关联校医干预与健康检查益处：一项观察性研究。

Associating school doctor interventions with the benefit of the health check: an observational study.

机构信息

Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

School and Student Healthcare, Department of Social Services and Healthcare, City of Helsinki, Helsinki, Finland.

出版信息

BMJ Paediatr Open. 2022 Feb;6(1). doi: 10.1136/bmjpo-2021-001394.

DOI:10.1136/bmjpo-2021-001394

PMID:36053658

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8889353/

Abstract

BACKGROUND

The benefits of school doctor interventions conducted at routine general health checks remain insufficiently studied. This study explored the associations of school doctor interventions with the doctor-evaluated and parent-evaluated benefits of routine health checks.

METHODS

Between August 2017 and August 2018, we recruited a random sample of 1341 children from grades 1 and 5 from 21 Finnish elementary schools in 4 municipalities. Doctors routinely examined all children, who were accompanied by parents. The doctor-reported interventions were categorised into six groups: instructions and/or significant discussions, prescriptions, laboratory tests and/or medical imaging, scheduling of follow-up appointments, referrals to other professionals and referrals to specialised care. Doctors evaluated the benefit of the appointment using predetermined criteria, and parents provided their subjective perceptions of benefit. Interventions and reported benefit were compared using multilevel logistic regression.

RESULTS

Doctors reported 52% and parents 87% of the appointments with interventions beneficial. All interventions were independently associated with doctor-evaluated benefit (ORs: 1.91-17.26). Receiving any intervention during the appointment was associated with parent-evaluated benefit (OR: 3.25, 95% CI 2.22 to 4.75). In analyses of different interventions, instructions and/or significant discussions (OR: 1.71, 95% CI 1.20 to 2.44), prescriptions (OR: 7.44, 95% CI 2.32 to 23.91) and laboratory tests and/or medical imaging (OR: 3.38, 95% CI 1.34 to 8.55) were associated with parent-evaluated benefit. Scheduled follow-up appointments and referrals to other professionals showed no significant association with parent-evaluated benefit.

CONCLUSIONS

Doctors and parents valued the appointments with interventions. Parents especially appreciated immediate help and testing from the doctor.

TRIAL REGISTRATION NUMBER

NCT03178331.

摘要

背景

在常规健康检查中进行校医干预的益处研究得还不够充分。本研究探讨了校医干预与医生评估和家长评估的常规健康检查益处之间的关联。

方法

2017 年 8 月至 2018 年 8 月，我们从芬兰 4 个市的 21 所小学随机招募了 1341 名 1 年级和 5 年级的儿童。医生对所有儿童进行常规检查，同时由家长陪同。医生报告的干预措施分为六组：指导和/或重要讨论、处方、实验室检查和/或医学影像、预约随访、转介给其他专业人员和转介至专科护理。医生使用预定标准评估预约的益处，家长则提供他们对益处的主观感知。使用多水平逻辑回归比较干预措施和报告的益处。

结果

医生报告了 52%的有干预措施的预约，家长报告了 87%的预约有好处。所有干预措施均与医生评估的益处独立相关（OR：1.91-17.26）。在预约期间接受任何干预措施与家长评估的益处相关（OR：3.25，95%CI 2.22-4.75）。在不同干预措施的分析中，指导和/或重要讨论（OR：1.71，95%CI 1.20-2.44）、处方（OR：7.44，95%CI 2.32-23.91）和实验室检查和/或医学影像（OR：3.38，95%CI 1.34-8.55）与家长评估的益处相关。预约后续随访和转介给其他专业人员与家长评估的益处无显著关联。