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一项关于照顾者前往急诊科时需求与经历的全国性调查。

A National Survey of Caregiver Needs and Experiences When Attending the Emergency Department.

作者信息

Ali Samina, Rahimi Asa, Rajagopal Manasi, Ma Keon, Yaskina Maryna, Clerc Paul, Stang Antonia, Beer Darcy, Poonai Naveen, Kam April, Principi Tania, Gardner Katie, Wright Bruce, Plint Amy, Gouin Serge, Schreiner Kurt, Scott Shannon D

机构信息

Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada.

Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada.

出版信息

Pediatr Emerg Care. 2025 Apr 1;41(4):297-304. doi: 10.1097/PEC.0000000000003327. Epub 2025 Jan 9.

Abstract

OBJECTIVES

Despite being a frequent entry point of care, it remains unknown if families' needs are being met across pediatric emergency departments (PEDs). Study objectives were to describe caregivers' perceived overall PED experience and needs and to what extent these needs were met.

METHODS

This descriptive, cross-sectional survey with medical record review was conducted in 10 Canadian PEDs. Caregivers completed electronic surveys in the PED and within 7 days postvisit. The primary outcome was the degree to which caregivers' overall needs were met in the PED.

RESULTS

A total of 2005 caregivers participated; mean age was 37.8 (standard deviation 7.7) years and 74.3% (1462/1969) were mothers. Mean child age was 5.9 (standard deviation 5.1) years; 51.9% (1040/2003) were male. The median [interquartile range (IQR)] length of stay was 3.9 (2.6-6.1) hours. A total of 22.1% (322/1454) of caregivers reported that their overall needs were not adequately met (Likert scale 1-3/5). The top unmet needs during a PED visit were prompt medical care [20.3% (194/955)], access to practical items [16.8% (160/955)], and effective communication surrounding care [8.7% (83/955)]. Caregiver needs being met were associated with their child's needs being met [odds ratio (OR) 21.2 (13.1-34.2)], child's pain being well managed [OR 3.7 (2.4-5.6)], and satisfaction with overall length of stay [OR 2.6 (1.8-3.8)].

CONCLUSIONS

Almost one fourth of caregivers report their overall needs were not fully met. Improving the quality of PED experience through better communication (ie, wait time delays, medical updates) and earlier pain care initiation may improve family experiences while policymakers work nationally to address lengthy wait times.

摘要

目的

尽管儿科急诊科(PEDs)是常见的医疗服务接入点,但家庭需求是否得到满足仍不明确。本研究的目的是描述照顾者对儿科急诊科总体体验和需求的感知,以及这些需求在多大程度上得到了满足。

方法

这项描述性横断面调查并进行病历审查的研究在加拿大的10家儿科急诊科开展。照顾者在儿科急诊科就诊时及就诊后7天内完成电子调查问卷。主要结果是照顾者在儿科急诊科的总体需求得到满足的程度。

结果

共有2005名照顾者参与;平均年龄为37.8(标准差7.7)岁,74.3%(1462/1969)为母亲。儿童平均年龄为5.9(标准差5.1)岁;51.9%(1040/2003)为男性。住院时间中位数[四分位间距(IQR)]为3.9(2.6 - 6.1)小时。共有22.1%(322/1454)的照顾者报告他们的总体需求未得到充分满足(李克特量表1 - 3/5)。儿科急诊科就诊期间未得到满足的首要需求是及时的医疗护理[20.3%(194/955)]、获取实用物品[16.8%(160/955)]以及围绕护理的有效沟通[8.7%(83/955)]。照顾者需求得到满足与他们孩子的需求得到满足相关[比值比(OR)21.2(13.1 - 34.2)]、孩子的疼痛得到良好控制[OR 3.7(2.4 - 5.6)]以及对总体住院时间的满意度[OR 2.6(1.8 - 3.8)]。

结论

近四分之一的照顾者报告他们的总体需求未得到充分满足。通过更好的沟通(即等待时间延迟、医疗进展更新)以及更早开始疼痛护理来改善儿科急诊科的体验质量,可能会提升家庭体验,同时政策制定者在全国范围内努力解决长时间等待的问题。

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