Green Cori, Leyenaar JoAnna K, Leslie Laurel K
Weill Cornell Medicine (C Green), New York, NY.
Department of Pediatrics and The Dartmouth Institute for Health Policy & Clinical Practice (JK Leyenaar), Dartmouth-Hitchcock Medical Center, Hanover, NH.
Acad Pediatr. 2023 Nov-Dec;23(8):1628-1635. doi: 10.1016/j.acap.2023.07.013. Epub 2023 Jul 29.
BACKGROUND/OBJECTIVES: Children with chronic medical conditions (CCMC) have high rates of mental health (MH) conditions. This study examines associations between MH educational resources during fellowship and 3 dependent variables: fellows' interest, perceived responsibility, and self-reported competence in assessing MH concerns of CCMC.
Subspecialty fellows taking the American Board of Pediatrics in-training examinations in February 2020 were invited to participate in a survey inquiring about MH educational resources. Logistic regression examined associations between MH educational resources and the 3 dependent variables, adjusting for demographics and program-level characteristics.
Of the 97.7% (4216) fellows who responded, 3870 were included in analyses. About 37.5% reported formal MH teaching sessions; 36.7% reported on-site MH professionals engaged in teaching; 41.6% reported co-assessing patients with MH specialists; and 28.3% reported performance evaluation of their MH skills. All 4 resources were significantly and positively associated with self-reported competence in adjusted analyses, with odds ratios (OR) ranging from 1.28 (95% confidence interval (95% CI): 1.03-1.58) for formal teaching sessions to 2.14 (95% CI: 1.73-2.65) for performance evaluation. Resources were positively associated with the dependent variables in a "dose-response" pattern. Respondents who reported having all 4 educational resources compared to zero resources had an OR of 2.20 (95% CI: 1.74-2.78) for high MH interest, 3.18 (95% CI: 2.45-4.12) for high perceived responsibility, and 4.38 (95% CI: 3.43-5.60) for high self-reported competence CONCLUSIONS: Access to mental health educational resources was associated with higher interest, perceived responsibility, and self-reported competence; investing in these resources may improve fellows' skills in addressing the emotional needs of CCMC.
背景/目的：患有慢性疾病的儿童（CCMC）心理健康问题发生率较高。本研究探讨了专科培训期间心理健康教育资源与三个因变量之间的关联：专科培训学员的兴趣、感知到的责任以及自我报告的评估CCMC心理健康问题的能力。
邀请参加2020年2月美国儿科学会在职考试的亚专科培训学员参与一项关于心理健康教育资源的调查。逻辑回归分析了心理健康教育资源与这三个因变量之间的关联，并对人口统计学和项目层面特征进行了调整。
在97.7%（4216名）回复的学员中，3870名被纳入分析。约37.5%的学员报告有正式的心理健康教学课程；36.7%的学员报告有现场心理健康专业人员参与教学；41.6%的学员报告与心理健康专家共同评估患者；28.3%的学员报告对其心理健康技能进行了绩效评估。在调整分析中，所有这四种资源均与自我报告的能力显著正相关，优势比（OR）范围从正式教学课程的1.28（95%置信区间（95%CI）：1.03 - 1.58）到绩效评估的2.14（95%CI：1.73 - 2.65）。资源与因变量呈“剂量反应”模式正相关。报告拥有所有四种教育资源的受访者与没有资源的受访者相比，心理健康高兴趣度的OR为2.20（95%CI：1.74 - 2.78），高感知责任的OR为3.18（95%CI：2.45 - 4.12），高自我报告能力的OR为4.38（95%CI：3.43 - 5.6）。结论：获得心理健康教育资源与更高的兴趣、感知到的责任以及自我报告的能力相关；投入这些资源可能会提高专科培训学员满足CCMC情感需求的技能。
