Pynnonen Melissa A, Handelsman Jaynee A, King Ericka F, Singer Dianne C, Davis Matthew M, Lesperance Marci M
Divisions of Laryngology, Rhinology, and General Otolaryngology, University of Michigan Health System, Ann Arbor.
Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor.
JAMA Otolaryngol Head Neck Surg. 2016 Jun 1;142(6):538-43. doi: 10.1001/jamaoto.2015.3948.
An unacceptably high number of children who do not pass universal newborn hearing screening (UNHS) are lost to follow-up.
To provide insight into parent recall of UNHS.
DESIGN, SETTING, AND PARTICIPANTS: In this nationally representative cross-sectional survey, 2144 US parent households were surveyed in May 2012 using the Knowledge Panel. Responses of parents whose children were born before vs after UNHS implementation were compared.
Outcome measures included recall of hearing screen at birth, hearing screen results, and recommendations for follow-up. All outcome measures were based on parent recall and report. Descriptive statistics and multiple logistic regression analyses were used.
The study participants included 1539 parent households and 605 nonparent households. Of the 1539 parent households surveyed, the mean age of the parents was 38.8 years (range, 18-88 years), the mean age of the children was 10.2 years (range, 0-17 years), and the mean age of children with hearing loss was 12.1 years (range, 0-17 years). A total of 1539 parents (55.8%) were women. Only 62.9% of parents (unweighted n = 950) recalled a newborn hearing screen, and among those children with risk indicators for hearing loss (n = 587), only 68.6% (unweighted n = 385) recalled a hearing screen. Higher parent educational level (odds ratio [OR], 2.27; 95% CI, 1.17-4.41, for some college and OR, 2.41; 95% CI, 1.22-4.78, for a bachelor's degree; P = .03), younger age of the child (OR, 1.16; 95% CI, 1.11-1.23; P < .001), and the presence of any risk indicator for hearing loss (OR, 1.5; 95% CI, 1.13-2.13; P = .007) were associated with parent recall of hearing screen. Reported pass rates were higher than expected. Parent recall of follow-up recommendations was not always consistent with guidelines.
Although this study is inherently limited by recall bias, the findings indicate a lack of parent awareness of UNHS. Changes in the system of reporting UNHS results are necessary to improve parent recall of screen results and improve follow-up for children who do not pass the screen.
未通过新生儿听力普遍筛查(UNHS)的儿童中,失访的数量高得令人无法接受。
深入了解家长对UNHS的回忆情况。
设计、地点和参与者:在这项具有全国代表性的横断面调查中,2012年5月使用知识面板对2144个美国家庭进行了调查。比较了其子女在UNHS实施之前和之后出生的家长的回答。
结局指标包括对出生时听力筛查的回忆、听力筛查结果以及后续随访建议。所有结局指标均基于家长的回忆和报告。使用了描述性统计和多元逻辑回归分析。
研究参与者包括1539个家长家庭和605个非家长家庭。在接受调查的1539个家长家庭中,家长的平均年龄为38.8岁(范围为18 - 88岁),孩子的平均年龄为10.2岁(范围为0 - 17岁),有听力损失的孩子的平均年龄为12.1岁(范围为0 - 17岁)。共有1539名家长(55.8%)为女性。只有62.9%的家长(未加权n = 950)回忆起新生儿听力筛查,在那些有听力损失风险指标的孩子中(n = 587),只有68.6%(未加权n = 385)回忆起听力筛查。家长教育水平较高(对于上过一些大学的家长,优势比[OR]为2.27;95%置信区间为1.17 - 4.41;对于拥有学士学位的家长,OR为2.41;95%置信区间为1.22 - 4.78;P = 0.03)、孩子年龄较小(OR为1.16;95%置信区间为1.11 - 1.23;P < 0.001)以及存在任何听力损失风险指标(OR为1.5;95%置信区间为1.13 - 2.13;P = 0.007)与家长回忆起听力筛查相关。报告的通过率高于预期。家长对后续随访建议的回忆并不总是与指南一致。
尽管本研究存在回忆偏倚这一固有局限性,但研究结果表明家长对UNHS缺乏认知。有必要改变UNHS结果的报告系统,以提高家长对筛查结果的回忆,并改善对未通过筛查儿童的随访。