Foye H, Chamberlin R, Charney E
Am J Dis Child. 1977 Jul;131(7):793-7.
The content and emphasis of well-child visits conducted by nine randomly selected pediatricians was compared with those of five experienced pediatric nurse practitioners. Twenty one nurse visits and 43 pediatrician visits with 1-year-old to 2-year-old children were monitored. The nurses discussed developmental and child behavior topics in significantly (P less than .05) greater depth, they asked more open-ended questions, made more specific recommendations, provided more maternal support, and the parents spoke a greater proportion of the time during the nurses' visits. Efficiency (number and depth of topics considered per unit time) of both groups was similar. Nurse visits were more time-consuming (mean, 25.5 vs 17.6 minutes for pediatricians). A subgroup of four pediatricians conducted visits much like those of the nurses, scoring as well in less time. The other five pediatricians conducted shorter visits, with little emphasis on child development and provided less time for the parent to talk. Overall, after five years in practice, these nurses were in no way less complete in child health supervision than a representative sample of pediatricians and were considerably more comprehensive in their approach than the average pediatrician.
研究人员将随机挑选的9名儿科医生进行的健康儿童检查的内容和重点，与5名经验丰富的儿科执业护士进行的检查进行了比较。对21次护士检查和43次针对1至2岁儿童的儿科医生检查进行了监测。护士们在讨论发育和儿童行为话题时，深度明显更深（P值小于0.05），她们提出了更多开放式问题，给出了更具体的建议，提供了更多的产妇支持，并且在护士检查期间家长讲话的时间占比更大。两组的效率（每单位时间考虑的话题数量和深度）相似。护士检查更耗时（平均而言，儿科医生检查为17.6分钟，护士检查为25.5分钟）。有4名儿科医生组成的一个亚组进行的检查与护士的检查非常相似，在更短的时间内得分也一样。其他5名儿科医生进行的检查时间较短，很少强调儿童发育，并且给家长谈话的时间较少。总体而言，在执业五年后，这些护士在儿童健康监督方面丝毫不比儿科医生的代表性样本差，而且在方法上比普通儿科医生更加全面。
