Yeo Michele S M, Bond Lyndal M, Sawyer Susan M
Centre for Adolescent Health, Royal Children's Hospital, 2 Gatehouse St, Melbourne, VIC 3052.
Med J Aust. 2005 Oct 17;183(8):427-9. doi: 10.5694/j.1326-5377.2005.tb07110.x.
To determine the extent to which comprehensive health screening of adolescents was undertaken in a tertiary inpatient setting.
Retrospective review of 100 consecutive medical records of 13-18-year-old adolescents admitted to The Royal Children's Hospital, Melbourne (first 20 consecutive admissions in 2001 to each of five units--general medicine, adolescent medicine, specialty medicine, general surgery, and specialty surgery).
Documentation of screening for biomedical (height, weight, pubertal staging, and hepatitis B vaccination) and psychosocial concerns (HEADSS framework categorised into four screening levels--none, incomplete, adequate, thorough). Risks identified and actions taken.
Weight was recorded for 98 patients, height for 17, pubertal staging for 12, and hepatitis B vaccination status for nine. Documentation of psychosocial screening was absent from 62 charts, inadequate in 29, thorough in three, and complete in seven charts. Adolescent medicine inpatients were more likely than patients in other units to have any screening of psychosocial risk recorded and more likely to be thoroughly screened (P < 0.005). Screening was more often documented for less sensitive issues (eg, home, tobacco) than higher risk behaviours (eg, illicit drug use) (P = 0.013). When screening identified risks, appropriate action was undertaken in most cases.
This study highlights deficiencies in comprehensive health screening in adolescents admitted to a tertiary children's hospital. These results support the development of more consistent approaches to screening adolescent inpatients.
确定在三级住院环境中对青少年进行全面健康筛查的程度。
对墨尔本皇家儿童医院收治的100例13 - 18岁青少年的连续病历进行回顾性研究（2001年五个科室——普通内科、青少年医学科、专科医学科、普通外科和专科外科各连续收治的前20例患者）。
生物医学筛查（身高、体重、青春期分期和乙肝疫苗接种）及心理社会问题筛查（采用HEADSS框架分为四个筛查级别——无、不完整、充分、全面）的记录情况。识别出的风险及采取的行动。
98例患者记录了体重，17例记录了身高，12例记录了青春期分期，9例记录了乙肝疫苗接种状况。62份病历中没有心理社会筛查记录，29份记录不充分，3份全面，7份完整。青少年医学科住院患者比其他科室患者更有可能记录任何心理社会风险筛查，且更有可能接受全面筛查（P < 0.005）。对敏感性较低问题（如家庭、烟草）的筛查记录比高风险行为（如非法药物使用）更常见（P = 0.013）。当筛查发现风险时，大多数情况下会采取适当行动。
本研究凸显了三级儿童医院收治的青少年全面健康筛查存在的不足。这些结果支持制定更一致的青少年住院患者筛查方法。
