家访可减少巴基斯坦卡拉奇儿童家庭伤害的危险因素：一项随机对照试验。

Home visits reduce the number of hazards for childhood home injuries in Karachi, Pakistan: a randomized controlled trial.

作者信息

Rehmani Rifat, Leblanc John C

出版信息

Int J Emerg Med. 2010 Dec 7;3(4):333-9. doi: 10.1007/s12245-010-0238-0.

DOI:10.1007/s12245-010-0238-0

PMID:21373302

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3047837/

Abstract

BACKGROUND

Although unintentional injuries are major causes of morbidity and mortality in less developed countries, they have received scant attention, and injury prevention policies and programs have just begun to be addressed systemically.

AIMS

To reduce hazards associated with home injuries due to falls and ingestions through an injury prevention program administered by home visitors.

METHODS

Non-blinded randomized controlled trial design of two interventions where one branch of the study group served as the control for the other in an urban neighborhood in Karachi, Pakistan. The study participants included 340 families with at least one child aged 3 years or less, discharged home from the Emergency Department following a visit for any reason other than an injury. The interventions included: (1) counseling to reduce falls; (2) counseling to reduce poisoning and choking. The primary outcome measure for each intervention was the relative risk of change in the home status from "unsafe" to "safe" after the intervention.

RESULTS

There were 170 families in the fall prevention and 170 families in the ingestion prevention branch of the study. The percentage of homes deemed "safe" in which the families had received fall intervention counseling was 13.5% compared to 3.5% in the control group (relative risk 3.8; 95% CI: 1.5 to 10.0; p = 0.002), whereas the percentage of homes deemed "safe" in which the families had received the ingestions intervention counseling was 18.8% compared to 2.4% in the control group (relative risk 7.8; 95% CI: 2.4 to 25.3; p < 0.001). Effectiveness did not depend on education or the socioeconomic status of the study participants. The mean number of fall hazards was reduced from 3.1 at baseline to 2.4 in the fall intervention counseling group, and the mean number of ingestion hazards decreased from 2.3 to 1.9. (p < 0.001).

CONCLUSIONS

Our study demonstrates the effectiveness of an educational intervention aimed at improving the home safety practices of families with young children.

摘要

背景

尽管意外伤害是欠发达国家发病和死亡的主要原因，但它们很少受到关注，伤害预防政策和项目才刚刚开始得到系统解决。

目的

通过家访人员实施的伤害预防项目，减少与家庭中跌倒和误食相关的危害。

方法

在巴基斯坦卡拉奇的一个城市社区，对两种干预措施采用非盲随机对照试验设计，其中一个研究组分支作为另一个分支的对照组。研究参与者包括340个家庭，这些家庭至少有一个3岁及以下的儿童，因非伤害原因到急诊科就诊后出院回家。干预措施包括：（1）减少跌倒的咨询；（2）减少中毒和窒息的咨询。每种干预措施的主要结局指标是干预后家庭状况从“不安全”变为“安全”的相对风险变化。

结果

研究的跌倒预防分支中有170个家庭，误食预防分支中有170个家庭。接受跌倒干预咨询的家庭中被认为“安全”的家庭比例为13.5%，而对照组为3.5%（相对风险3.8；95%置信区间：1.5至10.0；p = 0.002），而接受误食干预咨询的家庭中被认为“安全”的家庭比例为18.8%，对照组为2.4%（相对风险7.8；95%置信区间：2.4至25.3；p < 0.001）。有效性不取决于研究参与者的教育程度或社会经济地位。跌倒干预咨询组的跌倒危险因素平均数从基线时的3.1降至2.4，误食危险因素平均数从2.3降至1.9（p < 0.001）。