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适应性运动接触对小儿骨科医生治疗残疾患者的舒适度有影响。

Adaptive Sports Exposure Impacts Pediatric Orthopaedic Surgeon Comfort in Treating Patients With Disabilities.

作者信息

Wahle Charlotte F, Galoustian Nora A, Newman-Hung Nicole J, Rueda Alexander, Im Christina, Edogun Eghosa, Poplawski Charlotte, Hame Sharon L, Thompson Rachel M

机构信息

David Geffen School of Medicine, University of California, Los Angeles, CA, USA.

Department of Orthopaedic Surgery, University of California, Los Angeles, CA, USA.

出版信息

J Pediatr Soc North Am. 2025 May 26;12:100209. doi: 10.1016/j.jposna.2025.100209. eCollection 2025 Aug.

Abstract

BACKGROUND

Pediatric patients with physical disabilities often have difficulty accessing providers who are comfortable treating this unique patient population. The purpose of the study is to identify factors associated with increased pediatric orthopaedic surgeon familiarity in treating patients with disabilities and to assess whether involvement with adaptive sports (AS) improves their comfort level in treating these patients.

METHODS

An anonymous 36-question survey was administered from May to June 2024 to members of the Pediatric Orthopaedic Society of North America (POSNA). Demographic information and clinical practice details were collected. Survey questions assessed the comfort level of pediatric orthopaedic surgeons with treating and counseling patients with various types of disabilities, as well as their familiarity with AS. Data analysis was performed using chi-squared analysis, fisher exact test, and the Mann-Whitney U.

RESULTS

A total of 190 responses were recorded (13% of POSNA membership). Participants' ages ranged from 32 to 90; 93% of respondents completed fellowship training in pediatric orthopaedic surgery. Surgeon experience ranged from <5 to >20 years in practice. Surgeons with more experience had significantly higher comfort levels in treating patients with physical disabilities and counseling them regarding sports participation ( < .01, < .001, respectively). Surgeons who treat a higher proportion of patients with physical disabilities were also significantly more likely to have attended an AS event ( = .02). Furthermore, there was a statistically significant association between AS event attendance and comfort counseling patients with physical disabilities on sports risks ( < .001).

CONCLUSIONS

Pediatric orthopaedic surgeons with more practice experience and with greater exposure to patients with disabilities are more comfortable in treating and counseling these patients with disabilities. However, the data suggests that attending an AS event may improve pediatric orthopaedic surgeons' comfort and confidence in treating patients with disabilities regardless of practice experience. While AS have well-documented benefits for participants-including participation, community, and health benefits-these events may provide an excellent opportunity for exposing pediatric orthopaedic surgeons to patients with disabilities early in their career, with significant impact on their ability to treat patients with disabilities.

KEY CONCEPTS

(1)Pediatric orthopaedic surgeons with more years in practice report significantly greater comfort treating and counseling patients with disabilities.(2)Surgeons who have attended adaptive sports (AS) events demonstrate significantly higher comfort levels in caring for patients with disabilities, regardless of years in practice.(3)Many physicians lack formal training and experience caring for individuals with disabilities, highlighting the need for improved disability education in medical training.(4)Incorporating AS exposure into early medical education may help address healthcare disparities and build a more inclusive physician workforce.

LEVEL OF EVIDENCE

Level II Prospective Survey.

摘要

背景

身体残疾的儿科患者在寻求能自如治疗这一特殊患者群体的医疗服务提供者时常常面临困难。本研究的目的是确定与儿科骨科医生对残疾患者治疗熟悉度增加相关的因素,并评估参与适应性运动(AS)是否能提高他们治疗这些患者时的舒适度。

方法

2024年5月至6月,对北美儿科骨科学会(POSNA)的成员进行了一项包含36个问题的匿名调查。收集了人口统计学信息和临床实践细节。调查问题评估了儿科骨科医生治疗和咨询各类残疾患者的舒适度,以及他们对适应性运动的熟悉程度。使用卡方分析、费舍尔精确检验和曼 - 惠特尼U检验进行数据分析。

结果

共记录了190份回复(占POSNA成员的13%)。参与者年龄在32岁至90岁之间;93%的受访者完成了儿科骨科手术的专科培训。外科医生的从业经验从不到5年到超过20年不等。经验更丰富的外科医生在治疗身体残疾患者并就运动参与为他们提供咨询方面,舒适度显著更高(分别为P <.01,P <.001)。治疗身体残疾患者比例更高的外科医生也显著更有可能参加过适应性运动活动(P = .02)。此外,参加适应性运动活动与在为身体残疾患者提供关于运动风险的咨询时的舒适度之间存在统计学上的显著关联(P <.001)。

结论

有更多实践经验且更多接触残疾患者的儿科骨科医生在治疗和咨询这些残疾患者时更得心应手。然而,数据表明,无论实践经验如何,参加适应性运动活动可能会提高儿科骨科医生治疗残疾患者的舒适度和信心。虽然适应性运动对参与者有诸多已被充分记录的益处,包括参与、社交和健康方面的益处,但这些活动可能为儿科骨科医生在其职业生涯早期接触残疾患者提供绝佳机会,对他们治疗残疾患者的能力产生重大影响。

关键概念

(1)从业年限更长的儿科骨科医生在治疗和咨询残疾患者时报告的舒适度显著更高。(2)参加过适应性运动活动的外科医生在照顾残疾患者时表现出显著更高的舒适度,无论从业年限如何。(3)许多医生缺乏照顾残疾人的正规培训和经验,凸显了在医学培训中加强残疾教育的必要性。(4)将接触适应性运动纳入早期医学教育可能有助于解决医疗保健差距并建立更具包容性的医生队伍。

证据水平

二级前瞻性调查。

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