School of Nursing & Midwifery, Trinity College Dublin, University of Dublin, Dublin, Ireland.
School of Nursing & Midwifery, Trinity College Dublin, University of Dublin, Dublin, Ireland.
Lancet Child Adolesc Health. 2018 Nov;2(11):822-831. doi: 10.1016/S2352-4642(18)30272-4.
With improvements in neonatal and paediatric care, more children living with complex care needs are surviving beyond infancy into late childhood and adulthood than in the past. We examined the current approach to the management and integration of care of children living with complex care needs in 30 European countries, as well as the implications for primary care service delivery. This descriptive study, with an embedded qualitative aspect, consisted of questions adapted from the Standards for Systems of Care for Children and Youth with Special Health Care Needs, and included questions on a complex care European survey of change, adapted from the Eurobarometer survey. The analysis indicates that few systems are in place in countries across Europe to identify all the health-care providers who deliver care to a child living with complex care needs, and that less than half of all countries surveyed have policies in place to support care coordination for these children. Primary care physicians have little involvement in care planning for children before their discharge to the community setting, and there is little parental participation in policy development. Access to, and governance of, care for these children varies widely. Particular issues identified pertain to parents as catalysts of optimum integration of care, pathways to specialist care, and the need for comprehensive national integrated care programmes.
随着新生儿和儿科护理水平的提高,现在有比过去更多的患有复杂护理需求的儿童能够在婴儿期后存活到幼儿期和成年期。我们调查了 30 个欧洲国家在管理和整合患有复杂护理需求的儿童护理方面的现状,以及这对初级保健服务提供的影响。这项描述性研究具有嵌入式定性方面,包含了从特殊保健需求儿童和青年护理系统标准中改编的问题,并包括了从欧洲晴雨表调查中改编的复杂护理欧洲变革调查问题。分析表明,在欧洲各国,很少有系统能够识别所有为患有复杂护理需求的儿童提供护理的医疗保健提供者,而且不到一半的调查国家制定了支持这些儿童护理协调的政策。初级保健医生在将儿童出院到社区环境之前很少参与儿童的护理计划制定,而且家长在政策制定方面的参与度也很低。这些儿童的护理机会和治理方式差异很大。具体问题涉及到父母作为最佳护理整合的催化剂、专家护理的途径以及全面的国家综合护理计划的必要性。