AlAbdulKader Assim M, Morse Erica F, Daley Matthew F, Rao Goutham
University Hospitals of Cleveland/Case Western Reserve University, Cleveland, OH, USA.
Kaiser Permanente Colorado, Aurora, CO, USA.
Glob Pediatr Health. 2020 Dec 11;7:2333794X20981340. doi: 10.1177/2333794X20981340. eCollection 2020.
Clinical practice guidelines for diagnosis and management of pediatric hypertension have been available for decades. Yet, most cases of hypertension in children are undiagnosed. Provider and system-based factors, such as the complexity of diagnostic standards, and a failure among physicians to recognize the importance of hypertension in children, play a role in underdiagnosis. It is unclear, however, how patient and family behaviors impact the diagnosis and treatment of pediatric hypertension. We aimed to explore the perspectives of parents whose children have had multiple high blood pressure readings or have been diagnosed with hypertension to inform clinicians with areas for practice improvement. In a 2 site qualitative study, we interviewed parents of 15 children diagnosed with hypertension. Results from semi-structured interviews with parents revealed barriers to the diagnosis of pediatric hypertension, including uncertainty about the diagnosis and concerns around the accuracy of blood pressure measurements. Delay in diagnosis and lack of child engagement emerged as obstacles to the treatment of pediatric hypertension.
几十年来一直有小儿高血压诊断和管理的临床实践指南。然而，大多数儿童高血压病例未被诊断出来。基于医疗服务提供者和医疗系统的因素，如诊断标准的复杂性，以及医生未能认识到儿童高血压的重要性，在诊断不足中起到了作用。然而，尚不清楚患者和家庭行为如何影响小儿高血压的诊断和治疗。我们旨在探讨其子女有多次高血压读数或已被诊断为高血压的家长的观点，为临床医生提供实践改进的领域。在一项双地点定性研究中，我们采访了15名被诊断为高血压儿童的家长。对家长进行半结构化访谈的结果揭示了小儿高血压诊断的障碍，包括诊断的不确定性和对血压测量准确性的担忧。诊断延迟和儿童参与度不足成为小儿高血压治疗的障碍。
