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哪些人从校医健康检查中受益:一种筛查方法的前瞻性研究

Who benefit from school doctors' health checks: a prospective study of a screening method.

作者信息

Nikander Kirsi, Kosola Silja, Kaila Minna, Hermanson Elina

机构信息

School and Student Healthcare, Department of Social Services and Healthcare, City of Helsinki, Finland.

Doctoral School in Health Sciences, Doctoral Program in Population Health, University of Helsinki, Helsinki, Finland.

出版信息

BMC Health Serv Res. 2018 Jun 27;18(1):501. doi: 10.1186/s12913-018-3295-3.

Abstract

BACKGROUND

School health services provide an excellent opportunity for the detection and treatment of children at risk of later health problems. However, the optimal use of school doctors' skills and expertise remains unknown. Furthermore, no validated method for screening children for school doctors' assessments exists. The aims of the study are 1) to evaluate the benefits or harm of school doctors' routine health checks in primary school grades 1 and 5 (at ages 7 and 11) and 2) to explore whether some of the school doctors' routine health checks can be omitted using study questionnaires.

METHODS

This is a prospective, multicenter observational study conducted in four urban municipalities in Southern Finland by comparing the need for a school doctor's assessment to the benefit gained from it. We will recruit a random sample of 1050 children from 21 schools from primary school grades 1 and 5. Before the school doctor's health check, parents, nurses and teachers fill a study questionnaire to identify any potential concerns about each child. Doctors, blinded to the questionnaire responses, complete an electronic report after the appointment, including given instructions and follow-up plans. The child, parent, doctor and researchers assess the benefit of the health check. The researchers compare the need for a doctor's appointment to the benefit gained from it. At one year after the health check, we will analyze the implementation of the doctors' interventions and follow-up plans.

DISCUSSION

The study will increase our knowledge of the benefits of school doctors' routine health checks and assess the developed screening method. We hypothesize that targeting the health checks to the children in greatest need would increase the quality of school health services.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT03178331 , date of registration June 6 2017.

摘要

背景

学校卫生服务为发现和治疗有日后健康问题风险的儿童提供了绝佳机会。然而,学校医生技能和专业知识的最佳利用方式仍不明确。此外,不存在经过验证的用于学校医生评估儿童的筛查方法。本研究的目的是:1)评估小学一年级和五年级(7岁和11岁)学生进行学校医生常规健康检查的益处或危害;2)使用研究问卷探讨是否可以省略一些学校医生的常规健康检查。

方法

这是一项前瞻性、多中心观察性研究,在芬兰南部四个城市自治市进行,通过比较学校医生评估的必要性与其所带来的益处。我们将从21所学校的小学一年级和五年级随机抽取1050名儿童作为样本。在学校医生进行健康检查之前,家长、护士和教师填写一份研究问卷,以确定对每个孩子的任何潜在担忧。医生在不知道问卷回复的情况下,在预约后完成一份电子报告,包括给出的指示和后续计划。儿童、家长、医生和研究人员评估健康检查的益处。研究人员比较医生预约的必要性与其所带来的益处。在健康检查一年后,我们将分析医生干预措施和后续计划的实施情况。

讨论

该研究将增加我们对学校医生常规健康检查益处的了解,并评估所开发的筛查方法。我们假设将健康检查针对最有需要的儿童将提高学校卫生服务的质量。

试验注册

ClinicalTrials.gov标识符:NCT03178331,注册日期2017年6月6日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97eb/6020452/b923c72b54ee/12913_2018_3295_Fig1_HTML.jpg

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