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[照顾患有慢性病和残疾的难民儿童及青少年]

[Care of refugee children and adolescents with chronic diseases and disabilities].

作者信息

Spielberger Benedikt, Jackel-Neusser Kathrin, Schimana Werner, Fressle Roland, Langer Thorsten

机构信息

Zentrum für Kinder- und Jugendheilkunde, Pädiatrische Infektiologie und Rheumatologie, Universitätsklinikum Freiburg, Freiburg, Deutschland.

Abteilung Infektiologie, Klinik für Innere Medizin II, Department Innere Medizin, Universitätsklinikum Freiburg, Freiburg, Deutschland.

出版信息

Monatsschr Kinderheilkd. 2022;170(12):1085-1095. doi: 10.1007/s00112-022-01608-3. Epub 2022 Sep 28.

Abstract

Refugee children and adolescents with chronic diseases and disabilities are among the most vulnerable persons as their health and developmental chances are considerably at risk. This article describes the challenges and opportunities in the care of this group of patients from the perspective of different care sectors: initial reception center, public health service, pediatricians in private practice, social pediatric centers and patient organizations. The starting point is a presentation of the rights to optimal healthcare that can be derived from the United Nations (UN) Convention on the Rights of Persons with Disabilities and the UN Convention on the Rights of the Child. It becomes clear that for children and adolescents in the status of asylum seekers there are systematic gaps in the recognition and care of chronic diseases, disabilities and support needs. An expansion of the health examination after arrival, which has so far focused on the detection of communicable diseases, is important and necessary in order to identify individual needs and improve the data situation for this group. A strengthening of the school entry screening by the public health service, especially for older children entering school as lateral entrants, could also significantly improve the nationwide coverage. In contrast to these deficits, which require changes at the political level, there are innovative models of care, especially in local contexts, such as pediatric consultation clinics in initial reception centers, diverse examples of voluntary commitment or the use of social media in patient organizations, which are presented as examples.

摘要

患有慢性病和残疾的难民儿童及青少年是最脆弱的人群之一,因为他们的健康和发育机会面临着相当大的风险。本文从不同护理部门的角度描述了照顾这类患者所面临的挑战和机遇:初始接待中心、公共卫生服务机构、私人执业儿科医生、社会儿科中心和患者组织。出发点是阐述可从联合国《残疾人权利公约》和《儿童权利公约》中推导出来的获得最佳医疗保健的权利。显而易见,对于寻求庇护身份的儿童和青少年而言,在慢性病、残疾和支持需求的识别与护理方面存在系统性差距。为了确定个体需求并改善该群体的数据状况,扩大抵达后的健康检查(目前主要侧重于检测传染病)非常重要且必要。公共卫生服务机构加强入学筛查,尤其是对作为插班生入学的大龄儿童,也可显著提高全国范围内的覆盖率。与这些需要在政治层面进行变革的不足形成对比的是,存在一些创新的护理模式,特别是在地方层面,例如初始接待中心的儿科咨询诊所、各种志愿参与的例子,或者患者组织中社交媒体的使用,本文将这些作为示例进行介绍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d77/9516531/c6e70b1ae0aa/112_2022_1608_Fig1_HTML.jpg

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