Osman L M, Dunt D
Department of Behavioural Health Sciences, La Trobe University, Victoria, Australia.
Br J Gen Pract. 1995 Jun;45(395):310-2.
In the management of childhood illness only a small proportion of symptoms result in a medical consultation.
This pilot study set out to assess the influence of sociodemographic factors, social network, reason of choice of doctor and contact with allied health professionals on mothers' decisions to consult a general practitioner about their children's illnesses.
In one suburb of Melbourne, Australia all mothers with children aged 11 to 26 months were identified from the maternal and child health centre register. Mothers were invited for interview and if they attended were asked to keep a health diary for their child for four weeks. Logistic regression was used to test a multivariate model of factors predicting consultation with the general practitioner.
A total of 150 mothers were identified. Interviews were carried out with 81% of target mothers and diary data collected for 72% of target children. Over the four-week diary period, consultation rates with the general practitioner were significantly higher if symptoms were recorded on 15 days or more, or the general practitioner had been recommended by a friend or was the mother's own doctor before the child's birth. Contact with a maternal and child health nurse was also a significant predictor of medical contact. Contact with friends and relatives, whether or not the study child was the first child in the family, mother's education, husband's occupational status or contact with a chemist were not significantly related to medical consultation rates.
Choice of doctor (current doctor same as doctor before birth of child, or doctor recommended by a friend) resulted in significantly more consultations as did contact with a maternal and child health nurse. These factors would seem to require further study and inclusion in future models of consulting behaviour.
在儿童疾病管理中,只有一小部分症状会导致就医咨询。
这项试点研究旨在评估社会人口学因素、社交网络、选择医生的原因以及与专职医疗人员的接触对母亲就孩子疾病咨询全科医生决策的影响。
在澳大利亚墨尔本的一个郊区,从母婴健康中心登记册中识别出所有有11至26个月大孩子的母亲。邀请母亲参加访谈,若她们参加,则要求为孩子记录四周的健康日记。使用逻辑回归来测试预测与全科医生咨询的多因素模型。
共识别出150名母亲。对81%的目标母亲进行了访谈,并为72%的目标儿童收集了日记数据。在四周的日记记录期内,如果症状记录达15天或以上,或者全科医生是由朋友推荐的,或是孩子出生前母亲自己的医生,那么与全科医生的咨询率显著更高。与母婴健康护士的接触也是就医咨询的一个重要预测因素。与朋友和亲戚的接触、研究中的孩子是否是家庭中的第一个孩子、母亲的教育程度、丈夫的职业状况或与药剂师的接触与就医咨询率没有显著关系。
选择医生(孩子出生前的医生或朋友推荐的医生)以及与母婴健康护士的接触导致了显著更多的咨询。这些因素似乎需要进一步研究并纳入未来的咨询行为模型中。