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先天性甲状腺功能减退症新生儿筛查阳性结果的处理:对英格兰当前实践的定性探索

Processing of Positive Newborn Screening Results for Congenital Hypothyroidism: A Qualitative Exploration of Current Practice in England.

作者信息

Holder Pru, Cheetham Tim, Cocca Alessandra, Chinnery Holly, Chudleigh Jane

机构信息

Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London EC1V 0HB, UK.

Department of Paediatric Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK.

出版信息

Int J Neonatal Screen. 2021 Oct 13;7(4):64. doi: 10.3390/ijns7040064.

Abstract

The objective of this research was to explore current communication practices for positive newborn bloodspot screening results for congenital hypothyroidism from the newborn bloodspot screening laboratory to clinicians and then families, in order to (i) understand how the pathway is implemented in practice, (ii) highlight regional differences and (iii) identify barriers and facilitators. A qualitative exploratory design was employed using semi-structured interviews across 13 newborn bloodspot screening laboratories in England. Participants included 35 clinicians and 17 NBS laboratory staff across the 13 laboratories and 18 members of relevant clinical teams. Findings illuminated variations in how positive newborn bloodspot screening results for congenital hypothyroidism are communicated in practice. This included regional variations due to historical arrangements and local resources. Contacting the appropriate person could be challenging and obtaining feedback from clinical teams to the laboratory after the child has been seen could be time consuming for those involved. Standardised communication model(s) for positive newborn bloodspot screening results for congenital hypothyroidism, which include named contact individuals, defined pathways of care and processes for feeding back to laboratories, may help to ensure the process is less labour intensive, particularly from a laboratory perspective.

摘要

本研究的目的是探索从新生儿血斑筛查实验室向临床医生进而向家庭传达先天性甲状腺功能减退症新生儿血斑筛查阳性结果的当前沟通做法,以便:(i)了解该流程在实际中是如何实施的;(ii)突出区域差异;(iii)识别障碍和促进因素。采用定性探索性设计,对英格兰的13个新生儿血斑筛查实验室进行了半结构化访谈。参与者包括13个实验室的35名临床医生、17名新生儿血斑筛查实验室工作人员以及相关临床团队的18名成员。研究结果揭示了在实际中传达先天性甲状腺功能减退症新生儿血斑筛查阳性结果的方式存在差异。这包括由于历史安排和当地资源导致的区域差异。联系合适的人员可能具有挑战性,而且在看过患儿后从临床团队获取反馈给实验室的信息,对于相关人员来说可能很耗时。针对先天性甲状腺功能减退症新生儿血斑筛查阳性结果的标准化沟通模式,包括指定联系人、明确的护理路径以及反馈给实验室的流程,可能有助于确保该流程的劳动强度降低,特别是从实验室的角度来看。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8863/8544504/8d5d2b35abf1/IJNS-07-00064-g001.jpg

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