Simkiss D E, Stallard N, Thorogood M
Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, UK.
Child Care Health Dev. 2013 Sep;39(5):628-42. doi: 10.1111/cch.12010. Epub 2012 Dec 5.
Children who enter public care are among the most vulnerable in society. In addition to services for their medical needs, a focus on identifying and intervening with families in need where children are at high risk of entering public care is a public health priority. This paper aims to identify the characteristics of children, their parents or their social circumstances which are associated with children entering public care. The databases searched were CSA Illumina, British Education Index, ChildData, CINAHL, Excerpta Medica, MEDLINE, the Campbell and Cochrane Collaborations, NHS Centre for Reviews and Dissemination, NHS Evidence, Social Care Online and TRIP; from start dates to 7 February 2011. A total of 6417 titles were reviewed. After review, 10 papers with cohort or case-control methodologies met the inclusion criteria and the included papers were appraised using questions from the Critical Appraisal Skills Programme to guide the critique of case-control and cohort studies. A narrative synthesis is used to describe the research identified. Socio-economic status, maternal age at birth, health risk factors and other factors including learning difficulties, membership of an ethnic minority group and single parenthood are described as risk factors associated with children entering public care. Health risk factors have been explored using databases developed for other purposes such as health insurance or hospital discharge. A number of risk factors for children entering public care are identified from the literature, some were culturally specific and may not generalize. The interaction between different risk factors needs testing in longitudinal data sets.
进入公共照料体系的儿童是社会中最脆弱的群体之一。除了满足他们的医疗需求外，关注识别并干预那些孩子进入公共照料体系风险较高的困难家庭，是一项公共卫生优先事项。本文旨在确定与儿童进入公共照料体系相关的儿童、其父母或其社会环境的特征。所检索的数据库有CSA Illumina、英国教育索引、儿童数据、护理学与健康领域数据库、医学文摘、医学索引、坎贝尔协作网和考科蓝协作网、国民健康服务体系综述与传播中心、国民健康服务体系证据库、社会护理在线和循证医学资源平台；检索起始日期至2011年2月7日。共审查了6417篇文献标题。审查后，10篇采用队列研究或病例对照研究方法的论文符合纳入标准，并使用批判性评估技能计划中的问题对纳入论文进行评估，以指导对病例对照研究和队列研究的评判。采用叙述性综合分析来描述所确定的研究。社会经济地位、母亲生育年龄、健康风险因素以及其他因素，包括学习困难、少数民族身份和单亲家庭等，被描述为与儿童进入公共照料体系相关的风险因素。健康风险因素是利用为其他目的（如健康保险或医院出院）开发的数据库进行探究的。从文献中确定了一些儿童进入公共照料体系的风险因素，其中一些具有文化特异性，可能无法一概而论。不同风险因素之间的相互作用需要在纵向数据集中进行检验。
