Schaeffer Paula, Asnes Andrea G
Department of Pediatrics, Yale School of Medicine, 1 Long Wharf Dr. Suite 130, New Haven, CT, 06511, USA.
Matern Child Health J. 2018 Jan;22(1):51-58. doi: 10.1007/s10995-017-2353-5.
Background and objectives Despite the risks of bed-sharing, little is known about what pediatricians tell parents about bed-sharing with infants and whether pediatricians provide specific recommendations outlined by the American Academy of Pediatrics (AAP). This study aimed to understand pediatricians' opinions about bed-sharing and the advice pediatricians provide to parents about bed sharing. Methods The study employed a qualitative study design and the conceptual framework of the Theory of Planned Behavior. 24 primary care pediatricians from a variety of practice settings were interviewed about the anticipatory guidance they provide to families whose infants are in the at-risk age group for SIDS. Results Pediatricians' opinions about bed-sharing differed widely both with respect to identifying bed-sharing as a topic they routinely address in anticipatory guidance as well as in what they tell parents about bed sharing. Some strongly and routinely advise against bed-sharing and identify bed-sharing as a clear risk to infants. Others believe bed-sharing to be both safe and useful. A third group allow the content of anticipatory guidance to be driven by parental concerns. Most pediatricians are clearer in their recommendation to place infants supine to sleep than in their recommendation to avoid bed-sharing. Conclusions Overall, there is considerable variation among pediatricians in the advice they provide about bed-sharing, and most advice is not congruent with the AAP recommendations. Additional efforts to educate pediatricians may be necessary to change attitudes and behaviors with respect to anticipatory guidance about safe sleep.
背景与目的 尽管同床睡眠存在风险,但对于儿科医生就与婴儿同床睡眠向家长提供了哪些信息,以及儿科医生是否提供了美国儿科学会(AAP)概述的具体建议,人们知之甚少。本研究旨在了解儿科医生对同床睡眠的看法以及他们向家长提供的有关同床睡眠的建议。方法 本研究采用定性研究设计和计划行为理论的概念框架。对来自各种执业环境的24名初级保健儿科医生进行了访谈,询问他们对处于婴儿猝死综合征高危年龄组的家庭提供的预期指导。结果 儿科医生对同床睡眠的看法差异很大,既体现在将同床睡眠视为他们在预期指导中常规涉及的话题,也体现在他们告诉家长的有关同床睡眠的内容上。一些医生强烈且常规地建议不要同床睡眠,并将同床睡眠视为对婴儿的明显风险。另一些医生则认为同床睡眠既安全又有用。第三组医生则让预期指导的内容由家长的担忧来驱动。大多数儿科医生在建议婴儿仰卧睡眠方面比在建议避免同床睡眠方面更明确。结论 总体而言,儿科医生在提供的有关同床睡眠的建议方面存在很大差异,且大多数建议与AAP的建议不一致。可能需要做出更多努力来教育儿科医生,以改变他们在安全睡眠预期指导方面的态度和行为。