Johansen Kine, Persson Kristina, Sonnander Karin, Magnusson Margaretha, Sarkadi Anna, Lucas Steven
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Uppsala University Children's Hospital, Uppsala, Sweden.
PLoS One. 2017 Jul 19;12(7):e0181398. doi: 10.1371/journal.pone.0181398. eCollection 2017.
This study aimed to evaluate the clinical utility of the Structured Observation of Motor Performance in Infants (SOMP-I) when used by nurses in routine child healthcare by analyzing the nurses' SOMP-I assessments and the actions taken when motor problems were suspected.
Infants from three child health centers in Uppsala County, Sweden, were consecutively enrolled in a longitudinal study. The 242 infants were assessed using SOMP-I by the nurse responsible for the infant as part of the regular well-child visits at as close to 2, 4, 6 and 10 months of age as possible. The nurses noted actions taken such as giving advice, scheduling an extra follow-up or referring the infant to specialized care. The infants' motor development was reassessed at 18 months of age through review of medical records or parental report.
The assessments of level of motor development at 2 and 10 months showed a distribution corresponding to the percentile distribution of the SOMP-I method. Fewer infants than expected were assessed as delayed at 4 and 6 months or deficient in quality at all assessment ages. When an infant was assessed as delayed in level or deficient in quality, the likelihood of the nurse taking actions increased. This increased further if both delay and quality deficit were found at the same assessment or if one or both were found at repeated assessments. The reassessment of the motor development at 18 months did not reveal any missed infants with major motor impairments.
The use of SOMP-I appears to demonstrate favorable clinical utility in routine child healthcare as tested here. Child health nurses can assess early motor performance using this standardized assessment method, and using the method appears to support them the clinical decision-making.
本研究旨在通过分析护士对婴儿运动表现的结构化观察（SOMP-I）评估以及怀疑存在运动问题时采取的行动，评估护士在常规儿童保健中使用SOMP-I的临床效用。
瑞典乌普萨拉县三个儿童健康中心的婴儿连续纳入一项纵向研究。242名婴儿由负责该婴儿的护士使用SOMP-I进行评估，作为常规健康儿童检查的一部分，尽可能在接近2、4、6和10月龄时进行。护士记录采取的行动，如提供建议、安排额外随访或转诊至专科护理。通过查阅病历或家长报告，在18月龄时对婴儿的运动发育进行重新评估。
2月龄和10月龄时的运动发育水平评估显示出与SOMP-I方法百分位分布相对应的分布情况。在4月龄和6月龄时被评估为发育延迟或在所有评估年龄时质量不足的婴儿比预期的少。当婴儿被评估为水平延迟或质量不足时，护士采取行动的可能性增加。如果在同一次评估中发现延迟和质量缺陷，或者在重复评估中发现一项或两项缺陷，则这种可能性会进一步增加。18月龄时对运动发育的重新评估未发现任何遗漏的有严重运动障碍的婴儿。
如本研究测试所示，SOMP-I的使用在常规儿童保健中似乎显示出良好的临床效用。儿童健康护士可以使用这种标准化评估方法评估早期运动表现，并且使用该方法似乎有助于他们进行临床决策。
