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小儿高血压:医疗服务提供者的观点

Pediatric Hypertension: Provider Perspectives.

作者信息

Bello Jennifer K, Mohanty Nivedita, Bauer Victoria, Rittner Sarah S, Rao Goutham

机构信息

Saint Louis University, St. Louis, MO, USA.

NorthShore University HealthSystem Research Institute, Evanston, IL, USA.

出版信息

Glob Pediatr Health. 2017 Jun 6;4:2333794X17712637. doi: 10.1177/2333794X17712637. eCollection 2017.

Abstract

Pediatric hypertension is a risk for adult cardiovascular disease, making early detection important. The prevalence of pediatric essential hypertension is rising due to the increased prevalence of obesity. Though guidelines for screening, diagnosis, evaluation, and management are available, there are barriers to accurate diagnosis of pediatric hypertension, including lack of knowledge and complexity of blood pressure standards. We aimed to gain insights into reasons for low rates of diagnosis and treatment from primary care providers. As part of a multisite randomized controlled trial, we interviewed 8 providers in a community health center network. We used a grounded theoretical approach to analyze transcripts. Providers reflected on numerous barriers to diagnosis, management, and follow-up; recommendations for educational content; and how community health center systems can be improved. Findings informed development of a multifaceted intervention. Despite lack of training on essential hypertension, providers were comfortable recommending lifestyle changes to promote healthier weight and reduced blood pressure.

摘要

儿童高血压是成人心血管疾病的一个风险因素,因此早期检测很重要。由于肥胖患病率上升,儿童原发性高血压的患病率也在增加。尽管有关于筛查、诊断、评估和管理的指南,但儿童高血压的准确诊断存在障碍,包括知识缺乏和血压标准的复杂性。我们旨在深入了解初级保健提供者诊断和治疗率低的原因。作为一项多中心随机对照试验的一部分,我们采访了社区卫生中心网络中的8名提供者。我们采用扎根理论方法分析访谈记录。提供者反映了诊断、管理和随访方面的众多障碍;对教育内容的建议;以及社区卫生中心系统如何改进。研究结果为多方面干预措施的制定提供了依据。尽管缺乏原发性高血压方面的培训,但提供者乐于推荐生活方式改变以促进更健康的体重和降低血压。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b251/5464512/186c953e00b4/10.1177_2333794X17712637-fig1.jpg

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