Gaines Robin, Missiuna Cheryl, Egan Mary, McLean Jennifer
Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, K1H 8L1, Ontario and School of Rehabilitation Sciences, University of Ottawa, Ontario, Canada.
BMC Health Serv Res. 2008 Jan 24;8:21. doi: 10.1186/1472-6963-8-21.
Developmental Coordination Disorder (DCD) is a chronic neurodevelopmental condition that affects 5-6% of children. When not recognized and properly managed during the child's development, DCD can lead to academic failure, mental health problems and poor physical fitness. Physicians, working in collaboration with rehabilitation professionals, are in an excellent position to recognize and manage DCD. This study was designed to determine the feasibility and impact of an educational outreach and collaborative care model to improve chronic disease management of children with DCD.
The intervention included educational outreach and collaborative care for children with suspected DCD. Physicians were educated by and worked with rehabilitation professionals from February 2005 to April 2006. Mixed methods evaluation approach documented the process and impact of the intervention.
Physicians: 750 primary care physicians from one major urban area and outlying regions were invited to participate; 147 physicians enrolled in the project. Children: 125 children were identified and referred with suspected DCD. The main outcome was improvement in knowledge and perceived skill of physicians concerning their ability to screen, diagnose and manage DCD. At baseline 91.1% of physicians were unaware of the diagnosis of DCD, and only 1.6% could diagnose condition. Post-intervention, 91% of participating physicians reported greater knowledge about DCD and 29.2% were able to diagnose DCD compared to 0.5% of non-participating physicians. 100% of physicians who participated in collaborative care indicated they would continue to use the project materials and resources and 59.4% reported they would recommend or share the materials with medical colleagues. In addition, 17.6% of physicians not formally enrolled in the project reported an increase in knowledge of DCD.
Physicians receiving educational outreach visits significantly improved their knowledge about DCD and their ability to identify and diagnose children with this condition. Physicians who collaborated with occupational therapists in providing care reported more confidence in diagnosing children with DCD and were more likely to continue to use screening measures and to provide educational materials to families.
发育性协调障碍（DCD）是一种慢性神经发育疾病，影响5%至6%的儿童。如果在儿童发育过程中未得到识别和妥善管理，DCD可能导致学业失败、心理健康问题和身体素质差。医生与康复专业人员合作，在识别和管理DCD方面具有得天独厚的优势。本研究旨在确定一种教育推广和协作护理模式对改善DCD儿童慢性病管理的可行性和影响。
干预措施包括对疑似DCD儿童的教育推广和协作护理。2005年2月至2006年4月，医生接受康复专业人员的培训并与其合作。采用混合方法评估方法记录干预的过程和影响。
医生：邀请了来自一个主要城市地区和周边地区的750名初级保健医生参与；147名医生参与了该项目。儿童：识别出125名疑似DCD儿童并进行了转诊。主要结果是医生在筛查、诊断和管理DCD能力方面的知识和感知技能有所提高。基线时，91.1%的医生不知道DCD的诊断，只有1.6%的医生能够诊断该病。干预后，91%的参与医生报告对DCD有了更多了解；与0.5%的未参与医生相比，29.2%的参与医生能够诊断DCD。100%参与协作护理的医生表示他们会继续使用项目材料和资源，59.4%的医生报告他们会向医学同事推荐或分享这些材料。此外，17.6%未正式参与该项目的医生报告对DCD的了解有所增加。
接受教育推广访问的医生显著提高了他们对DCD的了解以及识别和诊断患有这种疾病儿童的能力。在提供护理方面与职业治疗师合作的医生在诊断患有DCD的儿童方面更有信心，并且更有可能继续使用筛查措施并向家庭提供教育材料。
