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家长对儿童健康和安全指南的遵守:医患关系的重要性。

Parents' adherence to pediatric health and safety guidelines: Importance of patient-provider relationships.

机构信息

Washington University in St. Louis, School of Medicine, Division of Public Health Sciences, St. Louis, MO, USA.

University of Louisville, Public Health and Information Sciences, Louisville, KY, USA.

出版信息

Patient Educ Couns. 2018 Sep;101(9):1570-1576. doi: 10.1016/j.pec.2018.05.003. Epub 2018 May 1.

Abstract

OBJECTIVE

To examine 1) parent-provider communication about pediatric health/safety guidelines, 2) trust in child's provider, 3) comfort discussing guidelines, 4) agreement with guideline advice, 5) self-efficacy following guidelines, and their impact on guideline adherence.

METHOD

256 parents of children ages 0-6 completed an online survey about sunscreen use, newborn Vitamin K injections, influenza vaccination, routine vaccination, car seats, infant safe sleep, furniture anchoring, large trampoline use, and firearm safety. Multivariable models regressed: 1) communication about each guideline on parents' corresponding guideline adherence; 2) trust, comfort discussing guidelines, agreement with guideline advice, self-efficacy, on parents' total guideline adherence.

RESULTS

Communication about furniture anchoring (OR = 2.26), sunscreen (OR = 5.28), Vitamin K injections (OR = 3.20), influenza vaccination (OR = 13.71), routine vaccination (OR = 6.43), car seats (OR = 6.15), and infant safe sleep (OR = 3.40) related to corresponding guideline adherence (ps < 0.05). Firearm safety communication was not related to adherence (OR = 1.11, n.s.). Trampoline communication related to lower likelihood of trampoline guideline adherence (OR = 0.24, p = 0.001). Agreement with guideline advice (β = 0.35), trust (β = 0.34), self-efficacy (β = 0.45), comfort discussing guidelines (β = 0.35) positively related to total guideline adherence (ps < 0.001).

CONCLUSION

Findings underscore the importance of provider communication about health/safety guidelines.

PRACTICE IMPLICATIONS

Providers should respectfully engage and build relationships with parents to support health/safety guideline adherence.

摘要

目的

考察 1)父母与提供者就儿科健康/安全指南进行沟通的情况,2)对孩子提供者的信任,3)讨论指南的舒适度,4)对指南建议的认同,5)遵循指南后的自我效能感,以及这些因素对指南遵循的影响。

方法

256 名 0-6 岁儿童的父母完成了一项关于防晒霜使用、新生儿维生素 K 注射、流感疫苗接种、常规疫苗接种、汽车座椅、婴儿安全睡眠、家具固定、大型蹦床使用和枪支安全的在线调查。多变量模型回归分析:1)父母对每个指南的沟通与父母相应的指南遵循情况;2)信任、讨论指南的舒适度、对指南建议的认同、自我效能感与父母的总体指南遵循情况。

结果

家具固定(OR=2.26)、防晒霜(OR=5.28)、维生素 K 注射(OR=3.20)、流感疫苗接种(OR=13.71)、常规疫苗接种(OR=6.43)、汽车座椅(OR=6.15)和婴儿安全睡眠(OR=3.40)的沟通与相应的指南遵循相关(p<0.05)。枪支安全沟通与遵守情况无关(OR=1.11,n.s.)。蹦床沟通与较低的蹦床指南遵守率相关(OR=0.24,p=0.001)。对指南建议的认同(β=0.35)、信任(β=0.34)、自我效能感(β=0.45)、讨论指南的舒适度(β=0.35)与总体指南遵循呈正相关(p<0.001)。

结论

研究结果强调了提供者就健康/安全指南与父母进行沟通的重要性。

实践意义

提供者应尊重并与父母建立关系,以支持健康/安全指南的遵循。

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