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“我刚带你去看了那个头上顶着光盘的人”:儿童复发性咽痛的经历与管理

'I've just taken you to see the man with the CD on his head': the experience and management of recurrent sore throat in children.

作者信息

Lock Catherine, Baker Rachel, Brittain Katie

机构信息

Public Health Research, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.

出版信息

J Child Health Care. 2010 Mar;14(1):95-110. doi: 10.1177/1367493509355613. Epub 2010 Feb 10.

Abstract

Tonsillectomies for children with recurrent sore throat are common. There is a perception amongst medical professionals that parents are eager for surgical intervention but the parent/child perspective is overlooked in the literature. This study aimed to identify parent/child experience of recurrent sore throat. The study was qualitative, using grounded theory approach to data collection/analysis. Semi-structured, in-depth, interviews were conducted with 12 dyads of children (aged 4-16) and their parents, attending two Ear, Nose and Throat outpatient clinics held at a hospital in North East England, referred by their General Practitioner for recurrent sore throats. Analysis revealed recurrent sore throats significantly affected the families' quality of life. Families felt the need for antibiotics and tonsillectomies although parent and child were not always in agreement over their choice of treatment. Families felt empowered when the health care system showed some flexibility, such as allowing self re-referral, giving families greater choice in the way they managed the condition. Policy makers need to be aware of the consequences of recurrent sore throats in children and the needs of families in managing this chronic condition. More flexible approaches to health care, such as self re-referral and use of waiting list to review symptoms, may be needed if the number of tonsillectomies is to be reduced.

摘要

为患有复发性喉咙痛的儿童进行扁桃体切除术很常见。医学专业人员中有这样一种看法,即家长渴望进行手术干预,但文献中忽略了家长/孩子的观点。本研究旨在确定家长/孩子对复发性喉咙痛的体验。该研究采用质性研究方法,运用扎根理论进行数据收集/分析。对12组儿童(4至16岁)及其家长进行了半结构化的深度访谈,这些儿童及其家长在英格兰东北部一家医院的两个耳鼻喉科门诊就诊,由他们的全科医生转诊来治疗复发性喉咙痛。分析显示,复发性喉咙痛严重影响了家庭的生活质量。尽管家长和孩子在治疗选择上并不总是意见一致,但家庭认为需要使用抗生素和进行扁桃体切除术。当医疗保健系统表现出一定灵活性时,比如允许自我转诊,让家庭在管理病情的方式上有更多选择,家庭会感到更有掌控感。政策制定者需要意识到儿童复发性喉咙痛的后果以及家庭在管理这种慢性病方面的需求。如果要减少扁桃体切除术的数量,可能需要采取更灵活的医疗保健方式,比如自我转诊和利用等候名单来复查症状。

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