Department of Agricultural, Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, Edmonton, AB, Canada.
Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada.
J Clin Nurs. 2020 Sep;29(17-18):3263-3271. doi: 10.1111/jocn.15350. Epub 2020 Jun 25.
To (a) characterise and determine proportions of referred and enrolled children and (b) explore public health nurses' (PHNs) experiences, perspectives and recommendations regarding a new nurse-led referral pathway for paediatric weight management.
Children with obesity and their families in Canada access specialised services for obesity management through physician referral. Since this requirement can prevent timely access to health services, we established and tested a referral pathway whereby PHNs directly refer children to specialised care for obesity management.
Nested mixed-methods study reported using GRAMMS.
Our research study included children (2-17 years of age; body mass index ≥85th percentile) referred by a PHN to the Pediatric Centre for Weight and Health (PCWH; Stollery Children's Hospital, Edmonton, Alberta, Canada) from April 2017-September 2018. We summarised referral and enrolment data using descriptive statistics and conducted one-on-one, semi-structured telephone interviews with PHNs; interviews were audio-recorded, transcribed verbatim, managed using NVivo 12 and analysed by two independent reviewers using content analysis.
Our sample included 79 referred children (4.4 ± 1.8 years old; 3.4 ± 1.3 BMI z-score; 52.7% male), of which 47 (59.5%) enrolled in care. PHNs' (n = 11) experiences, perspectives and recommendations regarding the new referral pathway were grouped into four categories: (a) practicality of the referral pathway (e.g., simple and straightforward), (b) utility of the referral pathway (e.g., economic and timesaving), (c) uptake of the referral pathway (e.g., physician's influence) and (d) recommendations to improve the referral pathway (e.g., having electronic access to the referral form).
A PHN-specific referral pathway led most children and families to enrol in paediatric weight management and overall was perceived as acceptable and appropriate among PHNs.
Our results highlight the valuable role that PHNs can play in directly referring children to specialised services for weight management. This pathway has the potential to reduce wait times and enhance treatment enrolment.
(a)描述和确定转介和入组儿童的比例，(b)探讨公共卫生护士（PHN）在新的护士主导的儿科体重管理转介途径方面的经验、观点和建议。
加拿大肥胖儿童及其家庭通过医生转介获得专门的肥胖管理服务。由于这一要求可能会妨碍及时获得卫生服务，我们建立并测试了一种转介途径，即 PHN 直接将儿童转介到专门的肥胖管理护理机构。
使用 GRAMMS 报告嵌套混合方法研究。
我们的研究包括 2017 年 4 月至 2018 年 9 月期间由 PHN 转介到小儿体重与健康中心（PCWH；加拿大艾伯塔省埃德蒙顿斯特罗利儿童医院）的儿童（2-17 岁；体重指数≥第 85 百分位）。我们使用描述性统计方法总结了转介和入组数据，并对 PHN 进行了一对一的半结构化电话访谈；访谈进行了录音，逐字转录，使用 NVivo 12 进行管理，并由两名独立审查员使用内容分析进行分析。
我们的样本包括 79 名转介儿童（4.4±1.8 岁；3.4±1.3 BMI z 评分；52.7%为男性），其中 47 名（59.5%）入组接受治疗。PHN（n=11）对新转介途径的经验、观点和建议分为四类：(a)转介途径的实用性（例如，简单直接），(b)转介途径的效用（例如，经济和节省时间），(c)转介途径的采用（例如，医生的影响）和 (d)改进转介途径的建议（例如，能够电子访问转介表）。
特定于 PHN 的转介途径使大多数儿童和家庭入组接受儿科体重管理，总体上在 PHN 中被认为是可以接受和合适的。
我们的研究结果强调了 PHN 在直接将儿童转介到专门的体重管理服务方面可以发挥的宝贵作用。这种途径有可能减少等待时间并提高治疗入组率。
