迈向儿童和青少年多重复杂需求的定义：佛兰德地区的德尔菲研究及国际调查
Towards a definition of multiple and complex needs in children and youth: Delphi study in Flanders and international survey.
作者信息
Van den Steene Helena, van West Dirk, Glazemakers Inge
机构信息
Collaborative Antwerp Psychiatric Research Institute - Youth, University of Antwerp, Belgium.
University Centre for Child & Adolescent Psychiatry (ZNA-UKJA), University of Antwerp, Belgium.
出版信息
Scand J Child Adolesc Psychiatr Psychol. 2019 May 30;7:60-67. doi: 10.21307/sjcapp-2019-009. eCollection 2019.
BACKGROUND
Multiple and complex needs (MCN) in children and youth jeopardize their development and pose significant challenges to the different professionals they meet. However, there is no agreed-upon definition of this vulnerable population.
OBJECTIVES
To develop a definition of 'MCN in children and youth' that is meaningful for all professionals involved in care delivery for this population.
METHOD
A cross-sector, multidisciplinary, and geographically spread panel of 47 experts representing mental health, youth care, juvenile justice, and education in Flanders participated in an online Delphi study. Qualitative analysis of answers in the first round yielded four definition possibilities that participants then ranked in the second round. In the last round, participants rated their agreement with the highest ranked definition. An additional survey asked 25 international experts to rate and comment their agreement with the final definition.
RESULTS
The final definition was: Children and adolescents with profound and interacting needs in the context of issues on several life domains (family context, functioning and integration in society) as well as psychiatric problems. The extent of their needs exceeds the capacity (expertise and resources) of existing services and sequential interventions lead to discontinuous care delivery. As such, existing services do not adequately meet the needs of these youths and their families. Cross-sector, integrated and assertive care delivery is necessary for safeguarding the wellbeing, development and societal integration of these young people. Response rates to the three Delphi rounds were 76.6, 89.1, and 91.3%. The definition was widely endorsed among Flemish (93.2% agreement) and international experts (88% agreement).
CONCLUSION
A definition of MCN in children and youth was constructed using the Delphi method and further evaluated for international relevance in an additional survey. Such an agreed-upon definition can be valuable for optimizing care delivery and conducting research.
背景
儿童和青少年的多重复杂需求（MCN）危及他们的发展，并给他们所接触的不同专业人员带来重大挑战。然而，对于这一弱势群体尚无公认的定义。
目的
制定一个对所有参与为该群体提供护理的专业人员有意义的“儿童和青少年多重复杂需求”定义。
方法
一个由47名专家组成的跨部门、多学科且地域分布广泛的小组参与了在线德尔菲研究，这些专家代表了弗拉芒地区的心理健康、青少年护理、少年司法和教育领域。第一轮答案的定性分析产生了四种定义可能性，参与者随后在第二轮中对其进行排序。在最后一轮中，参与者对排名最高的定义表示同意程度。另一项调查邀请了25名国际专家对最终定义的同意程度进行评分和评论。
结果
最终定义为：在几个生活领域（家庭环境、社会功能和融入）以及精神问题方面有深刻且相互作用需求的儿童和青少年。他们的需求程度超过了现有服务的能力（专业知识和资源），连续的干预导致护理服务不连贯。因此，现有服务无法充分满足这些年轻人及其家庭的需求。跨部门、综合且积极主动的护理服务对于保障这些年轻人的福祉、发展和社会融入是必要的。三轮德尔菲调查的回复率分别为76.6%、89.1%和91.3%。该定义在弗拉芒专家（同意率93.2%）和国际专家（同意率88%）中得到广泛认可。
结论
采用德尔菲法构建了儿童和青少年多重复杂需求的定义，并在另一项调查中进一步评估了其国际相关性。这样一个公认的定义对于优化护理服务和开展研究可能具有价值。
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