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多学科护理包对恐针儿童疫苗接种的影响:一项观察性研究。

The impact of a multidisciplinary care package for vaccination in needle phobic children: An observational study.

机构信息

Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia.

Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia.

出版信息

J Paediatr Child Health. 2022 Jul;58(7):1174-1180. doi: 10.1111/jpc.15928. Epub 2022 Feb 26.

Abstract

AIMS

Children with severe needle phobia find vaccination extremely distressing and can remain unvaccinated, which puts them at an increased risk of contracting and transmitting vaccine preventable disease. Referral to a specialist or hospital service may occur when they cannot be safely vaccinated in the community, but engagement of allied health services can be inconsistent. The aim of the study was to assess the impact of a multidisciplinary, consumer-oriented model of care on vaccinations for needle phobic children.

METHODS

Needle phobic children aged between 6 and 16 years attended multidisciplinary consultation, as part of a care package, to assess previous experiences and determine the level of intervention that was required to support vaccination. A multidisciplinary case meeting followed this appointment and an individualised plan formulated for each patient. The main outcome of the project was rate of successful vaccination.

RESULTS

The care package resulted in a successful vaccination rate of 83% (n = 20) with 69 vaccines administered across three clinics. Of those successful, 90% required multiple injections per visit. The majority of patients indicated moderate to high level of anxiety. Supportive care was escalated and de-escalated as tolerated.

CONCLUSIONS

Results demonstrate the diversity of patients presenting with needle phobia and indicate an individualised, collaborative approach is preferable to a 'one size fits all' model of care. The study highlights a need for the development of guidelines that streamline the assessment and individualisation of procedural anxiety plans to meet patient needs and embed these processes into standard care.

摘要

目的

患有严重恐针症的儿童对接种疫苗感到极其痛苦,可能因此未接种疫苗,从而增加了感染和传播疫苗可预防疾病的风险。当他们无法在社区安全接种疫苗时,可能会被转介到专科或医院服务,但联合保健服务的参与可能并不一致。本研究旨在评估多学科、以消费者为导向的护理模式对有恐针症儿童进行疫苗接种的影响。

方法

年龄在 6 至 16 岁之间的有恐针症的儿童参加了多学科会诊,作为护理包的一部分,以评估他们以前的经历,并确定为支持接种疫苗所需的干预程度。在预约后会举行多学科病例会议,并为每位患者制定个体化计划。该项目的主要结果是成功接种疫苗的比例。

结果

护理包的结果是成功接种疫苗的比例为 83%(n=20),在三个诊所共接种了 69 针疫苗。在成功接种的患者中,90%需要每次就诊多次注射。大多数患者表示有中度至高度焦虑。支持性护理可根据耐受情况逐步增加或减少。

结论

结果表明有恐针症的患者存在多样性,并表明个体化、协作的方法优于“一刀切”的护理模式。该研究强调需要制定指南,简化程序焦虑计划的评估和个体化,以满足患者的需求,并将这些流程纳入标准护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd44/9302978/69e6852be645/JPC-58-1174-g001.jpg

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