Bruijnzeels M A, Foets M, van der Wouden J C, van den Heuvel W J, Prins A
Department of General Practice, Erasmus University Rotterdam, The Netherlands.
Br J Gen Pract. 1998 Jan;48(426):880-4.
Fewer than 20% of all illnesses that occur in the home require the attention of a general practitioner (GP). Whether specific illnesses in children are more likely to need the attention of a GP is poorly understood, as is the influence of various other factors. Health diaries are the most suitable method of collecting comprehensive information about children's health problems at home and in general practice simultaneously.
To investigate the occurrence of, and consultation rates for, specific symptoms in childhood in relation to age, sex, birth order, and place of residence of the child, and season of the year.
The parents of 1805 children kept a health diary over three weeks and recorded symptoms and consultation behaviour. The symptoms were later combined into illness episodes.
Over three weeks, colds/flu (157/1000 children) and respiratory symptoms (114/1000 children) occurred most frequently. More young children (0-4 years) suffered from illness generally. Eleven per cent of all illness episodes required the attention of a GP. Consultation rates differed greatly according to symptoms. A GP was consulted most often for ear (36%) and skin (28%) problems, and least often for headaches (2%) and tiredness (1%). Regardless of symptoms, young children (0-4 years) were taken to a GP twice as often as older children (10-14 years).
This study emphasizes the enormous amount of illness that occurs in children and the fact that more than 80% of all illnesses are dealt with by parents without reference to the professional health care system.
家中出现的所有疾病中,只有不到20% 需要全科医生(GP)的关注。儿童的特定疾病是否更有可能需要全科医生的关注,以及各种其他因素的影响,目前还知之甚少。健康日记是同时收集儿童在家中和全科医疗中健康问题综合信息的最合适方法。
调查儿童特定症状的发生率和就诊率与年龄、性别、出生顺序、孩子的居住地点以及一年中的季节之间的关系。
1805名儿童的父母记录了三周的健康日记,记录症状和就诊行为。这些症状后来被合并为疾病发作情况。
在三周内,感冒/流感(每1000名儿童中有157例)和呼吸道症状(每1000名儿童中有114例)最为常见。总体而言,更多幼儿(0 - 4岁)患病。所有疾病发作中有11% 需要全科医生的关注。就诊率因症状差异很大。因耳部问题(36%)和皮肤问题(28%)咨询全科医生的频率最高,因头痛(2%)和疲劳(1%)咨询的频率最低。无论症状如何,幼儿(0 - 4岁)看全科医生的频率是大龄儿童(10 - 14岁)的两倍。
本研究强调了儿童患病的数量之多,以及超过80% 的疾病是由父母自行处理而未求助于专业医疗保健系统这一事实。