Brown Jonathan D, Wissow Lawrence S
Mathematica Policy Research Inc, Washington, DC 20024, USA.
Ambul Pediatr. 2008 Nov-Dec;8(6):368-74. doi: 10.1016/j.ambp.2008.08.004. Epub 2008 Oct 25.
To determine whether the discussion of maternal stress in pediatric primary care is associated with the mother's satisfaction with her child's provider.
Children ages 5-16 and their mothers (N=747) were recruited from the waiting rooms of 13 geographically diverse pediatric primary care sites from 2002 to 2005. Directly after the visit, the mother reported her satisfaction with the attention that the provider gave to her and her child's problems and also reported whether the provider understood the problems that she wanted to discuss during the visit. The mother also reported whether the visit included discussion of her "stresses and strains" and the discussion of child mood or behavior.
Thirty-five percent of mothers discussed their stresses and strains with their child's provider. The mother was more likely to be "completely" satisfied with the attention that she and her child received from the provider (odds ratio [OR] 2.43, 95% confidence interval [95% CI], 1.43-4.11) and to agree "strongly" that the provider understood the problems she wanted to discuss (OR 1.95, 95% CI, 1.32-2.93) when the visit included the discussion of maternal stress after controlling for the reason for the visit, number of previous visits, provider specialty (family practice or pediatrics), youth mental health status, whether the visit included the discussion of child mood or behavior, and maternal distress measured with a standard screening tool.
The mother was more satisfied with her child's primary care provider when maternal stress was discussed during the visit. This finding should somewhat alleviate fears that mothers will react negatively to discussion of their stress during pediatric visits.
确定在儿科初级保健中对母亲压力的讨论是否与母亲对其孩子的医疗服务提供者的满意度相关。
2002年至2005年期间，从13个地理位置不同的儿科初级保健机构的候诊室招募了5至16岁的儿童及其母亲（N = 747）。就诊结束后，母亲报告了她对医疗服务提供者对她和她孩子问题的关注程度的满意度，还报告了医疗服务提供者是否理解她在就诊期间想要讨论的问题。母亲还报告了就诊是否包括对她“压力和紧张情绪”的讨论以及对孩子情绪或行为的讨论。
35%的母亲与孩子的医疗服务提供者讨论了她们的压力和紧张情绪。在控制了就诊原因、既往就诊次数、医疗服务提供者专业（家庭医学或儿科学）、青少年心理健康状况、就诊是否包括对孩子情绪或行为的讨论以及用标准筛查工具测量的母亲痛苦程度后，当就诊包括对母亲压力的讨论时，母亲更有可能“完全”满意她和孩子从医疗服务提供者那里得到的关注（优势比[OR] 2.43，95%置信区间[95% CI]，1.43 - 4.11），并且更有可能“强烈”同意医疗服务提供者理解她想讨论的问题（OR 1.95，95% CI，1.32 - 2.93）。
当就诊期间讨论母亲压力时，母亲对其孩子的初级保健提供者更满意。这一发现应在一定程度上减轻对母亲在儿科就诊期间对讨论其压力会产生负面反应的担忧。
