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识别发育迟缓风险儿童的促进因素和障碍:澳大利亚母婴健康服务的试点研究。

Enablers and Barriers to Identifying Children at Risk of Developmental Delay: A Pilot Study of Australian Maternal and Child Health Services.

机构信息

Discipline of Nursing, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.

Discipline of Psychology, School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.

出版信息

Matern Child Health J. 2021 Jun;25(6):967-979. doi: 10.1007/s10995-020-03077-0. Epub 2020 Nov 30.

Abstract

BACKGROUND

Twenty per cent of Australian children enter primary school with at least one area of developmental vulnerability (Commonwealth of Australia. (2018). Australian early development census [AEDC]. Retrieved from https://www.aedc.gov.au/.). This statistic is in the context of Maternal and Child Health (MCH) services offering regular developmental screening up to 8 times between 2 weeks and 3.5 years of age.

OBJECTIVES

This study investigated: (1) enablers and barriers influencing MCH nurses in identifying children from birth to school age at risk of developmental delay. This focused on their experience, knowledge, attitudes and skills regarding the use of developmental screening tools. And (2) strategies to support MCH nurses and parents to identify children at risk of delay.

METHOD

This mixed-methods study combined an online questionnaire and three focus groups and participants were MCH Nurses (N = 19) from one Australian municipality.

RESULTS

MCH nurses surveyed (N = 19) reported more confidence in screening older children compared to children younger than 12 months. 15 of 19 nurses did not have accurate knowledge and skill in using PEDS and Brigance screens. In the focus group interviews (N = 16), time restraints, language used in developmental screening tools, and excessive waiting time for referral were raised as key barriers to identifying children at risk.

LIMITATIONS

While the study provides rich insight, caution needs to be exercised when making generalisations from the findings given the small number of participants from one municipality.

CONCLUSION

Recommendations for practice, service management, and further research are provided to improve the process of early detection.

摘要

背景

20%的澳大利亚儿童在进入小学时至少存在一个发育脆弱领域(澳大利亚联邦政府。2018 年。澳大利亚早期发展普查 [AEDC]。取自 https://www.aedc.gov.au/。)。这一统计数据是在提供常规发育筛查的儿童保健和母婴健康(MCH)服务的背景下得出的,这些服务在儿童 2 周到 3.5 岁期间提供了多达 8 次的筛查。

目的

本研究调查了:(1)影响 MCH 护士识别从出生到学龄期发育迟缓风险儿童的因素,重点关注他们在使用发育筛查工具方面的经验、知识、态度和技能。以及(2)支持 MCH 护士和家长识别发育迟缓风险儿童的策略。

方法

本混合方法研究结合了在线问卷和三个焦点小组,参与者为来自澳大利亚一个市的 MCH 护士(N=19)。

结果

接受调查的 MCH 护士(N=19)报告说,与 12 个月以下的儿童相比,他们对筛查较大儿童更有信心。19 名护士中有 15 名在使用 PEDS 和 Brigance 筛查工具方面没有准确的知识和技能。在焦点小组访谈(N=16)中,时间限制、发育筛查工具中使用的语言以及转介等待时间过长被认为是识别风险儿童的主要障碍。

局限性

尽管该研究提供了丰富的见解,但由于仅来自一个市的少数参与者,在从研究结果中进行推广时需要谨慎。

结论

为了改进早期发现的过程,提供了有关实践、服务管理和进一步研究的建议。

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