Montoro-Pérez Néstor, Richart-Martínez Miguel, Montejano-Lozoya Raimunda
Department of Nursing, Faculty of Health Science, University of Alicante, Spain; GREIACC Research Group, La Fe Health Research Institute, Valencia, Spain.
Department of Nursing, Faculty of Health Science, University of Alicante, Spain.
J Pediatr Nurs. 2023 Mar-Apr;69:38-46. doi: 10.1016/j.pedn.2022.12.027. Epub 2023 Jan 17.
Pediatric emergency department (PED) admissions have risen in recent years, a trend not justified by the severity of the pathologies presented. The aim of this study is to analyse factors related to the inappropriate use of pediatric emergency departments.
This is a systematic review reported in accordance with the PRISMA statement. We searched the PubMed, Web of Science and Science Direct databases, using keywords extracted from MeSH, and conducted a reverse search using Google Scholar and Open Grey, for the period January 2017 to August 2022. The quality of the papers was assessed using STROBE, CASPe, AMSTAR-2, GRADE, Levels Of Evidence and Grades Of Recommendation.
A total of 20 studies were selected. Factors related to inappropriate use included the younger age of children, black caregivers, lower socioeconomic status, lower parental educational attainment, perceived urgent demand for care, parental emotions in response to their children's health problems, psychological distress, the ineffective exercise of the parental role, the advantages of the PED and the nature of health insurance.
The results illustrate the heterogeneous nature of the phenomenon under investigation. Gaining an understanding of the factors related to the inappropriate demand of PEDs, from the perspective of health professionals, can help in developing interventions to reduce unnecessary consultations and relieve pressure on these healthcare services.
近年来，儿科急诊科（PED）的入院人数有所上升，而所呈现病症的严重程度并不能解释这一趋势。本研究的目的是分析与儿科急诊科使用不当相关的因素。
这是一项按照PRISMA声明报告的系统评价。我们使用从医学主题词表（MeSH）中提取的关键词，检索了PubMed、科学引文索引（Web of Science）和科学Direct数据库，并利用谷歌学术搜索（Google Scholar）和Open Grey进行反向检索，检索时间为2017年1月至2022年8月。使用加强流行病学观察性研究报告规范（STROBE）、批判性评估技能计划（CASPe）、测量工具改编的评估工具-2（AMSTAR-2）、推荐分级的评估、证据水平和推荐等级对论文质量进行评估。
共筛选出20项研究。与使用不当相关的因素包括儿童年龄较小、黑人护理人员、社会经济地位较低、父母教育程度较低、对护理的迫切需求、父母对孩子健康问题的情绪反应、心理困扰、父母角色的无效行使、儿科急诊科的优势以及医疗保险的性质。
结果说明了所调查现象的异质性。从卫生专业人员的角度了解与儿科急诊科不当需求相关的因素，有助于制定干预措施，以减少不必要的会诊，并减轻这些医疗服务的压力。
