Department of Obstetrics & Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Department of Public Health, Erasmus MC, Erasmus University Medical Centre, Rotterdam, The Netherlands.
J Adv Nurs. 2020 Dec;76(12):3654-3661. doi: 10.1111/jan.14547. Epub 2020 Sep 30.
To introduce the rationale and design of a postnatal risk assessment study, which will be embedded in Preventive Child Health Care. This study will evaluate: (a) the predictive value of an innovative postnatal risk assessment, meant to assess the risk of growth and developmental problems in young children; and (b) its effectiveness in combination with tailored care pathways.
This study concerns a historically controlled study design and is designed as part of the Healthy Pregnancy 4 All-2 program. We hypothesize that child growth and developmental problems will be reduced in the intervention cohort due to the postnatal risk assessment and corresponding care pathways.
The study was approved in August 2016. Children and their parents, visiting well-baby clinics during regular visits, will participate in the intervention (N = 2,650). Additional data of a historical control group (N = 2,650) in the same neighbourhoods will be collected. The intervention, consisting of the risk assessment and its corresponding care pathways, will be executed in the period between birth and 2 months of (corrected) age. The predictive value of the risk assessment and its effectiveness in combination with its corresponding care pathways will be assessed by Preventive Child Health Care nurses and physicians in four Preventive Child Health Care organisations in three municipalities with adverse perinatal outcomes. A total risk score above a predefined threshold, which is based on a weighted risk score, determines structured multidisciplinary consultation.
The successful implementation of this innovative postnatal risk assessment including corresponding care pathways has potential for further integration of risk assessment and a family-centred approach in the work process of Preventive Child Health Care nurses and physicians.
This study introduces a systematic approach in postnatal health care which may improve growth and developmental outcomes of children and even future generations.
介绍一项产后风险评估研究的原理和设计，该研究将嵌入预防儿童保健中。本研究将评估：（a）一种创新的产后风险评估的预测价值，旨在评估幼儿生长和发育问题的风险；以及（b）其与量身定制的护理途径相结合的效果。
本研究采用历史对照研究设计，是“全民健康妊娠 4 项计划”的一部分。我们假设，由于产后风险评估和相应的护理途径，干预组的儿童生长和发育问题将减少。
该研究于 2016 年 8 月获得批准。在常规就诊期间，参加健康婴儿诊所的儿童及其父母将参加干预组（N=2650）。还将在同一社区收集历史对照组（N=2650）的额外数据。干预措施包括风险评估及其相应的护理途径，将在出生至（校正）2 个月龄期间实施。预防儿童保健护士和医生将在三个市的四个预防儿童保健组织中评估风险评估的预测价值及其与相应护理途径相结合的有效性，这些组织存在不良围产期结局。总风险评分高于基于加权风险评分的预定阈值决定结构化多学科咨询。
成功实施这种创新的产后风险评估及其相应的护理途径，为进一步将风险评估和以家庭为中心的方法纳入预防儿童保健护士和医生的工作流程提供了潜力。
本研究介绍了一种产后保健的系统方法，可能会改善儿童甚至后代的生长和发育结果。
