Schonwald Alison, Horan Kelly, Huntington Noelle
Division of General Pediatrics, Children's Hospital, Boston, Massachusetts, Division of Developmental Medicine, Children's Hospital, Boston, Massachusetts, USA.
Clin Pediatr (Phila). 2009 Jul;48(6):648-55. doi: 10.1177/0009922809334350. Epub 2009 Apr 10.
The American Academy of Pediatrics recommends routine developmental screening in well-child care. Providers cite time restraints as a limitation preventing its widespread adoption. The objectives were to determine whether routine screening lengthened well-visits and was associated with changes in parent satisfaction and report of anticipatory guidance.
Visits before and after implementation of routine screening were timed. Parents whose children were seen before or after screening began were contacted to query their perceptions of the visit.
There was no change in visit lengths after the screener was included. With screening, more parents reported their provider talked about their concerns, and that their questions were answered. There were no changes in parent satisfaction ratings or reports of anticipatory guidance discussions.
The perceived obstacle that routine screening requires more time than pediatricians have should not prevent its adoption. Screening tools may empower some parents otherwise reluctant to raise concerns unsolicited.
美国儿科学会建议在儿童健康检查中进行常规发育筛查。医疗服务提供者称时间限制是阻碍其广泛采用的一个因素。本研究的目的是确定常规筛查是否会延长健康检查的时间,以及是否与家长满意度的变化和预期指导报告有关。
对实施常规筛查前后的就诊时间进行计时。联系在筛查开始之前或之后带孩子就诊的家长,询问他们对就诊的看法。
纳入筛查工具后,就诊时间没有变化。进行筛查后,更多家长报告称医疗服务提供者讨论了他们的担忧并回答了他们的问题。家长满意度评分或预期指导讨论报告没有变化。
认为常规筛查比儿科医生可用时间更多这一障碍不应妨碍其采用。筛查工具可能会让一些原本不愿主动提出担忧的家长更愿意表达。