资助医院。

方法

在一次儿童健康检查后，对一组接受标准护理的家长（对照组）和一组除标准护理外还使用计算机化教程的家长（干预组）进行了关于发热管理、口腔护理、睡眠姿势、营养和汽车座椅使用等问题的知识测试。

结果

对照组的52名家长和干预组的49名家长完成了知识评估。95%的干预组受试者在没有诊所工作人员参与的情况下完成了计算机化教程。与对照组相比，干预组在所有测试领域的知识水平更高。干预组在以下类别中对所有问题的正确回答百分比更高：汽车座椅使用（49%对31%，P<.01）、口腔护理（80%对27%，P<.001）和营养（43%对21%，P<.001）。在6周龄婴儿的家长中，干预组中更多的家长将发热温度确定为100.4华氏度或更高（86%对50%，P<.001），而回复在未咨询医疗服务提供者的情况下会给3个月以下发热儿童服用退烧药的家长更少（52%对100%，P<.001）。在21项测试中，干预组中获得满分或只错一题的家长百分比比对照组高17倍（P<.001）。