Ueki Shingo, Komai Kazuyo, Ohashi Kazutomo, Fujita Yuichi, Kitao Mika, Fujiwara Chieko
School of Nursing, Mukogawa Women's University, Nishinomiya, Japan.
Nakano Children Hospital, Osaka, Japan.
J Adv Nurs. 2019 Nov;75(11):2811-2819. doi: 10.1111/jan.14161. Epub 2019 Aug 20.
To examine characteristics of parents of children with acute, albeit mild, illnesses who used ambulance transport unnecessarily.
A cross-sectional study.
From 2016 - 2017, we recruited parents who visited the emergency room of a Japanese paediatric hospital and whose children were discharged without hospitalization. Participants whose children arrived by ambulance were classified as using ambulance services unnecessarily. Participants answered a questionnaire consisting of parents' characteristics, including health literacy scales and the Parents' Uncertainty regarding their Children with Acute Illness Scale. We conducted a receiver operating characteristic analysis to convert the Parents' Uncertainty regarding their Children with Acute Illness Scale results to binary scores. We analysed questionnaire responses using logistic regression analysis.
Analysed data were from 171 participants. The cut-off score was 59 for the Parents' Uncertainty regarding their Children with Acute Illness Scale. Results of the logistic regression indicated that parents who did not use resources to obtain information regarding their child's illness, had low health literacy, were observing presenting symptoms for the first time in their child, or had high uncertainty, were significantly more likely to unnecessarily use ambulances.
Publicizing available resources regarding child health information, social healthcare activities to raise parents' health literacy and providing explanations in accordance with parents' uncertainty, especially when confronting new symptoms in their child, might reduce unnecessary ambulance use.
Of patients transported to hospitals by ambulance, the rate of paediatric parents with mild conditions has been found to be high. The study findings could contribute to the appropriateness of using ambulances and have implications for policymakers and healthcare providers, particularly in the Japanese paediatric emergency system. In particular, parental uncertainty, one of four significant characteristics, could be resolved in clinical settings. Generalization for global health services requires further research.
调查那些让患有急性（尽管症状较轻）疾病的孩子不必要地使用救护车转运的家长的特征。
一项横断面研究。
在2016年至2017年期间，我们招募了前往一家日本儿科医院急诊室就诊且孩子未住院就出院的家长。孩子乘坐救护车前来就诊的参与者被归类为不必要地使用了救护车服务。参与者回答了一份问卷，内容包括家长的特征，如健康素养量表以及家长对孩子急性疾病的不确定性量表。我们进行了受试者工作特征分析，以将家长对孩子急性疾病的不确定性量表结果转换为二分得分。我们使用逻辑回归分析对问卷回复进行了分析。
分析的数据来自171名参与者。家长对孩子急性疾病的不确定性量表的临界值为59分。逻辑回归结果表明，那些不利用资源获取孩子疾病信息、健康素养较低、首次观察到孩子出现症状或者不确定性较高的家长，更有可能不必要地使用救护车。
宣传有关儿童健康信息的可用资源、开展提高家长健康素养的社会医疗活动以及根据家长的不确定性提供解释，尤其是当孩子出现新症状时，可能会减少不必要的救护车使用。
在通过救护车转运至医院的患者中，发现患有轻症的儿科患者家长的比例较高。该研究结果有助于合理使用救护车，对政策制定者和医疗服务提供者具有启示意义，尤其是在日本儿科急诊系统中。特别是，作为四个重要特征之一的家长不确定性，可以在临床环境中得到解决。对于全球卫生服务的推广，还需要进一步研究。
