Berger P, Luskin M, Krishel S
Department of Emergency Medicine, UCSD Medical Center, San Diego, California 92103-8676, USA.
J Emerg Med. 1998 Sep-Oct;16(5):691-4. doi: 10.1016/s0736-4679(98)00079-1.
We conducted a prospective clinical trial to determine the effectiveness of an emergency department informational pamphlet in improving patients' compliance with recommendations that they receive Pap smears, mammograms, and a pneumococcal vaccination. Informational pamphlets were distributed to 1,000 consecutive patients who presented to a university-affiliated emergency department (ED). The pamphlet contained information stating the indications for obtaining routine Pap smears, mammograms, and a pneumococcal vaccination. Target individuals were women 18 years and older and men 65 years and older. Target patients were called approximately 2 months after their ED visits to obtain follow-up data. There were 464 target patients obtained from the 1,000 pamphlets distributed (409 female/55 male), and 68% (316) of the 464 were contacted by telephone for follow-up data. Significantly more women than men had read the pamphlet (62% vs. 8%). Of the women contacted (279), 31.9% (89) were not up to date (UTD) with Pap smears, and 11.2% (10) stated that they had scheduled an appointment for a Pap smear; 14.5% (11) of the women were not UTD with mammograms, and none had scheduled an appointment to receive care. Of the patients over age 65, 67% were not UTD with a pneumococcal vaccination, and no appointments were scheduled to obtain one. We conclude that a significant number of patients who present to this ED are in need of preventive health care. Emergency department informational pamphlets may have a role in improving Pap smear compliance. Women may be more likely then men to read informational pamphlets distributed in the ED.
我们进行了一项前瞻性临床试验，以确定急诊科信息手册在提高患者接受巴氏涂片检查、乳房X光检查和肺炎球菌疫苗接种建议的依从性方面的有效性。信息手册分发给了连续1000名到一所大学附属医院急诊科就诊的患者。该手册包含了获取常规巴氏涂片检查、乳房X光检查和肺炎球菌疫苗接种的指征信息。目标人群为18岁及以上的女性和65岁及以上的男性。在目标患者急诊科就诊约2个月后致电获取随访数据。从分发的1000份手册中获得了464名目标患者（409名女性/55名男性），其中464名中的68%（316名）通过电话联系以获取随访数据。阅读手册的女性明显多于男性（62%对8%）。在接受联系的女性（279名）中，31.9%（89名）未进行最新的巴氏涂片检查，11.2%（10名）表示已预约巴氏涂片检查；14.5%（11名）的女性未进行最新的乳房X光检查，且无人预约接受检查。在65岁以上的患者中，67%未进行最新的肺炎球菌疫苗接种，也无人预约接种。我们得出结论，到该急诊科就诊的大量患者需要预防性医疗保健。急诊科信息手册可能在提高巴氏涂片检查的依从性方面发挥作用。女性可能比男性更有可能阅读在急诊科分发的信息手册。
