Paperny D M, Aono J Y, Lehman R M, Hammar S L, Risser J
Department of Pediatrics, University of Hawaii School of Medicine, Kaiser Permanente Medical Care Program, Honolulu, Hawaii.
J Pediatr. 1990 Mar;116(3):456-62. doi: 10.1016/s0022-3476(05)82844-6.
Because adolescents avoid bringing sensitive issues, such as substance abuse, suicide, and sexual activity, to pediatricians, and may fail to realize that they need health education or services, a computer program was designed to facilitate reporting of high-risk psychosocial and health behaviors and to provide specific health advice and referral for timely professional intervention. Computer printouts done anonymously by a random sample of 265 adolescents after a physical examination were compared with those of a matched group of 294 who were predirected to share the printout with the clinician at their examinations. The former elicited more positive responses to sensitive health problems, but both computer groups responded significantly more often about most high-risk issues than a matched written questionnaire group of 251. Almost all adolescents said that they reported true information to the computer and read all the information it printed. Experience with 3327 teenagers demonstrated that 89% preferred the computer over a questionnaire or personal interview, but nearly all were willing to share the printout with the pediatrician, which should facilitate clinical evaluation. The nonjudgmental computer can identify problem areas and deliver automated medical advice and referral. Automated health assessment and education may become a useful adjunct for addressing adolescent health issues.
由于青少年避免向儿科医生提及诸如药物滥用、自杀和性行为等敏感问题，并且可能没有意识到自己需要健康教育或服务，因此设计了一个计算机程序，以促进对高风险心理社会和健康行为的报告，并提供具体的健康建议以及转介服务，以便及时进行专业干预。对265名青少年在体检后匿名完成的计算机打印输出结果，与另外294名匹配组青少年的结果进行了比较，后一组在体检时被预先要求与临床医生分享打印输出结果。前一组对敏感健康问题给出了更多积极回应，但两个计算机组对大多数高风险问题的回应频率都显著高于与之匹配的由251名青少年组成的书面问卷组。几乎所有青少年都说他们向计算机报告了真实信息，并阅读了计算机打印的所有信息。对3327名青少年的调查显示，89%的青少年更喜欢计算机而不是问卷或个人访谈，但几乎所有人都愿意与儿科医生分享打印输出结果，这应该有助于临床评估。不做评判的计算机可以识别问题领域，并提供自动医疗建议和转介服务。自动化健康评估和教育可能会成为解决青少年健康问题的有用辅助手段。
