儿科医生对社区儿童健康的看法：按年龄划分的培训、参与情况及期望

Pediatricians' perspectives regarding community child health: training, involvement, and expectations according to age.

作者信息

Minkovitz Cynthia S, O'Connor Karen G, Grason Holly, Palfrey Judith S, Chandra Anita, Tonniges Thomas F

机构信息

Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, E4636, Baltimore, MD 21205, USA. E-mail

出版信息

Pediatrics. 2007 Nov;120(5):1036-43. doi: 10.1542/peds.2007-0842.

DOI:10.1542/peds.2007-0842

PMID:17974741

Abstract

OBJECTIVE

There are increasing opportunities for pediatricians to promote children's health through community involvement during and after residency training. Little is known about whether younger relative to established pediatricians have different experiences regarding community activities. In this study we examined whether pediatricians' training, perspectives, and involvement in community activities vary by age.

METHODS

Eight hundred seventy-six pediatricians participated in a national, random-sample, mailed periodic survey of US members of the American Academy of Pediatrics in 2004 (response rate: 58%). Chi2 statistics and median tests were used to measure associations of age (< or = 34, 35-39, 40-50, and > or = 51 years) with training, perspectives, and involvement.

RESULTS

Younger pediatricians reported more training in community child health during and before residency but were less likely to be involved currently (37.9% for < or = 34 years, 44.4% for 35-39 years, 46.2% for 40-50 years, 48.3% for > or = 51 years). They were more likely to report that their current involvement was too little versus just right or too much (81.3%, 73.5%, 60.7%, and 47.1%, respectively). Younger pediatricians were more willing to spend > or = 1 hour/month on community child health activities (95.0%, 91.2%, 89.7%, and 85.4%, respectively). Younger versus older pediatricians were more likely to sense moderate or greater responsibility for improving children's health in their community (83.6%, 77.2%, 76.7%, and 70.2%, respectively) and expected their community work to increase during the next 5 years (80.0%, 67.5%, 59.7%, and 40.1%, respectively). Age findings persisted when adjusted for gender.

CONCLUSIONS

Although practice constraints may limit community involvement, younger pediatricians anticipated growing participation in community activities. Longitudinal studies are needed to determine whether such expectations are realized.

摘要

目的

在住院医师培训期间及之后，儿科医生通过社区参与来促进儿童健康的机会越来越多。相对于资深儿科医生，年轻儿科医生在社区活动方面是否有不同经历，目前知之甚少。在本研究中，我们调查了儿科医生的培训、观点以及参与社区活动的情况是否因年龄而异。

方法

2004年，876名儿科医生参与了一项针对美国儿科学会美国会员的全国随机抽样邮寄定期调查（回复率：58%）。使用卡方统计和中位数检验来衡量年龄（≤34岁、35 - 39岁、40 - 50岁和≥51岁）与培训、观点及参与情况之间的关联。

结果

年轻儿科医生报告在住院医师培训期间及之前接受了更多社区儿童健康方面的培训，但目前参与的可能性较小（≤34岁的为37.9%，35 - 39岁的为44.4%，40 - 50岁的为46.2%，≥51岁的为48.3%）。他们更有可能报告自己目前的参与程度太少，而不是恰到好处或过多（分别为81.3%、73.5%、60.7%和47.1%）。年轻儿科医生更愿意每月花费≥1小时参与社区儿童健康活动（分别为95.0%、91.2%、89.7%和85.4%）。与年长儿科医生相比，年轻儿科医生更有可能感觉到自己对改善所在社区儿童健康负有中等或更大的责任（分别为83.6%、77.2%、76.7%和70.2%），并预计在未来5年内他们的社区工作会增加（分别为80.0%、67.5%、59.7%和40.1%）。在对性别进行调整后，年龄方面的研究结果依然存在。