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初级保健中的青少年行为风险筛查:医生的观点。

Adolescent behavioural risk screening in primary care: physician's point of view.

作者信息

Eisner-Fellay Taslina, Suris Joan-Carles, Barrense-Dias Yara

机构信息

Research Group on Adolescent Health, Department of Epidemiology and Health Services, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.

出版信息

Fam Pract. 2024 Apr 15;41(2):123-130. doi: 10.1093/fampra/cmad106.

Abstract

BACKGROUND

Despite regular consultation between adolescents/young adults (AYA) and their physicians, they are not regularly screened for psychosocial risk behaviours. This study examines physicians' self-reported psychosocial risk behaviour screening in AYA. It aims to highlight which elements hinder or improve screening abilities.

METHODOLOGY

The design was a cross-sectional quantitative survey. Data were obtained through a self-reported questionnaire sent out to primary care physicians (PCP) in Switzerland in 2018. The target population consisted of 1,824 PCP (29% response rate). Participants were asked whether they screened youths from 3 age groups [10-14 y/o, 15-20 y/o, and 21-25y/o] for the HEEADSSS items during child well visits and routine checkups. Barriers to screening included primary consultation motive prioritization, insufficient time, patient compliance, reimbursement, lack of skills related to adolescent health, lack of referral options. Data were analysed first through a bivariate analysis using Chi-square tests then through a multinomial logistic regression.

RESULTS

The majority of physicians partook in preventive screening for 3-5 psychosocial risk elements. They reported the primary consultation motive as well as a lack of available time as having a high impact on their screening habits. Physician's experience and having discussed confidentiality were related to an increase in the number of topics addressed. Confidentiality remained a significant variable throughout all analyses.

CONCLUSION

Barriers such as lack of consultation time and prioritization issues were found by physicians to be critical but did not hinder screening habits. The main element impacting screening habits was assuring confidentiality and the second is self-efficacy.

摘要

背景

尽管青少年/青年(AYA)与他们的医生定期进行咨询,但他们并未定期接受心理社会风险行为筛查。本研究调查了医生自我报告的对AYA心理社会风险行为的筛查情况。旨在突出哪些因素会阻碍或改善筛查能力。

方法

采用横断面定量调查设计。数据通过2018年向瑞士初级保健医生(PCP)发放的一份自我报告问卷获得。目标人群包括1824名初级保健医生(回复率为29%)。参与者被问及在儿童健康检查和常规体检期间,他们是否对三个年龄组[10 - 14岁、15 - 20岁和21 - 25岁]的青少年进行了HEEADSSS项目筛查。筛查的障碍包括初级咨询动机的优先级、时间不足、患者依从性、报销、缺乏与青少年健康相关的技能、缺乏转诊选择。数据首先通过使用卡方检验的双变量分析进行分析,然后通过多项逻辑回归进行分析。

结果

大多数医生对3 - 5种心理社会风险因素进行了预防性筛查。他们报告说,初级咨询动机以及时间不足对他们的筛查习惯有很大影响。医生的经验和讨论过保密性与所涉及话题数量的增加有关。在所有分析中,保密性仍然是一个显著变量。

结论

医生发现诸如缺乏咨询时间和优先级问题等障碍很关键,但并未阻碍筛查习惯。影响筛查习惯的主要因素是确保保密性,其次是自我效能感。

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