Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts;
Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC; and.
Hosp Pediatr. 2021 Apr;11(4):417-421. doi: 10.1542/hpeds.2020-000216.
To assess the frequency and completeness of adolescent psychosocial screening documentation for adolescents and young adults hospitalized to a pediatric hospitalist medicine service.
All patients 12 to 21 years old on the hospital medicine service in an urban, academic, free standing children's hospital in the Mid-Atlantic United States from January 1, 2014, to December 31, 2015, were identified. A retrospective review was conducted to assess the frequency of documentation of a complete psychosocial screening using the Home, Education, Activities, Drugs, Sex, Suicide assessment within 48 hours of admission. Differences in screening rates according to race, sex, age, patient's medical complexity, and whether they required transfer to a higher level of care were assessed through logistic regression analyses.
Only 5.3% (24 of 435 patients) had all 6 domains of the Home, Education, Activities, Drugs, Sex, Suicide psychosocial assessment documented. Controlling for patient characteristics (demographic, medical complexity, and level of care), the odds of being screened for sensitive domains (drugs, sex, and suicide) were higher in female patients, patients ≥16 years old, and those transferred to a higher level of care. Those considered high medical complexity were screened less across all domains.
Overall, pediatric hospitalist documentation lacked adolescent psychosocial screening. Potential opportunities exist through screening early in the hospitalization to connect youth with services that influence health outcomes.
评估青少年心理社会筛查文件的频率和完整性，这些文件针对的是住院于儿科医院医学科的青少年和年轻成年人。
在美国中大西洋地区的一家城市、学术性的独立儿童医院，从 2014 年 1 月 1 日至 2015 年 12 月 31 日，确定了所有 12 至 21 岁的医院医学科的患者。进行了回顾性研究，以评估在入院后 48 小时内完整的心理社会筛查文件记录的频率，使用家庭、教育、活动、药物、性、自杀评估。通过逻辑回归分析，评估了根据种族、性别、年龄、患者的医疗复杂性以及是否需要转移到更高水平的护理来评估筛查率的差异。
只有 5.3%（435 名患者中的 24 名）记录了家庭、教育、活动、药物、性、自杀心理社会评估的所有 6 个领域。控制患者特征（人口统计学、医疗复杂性和护理水平）后，女性患者、≥16 岁的患者和被转移到更高水平护理的患者在敏感领域（药物、性和自杀）被筛查的可能性更高。被认为具有高医疗复杂性的患者在所有领域的筛查率都较低。
总体而言，儿科医院医生的文件记录缺乏青少年心理社会筛查。在住院早期筛查中存在潜在的机会，可以为影响健康结果的服务联系青年。
