School of Nursing and Midwifery, Western Sydney University, Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia.
Population Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
PLoS One. 2022 Oct 3;17(10):e0275423. doi: 10.1371/journal.pone.0275423. eCollection 2022.
Little is known about the efficacy of pregnancy screening tools using non-sensitive sociodemographic questions to identify the possible presence of as yet undiagnosed disease in individuals and later adverse childhood events disclosure.
The study aims were to: 1) record the prevalence of risk disclosed by families during receipt of a sustained nurse home visiting program; and 2) explore patterns of relationships between the disclosed risks for their child having adverse experiences and the antenatal screening tool, which used non-sensitive demographic questions.
Retrospective, observational study.
Data about the participants in the intervention arm of the Australian right@home trial, which is scaffolded on the Maternal Early Childhood Sustained Home-visiting model, collected between 2013 and 2017 were used. Screening data from the 10-item antenatal survey of non-sensitive demographic risk factors and disclosed risks recorded by the nurse in audited case files during the subsequent 2 year intervention were examined (n = 348). Prevalence of disclosed risks for their child having adverse experiences were analysed in 2019 using multiple response frequencies. Phi correlations were conducted to test associations between screening factors and disclosed risks.
Among the 348 intervention participants whose files were audited, 300 were noted by nurses to have disclosed risks during the intervention, with an average of four disclosures. The most prevalent maternal disclosures were depression or anxiety (57.8%). Mental health issues were the most prevalent partner and family disclosures. Screening tool questions on maternal smoking in pregnancy, not living with another adult, poverty and self-reporting anxious mood were significantly associated with a number of disclosed risks for their child having adverse experiences.
These findings suggest that a non-sensitive sociodemographic screening tool may help to identify families at higher risk for adverse childhood experiences for whom support from a sustained nurse home visiting program may be beneficial.
对于使用非敏感社会人口学问题的妊娠筛查工具来识别个体中尚未诊断出的疾病以及随后的不良儿童事件披露的效果知之甚少。
本研究旨在：1）记录在接受持续护士家访计划期间家庭披露的风险的发生率；2）探讨所披露的风险与用于筛查的非敏感人口统计学问题之间的关系模式，这些风险与儿童发生不良经历有关。
回顾性观察性研究。
使用了澳大利亚 right@home 试验干预组的参与者数据，该试验基于 Maternal Early Childhood Sustained Home-visiting 模型，收集于 2013 年至 2017 年期间。对 10 项非敏感人口统计学风险因素的产前筛查数据和护士在随后 2 年干预期间在审核病例档案中记录的披露风险进行了检查（n=348）。2019 年，使用多项响应频率分析了儿童发生不良经历的披露风险的发生率。使用 Phi 相关性检验了筛查因素与披露风险之间的关联。
在接受审核的 348 名干预参与者中，有 300 名护士记录了在干预期间披露了风险，平均有四项披露。最常见的母亲披露风险是抑郁或焦虑（57.8%）。心理健康问题是伴侣和家庭最常见的披露风险。筛查工具中关于孕妇吸烟、未与其他成年人同住、贫困和自我报告焦虑情绪的问题与儿童发生不良经历的多项披露风险显著相关。
这些发现表明，非敏感社会人口统计学筛查工具可能有助于识别处于不良儿童经历高风险的家庭，对于这些家庭，持续的护士家访计划的支持可能是有益的。
