Hunter Lindsay R, Lynch Brian A
Mayo Clinic, Rochester, MN, USA.
J Prim Care Community Health. 2014 Jan 1;5(1):9-13. doi: 10.1177/2150131913484340. Epub 2013 Apr 1.
Early recognition and treatment of social and emotional disorders in children is significant for school preparation. These disorders are frequently underdetected without the use of standardized screening instruments. The purpose of our study is to describe the implementation of the Ages and Stages Questionnaire: Social-Emotional (ASQ:SE) in primary care practice by mail when children are 30 months old.
In this 4-month study, parents of all 30-month-old children who receive primary care at our study site were mailed the ASQ:SE. In children who did not pass screening or received a call from a registered nurse for parental concerns documented on the questionnaire, short-term clinical outcomes were obtained from the electronic medical record. During the last month of the study, the demographics variables of race and insurance type were analyzed for an association with questionnaire completion by mail.
Of the 870 families mailed 30-month ASQ:SE screens, 507 (58.3%) were returned by mail. Out of the children with returned screens, 38 (7.5%) of parents were contacted for either elevated scores or concerning comments and 6 (1.2%) were referred to Early Intervention. Parents of children with government insurance returned the ASQ:SE questionnaire 34.2% (13/38) of the time compared with 65.5% (76/116) of those with private insurance (P < .001).
Our results indicate that mental health screening can be effectively managed in primary care practice by a registered nurse using a follow-up protocol. Mailing the ASQ:SE is likely not an effective way to comprehensively screen most primary care populations.
儿童社交和情感障碍的早期识别与治疗对入学准备至关重要。若不使用标准化筛查工具，这些障碍常常难以被发现。我们研究的目的是描述在儿童30个月大时通过邮件在初级保健实践中实施《年龄与阶段问卷：社交 - 情感》（ASQ:SE）的情况。
在这项为期4个月的研究中，向在我们研究地点接受初级保健的所有30个月大儿童的家长邮寄了ASQ:SE问卷。对于筛查未通过或因问卷上记录的家长担忧而接到注册护士电话的儿童，从电子病历中获取短期临床结果。在研究的最后一个月，分析种族和保险类型等人口统计学变量与通过邮件完成问卷情况之间的关联。
在邮寄30个月大ASQ:SE筛查问卷的870个家庭中，507份（58.3%）通过邮件返回。在返回问卷的儿童中，38名（7.5%）家长因分数升高或有相关评论而被联系，6名（1.2%）被转介至早期干预。有政府保险的儿童家长返回ASQ:SE问卷的比例为34.2%（13/38），而有私人保险的儿童家长这一比例为65.5%（76/116）（P < .001）。
我们的结果表明，在初级保健实践中，注册护士使用后续方案能够有效地管理心理健康筛查。邮寄ASQ:SE可能不是全面筛查大多数初级保健人群的有效方式。
