在早产儿神经发育的家长和医疗分类
Lindsay L Richter1, Annie Janvier2,3,4,5, Rebecca Pearce6,7
1Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
Pediatrics
|January 9, 2025
概括
父母对早产婴儿神经发育障碍 (NDI) 的看法与医疗评估有很大的不同. 这凸显了潜在的错误沟通和需要在NDI讨论中纳入家长的观点.
科学领域:
- 儿科 儿科 儿科
- 神经发育障碍 神经发育障碍
- 父母对孩子的看法
背景情况:
- 神经发育障碍 (NDI) 显著影响早产婴儿的医疗保健决策.
- 目前的NDI定义缺乏家长的意见,可能会扭曲评估.
- 了解父母的观点对于准确的NDI分类至关重要.
研究的目的:
- 调查 NDI 在早产儿的父母和医疗分类之间的一致性.
- 根据父母与医疗标准确定NDI分类中的差异.
- 探索影响NDI分类分歧的因素.
主要方法:
- 一项多中心研究评估了1098名早产婴儿 (<29周) 在18-21个月的校正年龄.
- 父母对孩子的发育进行了分类 (正常,轻度/中度,严重障碍).
- 医学分类使用听力,视力,脑和贝利-III分数;使用科恩的卡帕分析的协议.
主要成果:
- 在家长和医疗NDI分类之间发现了较差的一致性 (κ=0.30).
- 父母普遍认为孩子的发育比医疗评估显示的不太受损.
- 显著的分歧来自认知,语言和运动得分,但不是脑;差异因父母的教育和种族而异.
结论:
- 家长对NDI的看法与医疗分类有所不同,可能造成误解.
- 临床医生可能会高估残疾的影响,可能会影响关键护理决策.
- 纳入父母的观点对于报告和讨论神经发育结果至关重要.
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