Keating D, Syrmis M, Hamilton L, McMahon S
Royal Children's Hospital and District Health Service, Herston, Queensland, Australia.
J Paediatr Child Health. 1998 Oct;34(5):451-5. doi: 10.1046/j.1440-1754.1998.00273.x.
This study aimed to examine paediatricians' training in and understanding of communication development and disabilities and their attitudes to speech pathology waiting lists and management practices. The relationship between these factors and referral rates was also investigated.
A total of 229 paediatricians registered with the Australian College of Paediatrics participated in the study in November 1996. They answered 15 multiple-choice questions designed to collect demographic information and data pertaining to their training and understanding of communication development and disabilities. The survey also obtained data on referral rates to public and private speech pathology services and on paediatricians' perceptions of speech pathology waiting lists and possible management strategies.
Referral rate to public and private speech pathology services was found to be associated with the quality of paediatricians' training in and knowledge of communication development and disabilities. Paediatricians who had regular contact with speech pathologists were also more likely to make more referrals. Waiting lists had a negative influence on referral rate. Treatment rather than assessment waiting lists were preferred. Paediatricians believed the best solution to speech pathology waiting lists was an increase in staffing levels particularly in community health centres. Respondents reported that 1-4 months was an acceptable time to wait for speech pathology care and indicated the order of importance of factors for prioritising children.
The results have important implications for developing best practice models for improving referral processes and access to speech pathology services for children with communication disabilities.
本研究旨在调查儿科医生在沟通发展与残疾方面的培训及理解情况，以及他们对言语病理学等候名单和管理实践的态度。同时还研究了这些因素与转诊率之间的关系。
1996年11月，共有229名在澳大利亚儿科学会注册的儿科医生参与了该研究。他们回答了15道多项选择题，这些题目旨在收集人口统计学信息以及与他们在沟通发展与残疾方面的培训和理解相关的数据。该调查还获取了有关向公立和私立言语病理学服务机构转诊率的数据，以及儿科医生对言语病理学等候名单和可能的管理策略的看法。
发现向公立和私立言语病理学服务机构的转诊率与儿科医生在沟通发展与残疾方面的培训质量和知识水平相关。与言语病理学家有定期联系的儿科医生也更有可能进行更多转诊。等候名单对转诊率有负面影响。相比评估等候名单，治疗等候名单更受青睐。儿科医生认为解决言语病理学等候名单的最佳办法是增加人员配备，尤其是在社区卫生中心。受访者表示，等待言语病理学护理1 - 4个月是可以接受的时间，并指出了确定儿童优先顺序的因素的重要性顺序。
这些结果对于制定最佳实践模式以改善转诊流程和为有沟通障碍的儿童提供言语病理学服务具有重要意义。
