Bax Ami C, Shawler Paul M, Anderson Michael P, Wolraich Mark L
Section on Developmental and Behavioral Pediatrics, Department of Pediatrics, Child Study Center, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma, OK, United States.
Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma, OK, United States.
Front Pediatr. 2018 Dec 12;6:395. doi: 10.3389/fped.2018.00395. eCollection 2018.
Factors surrounding pediatricians' parenting advice and training on parenting during residency have not been well studied. The Resident Parenting Questionnaire (RPQ) was developed to assess (a) the relationship between pediatric residents' upbringing and their parenting advice style and (b) factors associated with confidence and resource use when delivering parenting advice. Three hundred and one pediatric residents from 15 United States residency programs completed the RPQ with upbringing and advice responses categorized using Baumrind's parenting model (authoritative, authoritarian, permissive). Chi-square/Fisher's exact tests, Bowker's test of symmetry, and regression analyses assessed associations between residents' upbringing, parenting advice style/content, and confidence in providing parenting advice. Most participants indicated being raised authoritatively (68%) and giving authoritative parenting advice (83%), but advice differed based on how they perceived their upbringing ( < 0.001). Residents noting authoritative upbringing were more likely to give authoritative advice (85%) while others tended to give advice differing from upbringing (e.g., those perceiving authoritarian upbringing were more likely to give authoritative/permissive). Analyses suggest resident race, acculturation, future plans, and resident level are associated with parenting advice type. Confidence in giving parenting advice decreased significantly as patient age increased and increased with resident level advancement. Residents reported consulting attending physicians for parenting advice guidance more than any other evidence-based resources. Most pediatric residents appear to be aware of appropriate authoritative parenting advice regardless of upbringing, especially as they advance through residency. Residents may benefit from opportunities to reflect upon their upbringing, particularly if raised in authoritarian or permissive styles. Targeted training of residents on evidence-based parenting strategies, particularly for older pediatric patients, appears warranted.
关于儿科医生育儿建议以及住院医师培训期间育儿相关内容的影响因素尚未得到充分研究。住院医师育儿问卷(RPQ)旨在评估:(a)儿科住院医师的成长经历与其育儿建议风格之间的关系;(b)提供育儿建议时与自信程度和资源利用相关的因素。来自美国15个住院医师培训项目的301名儿科住院医师完成了RPQ,其成长经历和建议回答按照鲍姆林德的育儿模式(权威型、专制型、放任型)进行分类。卡方检验/费舍尔精确检验、鲍克对称性检验以及回归分析评估了住院医师的成长经历、育儿建议风格/内容以及提供育儿建议的自信程度之间存在的关联。大多数参与者表示自己是在权威型教养方式下长大的(68%),并且给出的是权威型育儿建议(83%),但建议会因他们对自己成长经历的认知而有所不同(P<0.001)。那些认为自己是在权威型教养方式下长大的住院医师更有可能给出权威型建议(85%),而其他人给出的建议则与成长经历不同(例如,那些认为自己是在专制型教养方式下长大的人更有可能给出权威型/放任型建议)。分析表明,住院医师的种族、文化适应程度、未来规划以及住院医师级别与育儿建议类型有关。随着患者年龄的增加,提供育儿建议的自信程度显著降低,而随着住院医师级别的提升而增加。住院医师报告称,在寻求育儿建议指导时,向主治医生咨询的次数比向任何其他循证资源咨询的次数都多。大多数儿科住院医师似乎都知道适当的权威型育儿建议,无论其成长经历如何,尤其是随着他们在住院医师培训期间不断进步。住院医师可能会从反思自己成长经历的机会中受益,特别是如果他们是在专制型或放任型教养方式下长大的。有必要针对住院医师开展基于循证育儿策略的培训,特别是针对年龄较大的儿科患者。