Department of Urology, Stanford University School of Medicine, Stanford, California, USA.
Flushing Hospital Medical Center, Flushing, New York, USA.
BMJ Paediatr Open. 2024 Apr 2;8(1):e002372. doi: 10.1136/bmjpo-2023-002372.
Paediatric lower urinary tract symptoms (LUTS) are common experiences among school-aged children, with prevalence rates reaching as high as 20%. Paediatricians are often first-line stakeholders in providing treatment for these bothersome symptoms, yet there is no formal resource to support them with the treatment of LUTS. Evaluating paediatricians' experiences is an important step in informing health promotion efforts to improve health outcomes in children. This study aims to explore paediatricians' knowledge, beliefs, practice patterns, and perceived barriers and facilitators in providing LUTS care.
In this qualitative study, we conducted semistructured focus groups of paediatricians within California. Focus groups were conducted via Zoom, and participants were enrolled until thematic saturation was reached. Participants were asked about their current practices, knowledge and beliefs, barriers and facilitators to care, training and education, and responsibility for behaviour and action. Thematic analysis was performed using deductive and inductive approaches; themes were mapped through an iterative, team-based process.
15 paediatricians, aged 30-69 years, with 13 (86.7%) women, were interviewed. Most (11, 73.3%) practised in general outpatient settings. Interviewed paediatricians recognised paediatric LUTS as a common problem that can significantly impact children's well-being. In practice, paediatricians did not actively screen for LUTS beyond the potty-training milestone due to short visit duration and competing healthcare demands. Lack of guidelines, parental mistrust and inadequate clinical education were barriers identified by paediatricians.
Paediatricians expressed a willingness to help patients but indicated several limitations to providing adequate LUTS care. Future professional development work can emphasise guideline development, early screening strategies to support timely intervention and better education for clinicians.
儿科下尿路症状（LUTS）在学龄儿童中很常见，患病率高达 20%。儿科医生通常是治疗这些烦扰症状的一线利益相关者，但没有正式的资源来支持他们治疗 LUTS。评估儿科医生的经验对于告知促进健康的努力以改善儿童健康结果是很重要的一步。本研究旨在探讨儿科医生在提供 LUTS 护理方面的知识、信念、实践模式以及感知到的障碍和促进因素。
在这项定性研究中，我们在加利福尼亚州对儿科医生进行了半结构式焦点小组访谈。焦点小组通过 Zoom 进行，直到达到主题饱和为止招募参与者。参与者被问及他们目前的实践、知识和信念、护理的障碍和促进因素、培训和教育以及行为和行动的责任。使用演绎和归纳方法进行主题分析；通过迭代、基于团队的过程映射主题。
采访了 15 名年龄在 30-69 岁之间的儿科医生，其中 13 名（86.7%）为女性。大多数（11 名，73.3%）在普通门诊环境中执业。接受采访的儿科医生认为儿科 LUTS 是一个常见问题，可以严重影响儿童的幸福感。在实践中，由于就诊时间短和医疗保健需求竞争激烈，儿科医生不会主动筛查 LUTS，除了如厕训练里程碑之外。儿科医生认为缺乏指南、父母不信任和临床教育不足是障碍。
儿科医生表示愿意帮助患者，但表示在提供足够的 LUTS 护理方面存在一些限制。未来的专业发展工作可以强调指南的制定、支持及时干预的早期筛查策略以及为临床医生提供更好的教育。
