Dassi Natália, Cappellano Andrea Maria, de Souza Fabiola Isabel Suano, Puccini Rosana Fiorini, da Silva Nasjla Saba, Strufaldi Maria Wany Louzada
Department of Pediatric Oncology, IOP-GRAACC-Federal University of Sao Paulo, Sao Paulo, Brazil.
Department of Pediatrics', Federal University of Sao Paulo, Sao Paulo, Brazil.
Pediatr Blood Cancer. 2025 Apr;72(4):e31574. doi: 10.1002/pbc.31574. Epub 2025 Feb 3.
Delays in diagnosing pediatric brain tumors are often associated with limited awareness of the signs and symptoms by parents and healthcare professionals, as well as the absence of routine childcare follow-ups and delays in healthcare system referrals.
To explore opportunities for reducing diagnostic delays, the study assessed the knowledge of pediatric brain tumor signs and symptoms, routine follow-up care for children, use of the Child Health Book (CHB), and referral intervals of a suspected case to a specialized center.
This cross-sectional study collected data through interviews and virtual questionnaires.
Between August and November 2023, 200 parents (pediatric and oncology departments) and 147 healthcare professionals (primary and tertiary care) participated. Except for headaches and seizures, the rates of parental recognition of warning signs were below 70%. Physicians in tertiary care demonstrated greater recognition of these warning signs than those in primary care (p = 0.011). Recognition rates among nurses were below 75%. Primary and tertiary care professionals reported referral intervals >1 month in 10%-15% cases. Children routine follow-up care was reported in both levels. Over 75% of all participants reported that the CHB could be a useful tool for educating about childhood cancer.
Our study provides essential insights to improve the early diagnosis of pediatric brain tumors. The findings emphasize the need to strengthen pediatric care follow-ups and use of CHB by parents and healthcare professionals to raise awareness of warning signs and symptoms, along with a flowchart for timely and accurate referrals to specialized centers.
小儿脑肿瘤诊断延迟通常与家长和医护人员对体征和症状的认知有限、缺乏常规儿童保健随访以及医疗系统转诊延迟有关。
为探索减少诊断延迟的机会，该研究评估了小儿脑肿瘤体征和症状的知晓情况、儿童的常规随访护理、《儿童健康手册》（CHB）的使用情况以及疑似病例转诊至专科中心的间隔时间。
这项横断面研究通过访谈和虚拟问卷收集数据。
2023年8月至11月期间，200名家长（儿科和肿瘤科）和147名医护人员（初级和三级护理）参与了研究。除头痛和癫痫外，家长对警示体征的识别率低于70%。三级护理的医生对这些警示体征的识别率高于初级护理的医生（p = 0.011）。护士的识别率低于75%。初级和三级护理专业人员报告称，在10%-15%的病例中转诊间隔时间超过1个月。两个级别均报告了儿童的常规随访护理。超过75%的参与者表示，CHB可能是用于儿童癌症教育的有用工具。
我们的研究为改善小儿脑肿瘤的早期诊断提供了重要见解。研究结果强调，需要加强儿童保健随访，家长和医护人员需使用CHB来提高对警示体征和症状的认识，同时还需要一个及时准确转诊至专科中心的流程图。
