Queensland Children's Hospital, 501 Stanley Street, South Brisbane, QLD 4101, Australia; The Queensland University of Technology, 2 George Street, Brisbane City, QLD 4000, Australia.
School of Medicine, Deakin University, 75 Pigdons Rd, Geelong, VIC, 3216, Australia.
Aust Crit Care. 2023 Jul;36(4):492-498. doi: 10.1016/j.aucc.2022.07.007. Epub 2022 Oct 6.
While paediatric critical illness mortality rates in Australia are declining, the growing cohort of paediatric intensive care unit (PICU) survivors means an increasing number of children facing substantial health challenges after their discharge from intensive care. General practitioners (GPs) play a key role in provision of comprehensive health care to children and families and are ideally positioned to provide developmental surveillance and support the care of both the child and family following critical illness.
An anonymous, cross-sectional survey of 60 GPs, reached via private invitation (19% response) or via social media weblink, was conducted where the GPs were asked about their current confidence and knowledge in managing children post PICU. This included awareness of short- and long-term problems, of paediatric intensive care syndrome in paediatrics (PICS-p), and of educational materials. Lastly, a parent-completed screening questionnaire and shared-care pathway were proposed to GPs for their feedback on perceived benefit and willingness to participate. Data were analysed using frequency distributions and chi-square statistics.
Ninety-three percent of GPs had some level of confidence in caring for a child post PICU admission and low confidence in their knowledge of potential short- and long-term complications. Eighty percent of GPs had not heard of PICS-p, and 93% were unaware of educational materials available on this topic. Ninety-five percent of GPs perceived that the proposed patient-screening tool and shared-care pathways would be beneficial, and 70% predicted that they would definitely use educational materials if accessible through GP central repositories.
To reduce ongoing health problems for children recovering from critical illness, the family GP plays a pivotal role in providing community-level developmental care, particularly in Australia. Increasing GP confidence and knowledge through education is essential, and using a parent-completed screening questionnaire and shared-care pathway to improve care may be beneficial. GPs must also be involved in the implementation stages of future shared-care models.
尽管澳大利亚儿科危重病死亡率正在下降，但儿科重症监护病房（PICU）幸存者的人数不断增加，这意味着越来越多的儿童在离开重症监护室后面临着重大的健康挑战。全科医生（GP）在为儿童和家庭提供全面医疗保健方面发挥着关键作用，他们是最适合进行发育监测并在儿童患重病后为其提供支持和照顾其家庭的人。
通过私人邀请（19%的回复率）或通过社交媒体链接向 60 名全科医生进行了匿名、横断面调查，调查询问了他们目前在管理 PICU 后儿童方面的信心和知识水平。这包括对短期和长期问题、儿科重症监护综合征（PICS-p）以及教育材料的认识。最后，向全科医生提出了家长完成的筛查问卷和共同护理途径，以征求他们对受益和参与意愿的反馈。使用频率分布和卡方检验对数据进行分析。
93%的全科医生对照顾 PICU 后入院的儿童有一定程度的信心，但对潜在短期和长期并发症的知识缺乏信心。80%的全科医生没有听说过 PICS-p，93%的人不知道关于这个主题的教育材料。95%的全科医生认为拟议的患者筛查工具和共同护理途径将是有益的，如果可以通过全科医生中央存储库获得，70%的人预测他们肯定会使用教育材料。
为了减少儿童从危重病中康复后的持续健康问题，家庭全科医生在提供社区层面的发育护理方面发挥着关键作用，特别是在澳大利亚。通过教育提高全科医生的信心和知识至关重要，使用家长完成的筛查问卷和共同护理途径来改善护理可能是有益的。全科医生还必须参与未来共同护理模式的实施阶段。
