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医学伴随者在体格检查中的应用:青少年及其照护者的认知。

The Use of Medical Chaperones During Physical Examinations: The Perceptions of Adolescents and Their Caregivers.

机构信息

From the Section of Pediatric Emergency Medicine, Department of Pediatrics, Yale School of Medicine, New Haven, CT.

University of Connecticut School of Medicine, Farmington, CT.

出版信息

Pediatr Emerg Care. 2024 May 1;40(5):e46-e51. doi: 10.1097/PEC.0000000000003087. Epub 2023 Nov 30.

Abstract

PURPOSE

A medical chaperone serves as a witness for a patient and health care practitioner during a medical examination. We sought to better understand the preferences of parents and children toward the use of chaperones during pediatric physical examinations.

METHODS

This cross-sectional study surveyed patients aged 8 to 18 years and their parents presenting primarily to the emergency department as well as primary care ambulatory clinic and inpatient units. Participants were asked which individuals (patient alone, parent, or medical chaperone) should be present for each aspect of the child's physical examination.

RESULTS

The survey was completed by 121 patients (mean age 14 years, 58.5% girls) and 122 parents (mean age 42 years, 82.8% women) in a variety of clinical settings (17 in inpatient, 17 in outpatient clinic, and 87 emergency department admissions). Significant differences existed between male and female patients regarding preferred presence for every body part being examined ( P ≤ 0.002). Female patients preferred to have a same-sex parent in the room, particularly for examination of the breasts, genitalia, or rectum and when the examination was performed by a male provider. Male patients preferred to be alone or with either parent for any body part being examined, regardless of provider sex.

CONCLUSIONS

Adolescents have significant differences in who they prefer to be in the room for the physical examination based on patient and provider sex in settings where they are unfamiliar with the health care examiner. Few patients and parents preferred a medical chaperone; most preferred a parent to be in the room. Patient and parent considerations should be prioritized when creating policies for the use of medical chaperones.

摘要

目的

在医学检查中,医疗陪护者作为患者和医疗保健从业者的证人。我们试图更好地了解父母和孩子在儿科体检中对使用陪护者的偏好。

方法

这项横断面研究调查了年龄在 8 至 18 岁的患者及其父母,他们主要在急诊部门以及初级保健门诊和住院病房就诊。参与者被问及在儿童体格检查的各个方面,哪些人(患者单独、父母或医疗陪护者)应该在场。

结果

在各种临床环境中(17 例住院患者、17 例门诊患者和 87 例急诊入院患者),完成了 121 名患者(平均年龄 14 岁,58.5%为女性)和 122 名父母(平均年龄 42 岁,82.8%为女性)的调查。在被检查的每个身体部位,男性和女性患者对首选存在的偏好存在显著差异(P ≤ 0.002)。女患者希望有同性父母在场,特别是在检查乳房、生殖器或直肠以及检查医生为男性时。男患者无论检查医生的性别如何,都希望独自或与父母中的任何一方一起进行任何身体部位的检查。

结论

在患者和检查医生性别不熟悉的环境中,青少年在体检时希望谁在房间里有明显的差异。很少有患者和家长喜欢有医疗陪护者;大多数人希望父母在场。在制定使用医疗陪护者的政策时,应优先考虑患者和家长的考虑因素。

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