Pantell R H, Lewis C C
J Chronic Dis. 1987;40 Suppl 1:99S-115S. doi: 10.1016/s0021-9681(87)80039-5.
To assess the impact of medical care on children we have developed a conceptual model based on both theoretical considerations and empirical research. Child health is viewed as the ability to participate fully in developmentally appropriate activities and requires physical, psychological, and social energy. The medical system influences health through interventions addressing these domains. Many methodologic issues are unique to the measurement of medical care processes and outcomes for children. Problems in measuring the process of medical interviews include developing systems that capture the dynamics of interactions, assess the cognitive appropriateness and metaphorical interpretation of language, and reflect the emotional impact of certain incidents. Issues that confound measurement of children's views include position bias, acquiescence response bias, and limited understanding of negatively worded items. Further, the concordance between parent and children reports or health constructs varies widely, which suggests the need to include children's reports to obtain a comprehensive view of their health.
为了评估医疗保健对儿童的影响，我们基于理论思考和实证研究构建了一个概念模型。儿童健康被视为充分参与适合其发育阶段活动的能力，这需要身体、心理和社会能量。医疗系统通过针对这些领域的干预措施来影响健康。许多方法学问题是儿童医疗保健过程和结果测量所特有的。医疗访谈过程测量中的问题包括开发能够捕捉互动动态、评估语言的认知适宜性和隐喻解释以及反映某些事件情感影响的系统。混淆儿童观点测量的问题包括位置偏差、默许反应偏差以及对否定措辞项目的理解有限。此外，父母与儿童报告或健康结构之间的一致性差异很大，这表明需要纳入儿童报告以全面了解他们的健康状况。
