Benioff Children's Hospital and University of California San Francisco, San Francisco, California
Benioff Children's Hospital and University of California San Francisco, San Francisco, California.
Hosp Pediatr. 2021 Mar;11(3):293-297. doi: 10.1542/hpeds.2020-001792. Epub 2021 Feb 10.
Risky behaviors are the main threats to adolescents' health. Consequently, guidelines recommend adolescents be screened annually for high-risk behaviors. Our objectives were to (1) determine rates of physician-documented risk behavior screening of hospitalized adolescents, (2) determine rates of positive screening results, and (3) evaluate associations between risk behavior screening and provision of risk behavior-related health care interventions.
We conducted a cross-sectional study of patients aged 12 to 24 years admitted to the pediatric hospital medicine service at an urban tertiary children's hospital from January to December 2018. Exclusion criteria were transfer to a different service, nonverbal status, or altered mental status. We reviewed 20 charts per month. Outcomes included (1) documentation of risk behavior screening (mood, sexual activity, substance use, abuse and/or violence, and suicidal ideation), and (2) risk behavior-related health care interventions (eg, testing for sexually transmitted infections). We determined associations between screening and risk behavior-related interventions using χ tests.
We found that 38% (90 of 240) of adolescents had any documented risk behavior screening, 15% (37 of 240) had screening in 4 of 5 risk behavior domains, and 2% (5 of 240) had screening in all 5 domains. The majority of screened adolescents had a positive screening result (66%), and most with positive results received a risk behavior-related health care intervention (64%-100% across domains). Adolescents with documented screening were significantly more likely to receive a risk behavior-related health care intervention.
We found low rates of risk behavior screening documentation among hospitalized adolescents. There was a high rate of positive screen results, and those who were documented as screened were more likely to receive risk behavior-related interventions.
危险行为是青少年健康的主要威胁。因此，指南建议每年对青少年进行高危行为筛查。我们的目的是：(1)确定住院青少年医生记录的危险行为筛查率，(2)确定阳性筛查结果率，以及(3)评估危险行为筛查与提供危险行为相关的保健干预措施之间的关联。
我们对 2018 年 1 月至 12 月在城市三级儿童医院儿科住院医学服务中住院的 12 至 24 岁患者进行了一项横断面研究。排除标准为转至其他服务、无法言语或意识改变。我们每月审查 20 份病历。结果包括：(1)记录危险行为筛查(情绪、性行为、物质使用、滥用和/或暴力以及自杀意念)，以及(2)与危险行为相关的保健干预措施(例如，性传播感染检测)。我们使用 χ 检验确定筛查与危险行为相关干预之间的关联。
我们发现，38%(240 例中有 90 例)的青少年有任何记录的危险行为筛查，15%(240 例中有 37 例)在 5 个危险行为领域中的 4 个领域进行了筛查，2%(240 例中有 5 例)在所有 5 个领域进行了筛查。大多数接受筛查的青少年筛查结果呈阳性(66%)，大多数阳性结果的青少年接受了与危险行为相关的保健干预措施(各领域的 64%-100%)。有记录筛查的青少年更有可能接受与危险行为相关的保健干预措施。
我们发现住院青少年的危险行为筛查记录率较低。阳性筛查结果率较高，有记录的筛查者更有可能接受与危险行为相关的干预措施。
