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儿童保健护士对发育性髋关节发育不良的筛查准确性

Screening Accuracy for Developmental Dysplasia of the Hip by Child Health Nurses.

作者信息

Smart Larissa, Cundy William, Williams Nicole, Arnold Abigail, Childs Jessie, Pelentsov Lemuel, Esterman Adrian

机构信息

School of Nursing, University of Tasmania, Locked Bag 3513, Burnie, TAS 7320, Australia.

Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia.

出版信息

Children (Basel). 2024 Jul 29;11(8):915. doi: 10.3390/children11080915.

Abstract

BACKGROUND

Developmental Dysplasia of the Hip (DDH) describes a spectrum of abnormalities that impact the normal function of the joint. These abnormalities are detectable during infancy using physical assessment, universal ultrasound, or a combination of both. In Australia, child health nurses predominantly screen for this disease using physical assessment. The aim of this study was to determine if child health nurses can accurately screen for DDH using physical assessment.

METHODS

This Australian study estimated the accuracy and utility of child health nurses using physical assessment to screen for DDH by comparing it to a handheld ultrasound device.

RESULTS

This study (N = 44) concluded that using a point prevalence study design, child health nurses in Australia are unable to accurately assess for DDH in infants using physical assessment; overall, clinicians had 50.5% sensitivity (95% CI, 15.7 to 84.3), a specificity of 75.0% (95% CI, 57.8 to 87.9), and 71.3% accuracy (95% CI, 55.6 to 83.9).

CONCLUSION

This study suggests that child health nurses cannot screen for DDH using physical assessment. Understanding education, experience and what assessments are used suggests that the utility of nurses performing DDH screening requires further investigation.

摘要

背景

发育性髋关节发育不良(DDH)描述了一系列影响关节正常功能的异常情况。这些异常情况在婴儿期可通过体格检查、常规超声检查或两者结合来检测。在澳大利亚,儿童健康护士主要通过体格检查来筛查这种疾病。本研究的目的是确定儿童健康护士能否通过体格检查准确筛查DDH。

方法

这项澳大利亚的研究通过将儿童健康护士的体格检查与手持式超声设备进行比较,评估了其筛查DDH的准确性和实用性。

结果

本研究(N = 44)得出结论,采用现患率研究设计,澳大利亚的儿童健康护士无法通过体格检查准确评估婴儿的DDH;总体而言,临床医生的敏感度为50.5%(95%可信区间,15.7至84.3),特异度为75.0%(95%可信区间,57.8至87.9),准确率为71.3%(95%可信区间,55.6至83.9)。

结论

本研究表明,儿童健康护士无法通过体格检查筛查DDH。对教育、经验以及所采用的评估方法的了解表明,护士进行DDH筛查的实用性需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7947/11353034/36e16c2ef016/children-11-00915-g001.jpg

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