Asp Rebecca A, Paquette Erin T
Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Division of Critical Care Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
Pediatr Crit Care Med. 2024 Oct 1;25(10):953-958. doi: 10.1097/PCC.0000000000003580. Epub 2024 Jul 17.
Health inequities are widespread and associated with avoidable poor health outcomes. In the PICU, we are increasingly understanding how health inequities relate to critical illness and health outcomes. Experts recommend assessing for health inequities by screening for social determinants of health (SDOH) and adverse childhood experiences (ACEs); however, guidance on screening is limited and screening has not been universally implemented. Our study aimed to understand parent perspectives on screening for SDOH/ACEs in the PICU, with the primary objective of determining whether screening would be acceptable in this setting.
We conducted a qualitative study using semistructured interviews with a convenience sample of eleven PICU parents between November 2021 and January 2022.
Urban, quaternary free-standing children's hospital.
Parents of children with a PICU hospitalization between November 2020 and October 2021.
None.
Domains of interest included experience with and attitudes toward SDOH/ACEs screening, perspectives on addressing needs with/without resources and their relationship to health, and recommendations for screening. Interviews were transcribed verbatim and coded with an inductive approach using thematic analysis and constant comparative methods. Ann & Robert H. Lurie Children's Institutional Review Board approved this study (2021- 4781, Approved September 13, 2021). Ten participants found SDOH/ACEs screening to be acceptable and valuable in the PICU, even for topics without a readily available resource. Participants did not have broad experience with ACEs screening, though all believed this provided the medical team with valuable context regarding their child. Ten participants recommended screening occur after their child has been stabilized and that they are notified that screening is universal.
Participants found screening for SDOH/ACES to be acceptable and valuable in the PICU. Families have important insight that should be leveraged to improve the support of unmet needs through the development of strengths-based, parent-informed screening initiatives.
健康不平等现象普遍存在，并与可避免的不良健康结果相关。在儿科重症监护病房（PICU），我们越来越了解健康不平等与危重病和健康结果之间的关系。专家建议通过筛查健康的社会决定因素（SDOH）和儿童期不良经历（ACEs）来评估健康不平等；然而，关于筛查的指导有限，且筛查尚未得到普遍实施。我们的研究旨在了解家长对PICU中SDOH/ACEs筛查的看法，主要目的是确定在这种情况下筛查是否可以接受。
我们在2021年11月至2022年1月期间，对11名PICU患儿家长的便利样本进行了半结构式访谈，开展了一项定性研究。
城市中的独立四级儿童医院。
2020年11月至2021年10月期间在PICU住院的患儿的家长。
无。
感兴趣的领域包括对SDOH/ACEs筛查的经历和态度、对有无资源满足需求的看法及其与健康的关系，以及对筛查的建议。访谈内容逐字转录，并采用主题分析和持续比较法进行归纳编码。安&罗伯特·H·卢里儿童医院机构审查委员会批准了本研究（2021-4781，2021年9月13日批准）。10名参与者认为在PICU中进行SDOH/ACEs筛查是可以接受且有价值的，即使是对于没有现成资源的主题。参与者对ACEs筛查的经验并不广泛，不过他们都认为这为医疗团队提供了有关其孩子的有价值背景信息。10名参与者建议在孩子病情稳定后进行筛查，并通知他们筛查是普遍进行的。
参与者认为在PICU中进行SDOH/ACES筛查是可以接受且有价值的。家庭有重要的见解，应通过制定基于优势、家长参与的筛查计划来利用这些见解，以改善对未满足需求的支持。
