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高危儿童的长期随访:对象、原因及方式?

Long term follow up of high risk children: who, why and how?

作者信息

Doyle Lex W, Anderson Peter J, Battin Malcolm, Bowen Jennifer R, Brown Nisha, Callanan Catherine, Campbell Catherine, Chandler Samantha, Cheong Jeanie, Darlow Brian, Davis Peter G, DePaoli Tony, French Noel, McPhee Andy, Morris Shusannah, O'Callaghan Michael, Rieger Ingrid, Roberts Gehan, Spittle Alicia J, Wolke Dieter, Woodward Lianne J

机构信息

Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia.

出版信息

BMC Pediatr. 2014 Nov 17;14:279. doi: 10.1186/1471-2431-14-279.

Abstract

BACKGROUND

Most babies are born healthy and grow and develop normally through childhood. There are, however, clearly identifiable high-risk groups of survivors, such as those born preterm or with ill-health, who are destined to have higher than expected rates of health or developmental problems, and for whom more structured and specialised follow-up programs are warranted.

DISCUSSION

This paper presents the results of a two-day workshop held in Melbourne, Australia, to discuss neonatal populations in need of more structured follow-up and why, in addition to how, such a follow-up programme might be structured. Issues discussed included the ages of follow-up, and the personnel and assessment tools that might be required. Challenges for translating results into both clinical practice and research were identified. Further issues covered included information sharing, best practice for families and research gaps.

SUMMARY

A substantial minority of high-risk children has long-term medical, developmental and psychological adverse outcomes and will consume extensive health and education services as they grow older. Early intervention to prevent adverse outcomes and the effective integration of services once problems are identified may reduce the prevalence and severity of certain outcomes, and will contribute to an efficient and effective use of health resources. The shared long-term goal for families and professionals is to work toward ensuring that high risk children maximise their potential and become productive and valued members of society.

摘要

背景

大多数婴儿出生时健康,并在童年时期正常成长和发育。然而,确实存在一些可明确识别的高危幸存群体,例如早产或健康状况不佳的婴儿,他们注定会出现高于预期的健康或发育问题发生率,因此需要更有组织、更专业的随访计划。

讨论

本文介绍了在澳大利亚墨尔本举行的为期两天的研讨会的结果,该研讨会讨论了需要更有组织随访的新生儿群体、原因以及如何构建这样一个随访计划。讨论的问题包括随访年龄、可能需要的人员和评估工具。确定了将结果转化为临床实践和研究面临的挑战。涵盖的其他问题包括信息共享、家庭最佳实践和研究差距。

总结

相当一部分高危儿童有长期的医学、发育和心理不良后果,随着年龄增长,他们将消耗大量的健康和教育服务。早期干预以预防不良后果,以及一旦发现问题就有效地整合服务,可能会降低某些后果的发生率和严重程度,并有助于高效利用卫生资源。家庭和专业人员共同的长期目标是努力确保高危儿童充分发挥其潜力,成为有生产力和受重视的社会成员。

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