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小儿反复腹痛的医师咨询——一项基于人群的研究。

Physician consultation in young children with recurrent pain-a population-based study.

机构信息

Faculty of Business Management and Social Sciences, University of Applied Sciences Osnabrück , Osnabrück , Germany ; German Paediatric Pain Centre, Children's Hospital Datteln , Germany.

German Paediatric Pain Centre, Children's Hospital Datteln , Germany ; Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University , Germany.

出版信息

PeerJ. 2015 Apr 28;3:e916. doi: 10.7717/peerj.916. eCollection 2015.

Abstract

Background. Recurrent pain is a common experience in childhood, but only few children with recurrent pain attend a physician. Previous studies yielded conflicting findings with regard to predictors of health care utilization in children with recurrent pain. Methods. The present study analyzes data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study comprising n = 2,149 children (3-10 years old) with recurrent pain to find robust predictors. We used multiple logistic regressions to investigate age, gender, socio-economic status (SES), migration background, pain intensity, pain frequency, pain-related disability, mental health problems, and health-related quality of life (HRQL) as predictors for visiting a doctor due to pain. Results. Overall, young girls with high pain-related disability, intensity, frequency, and migration background were more likely to attend a physician. Pain-related disability had the largest impact. Socioeconomic status, health-related quality of life and mental health problems were not systematically related to health care utilization. An analysis of the variability of these results indicated that several hundred participants are needed until the results stabilize. Conclusions. Our findings highlight the importance of pain-related disability and frequency in assessing the severity of recurrent pain. Generic predictors and demographic variables are of lesser relevance to children with recurrent pain. On a methodological level, our results show that large-scale studies are need to reliably identify predictors of health care utilization.

摘要

背景

反复发作的疼痛是儿童常见的经历,但只有少数患有反复发作性疼痛的儿童会去看医生。之前的研究对于预测患有反复发作性疼痛的儿童的医疗保健利用情况存在相互矛盾的结果。

方法

本研究分析了来自德国儿童和青少年健康访谈和体检调查(KiGGS)研究的数据,该研究包括 n = 2149 名(3-10 岁)患有反复发作性疼痛的儿童,以寻找可靠的预测因素。我们使用多项逻辑回归来研究年龄、性别、社会经济地位(SES)、移民背景、疼痛强度、疼痛频率、与疼痛相关的残疾、心理健康问题以及健康相关的生活质量(HRQL)作为因疼痛就诊的预测因素。

结果

总体而言,患有高与疼痛相关的残疾、强度、频率和移民背景的年轻女孩更有可能去看医生。与疼痛相关的残疾影响最大。社会经济地位、健康相关的生活质量和心理健康问题与医疗保健的利用没有系统的关系。对这些结果的可变性进行分析表明,需要几百名参与者才能使结果稳定下来。

结论

我们的研究结果强调了在评估反复发作性疼痛的严重程度时,疼痛相关的残疾和频率的重要性。通用预测因素和人口统计学变量对患有反复发作性疼痛的儿童的相关性较小。在方法论层面上,我们的结果表明需要进行大规模研究,以可靠地确定医疗保健利用的预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/adab/4419529/cc5fa92f9f67/peerj-03-916-g001.jpg

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