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儿科疫情危机:政策与实践发展的经验教训

Pediatric epidemic crisis: Lessons for policy and practice development.

作者信息

Nicholas David B, Gearing Robin E, Koller Donna, Salter Robyn, Selkirk Enid K

机构信息

The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8.

出版信息

Health Policy. 2008 Dec;88(2-3):200-8. doi: 10.1016/j.healthpol.2007.11.006. Epub 2008 May 5.

Abstract

OBJECTIVES

This research study addresses health policy and patient care considerations, and outlines policy and practice implications resulting from a crisis in a pediatric setting. This crisis, an epidemic outbreak of Severe Acute Respiratory Syndrome (SARS), dramatically impacted the delivery of health care in Canada. Despite the passage of time since the last diagnosed case of SARS in April 2004, researchers have warned the global community to be prepared for future outbreaks of SARS or other infectious diseases.

METHODS

Qualitative interviews were conducted with 23 participants representing key stakeholder groups: (a) pediatric patients with probable or suspected SARS, (b) their parents, and (c) health care professionals providing direct care to SARS patients.

RESULTS

Participants conveyed key areas in which health policy and practice were affected. These included the development of communication strategies for responding to SARS; easing vulnerability among all stakeholders; and the rapid development of practice guidelines.

CONCLUSION

Given the continuing threat of current and future airborne viruses with potential for epidemic spread and devastating outcomes, preparedness strategies are certainly needed. Effective strategies in pediatrics include practices that provide family centered care while minimizing disease transmission. Toward this end, lessons learned from previous outbreaks merit consideration and may inform future epidemics.

摘要

目标

本研究探讨了卫生政策和患者护理方面的考量,并概述了儿科环境中的危机所产生的政策和实践影响。这场危机即严重急性呼吸综合征(SARS)的疫情爆发,对加拿大的医疗服务提供产生了巨大影响。尽管自2004年4月最后一例SARS确诊病例以来已有一段时间,但研究人员已警告全球社会要为未来SARS或其他传染病的爆发做好准备。

方法

对代表关键利益相关者群体的23名参与者进行了定性访谈,这些群体包括:(a)可能感染或疑似感染SARS的儿科患者,(b)他们的父母,以及(c)为SARS患者提供直接护理的医护人员。

结果

参与者传达了卫生政策和实践受到影响的关键领域。这些领域包括制定应对SARS的沟通策略;减轻所有利益相关者的脆弱性;以及迅速制定实践指南。

结论

鉴于当前和未来空气传播病毒持续存在传播流行并造成毁灭性后果的威胁,防范策略肯定是必要的。儿科的有效策略包括提供以家庭为中心的护理同时尽量减少疾病传播的做法。为此,从以往疫情中吸取的教训值得考虑,并可能为未来的疫情提供参考。

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