父母的不良童年经历和医疗保健在患有状细胞疾病的儿童中的使用
David K Wilson1,2, Shelley Crary1,2, Gabbey Hobbs2
1Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock.
JAMA network open
|July 10, 2025
概括
父母的不良童年经历 (ACE) 和护理人员的抵抗力降低与状细胞疾病 (SCD) 儿童的急诊室访问增加有关. 查护理人员的ACE和弹性可以改善创伤知情护理.
科学领域:
- 儿科健康 儿科健康
- 慢性疾病中的心理社会因素
- 创伤信息化的护理
背景情况:
- 儿童不良经历 (ACE) 与较差的医疗保健利用率有关.
- 非洲裔美国人社区中ACE更为普遍,因此需要研究它们对诸如状细胞病 (SCD) 等慢性疾病的影响.
- 了解家长ACE和儿科SCD护理之间的关系对于开发有效的创伤知情干预至关重要.
研究的目的:
- 调查父母ACE与SCD儿科患者的医疗保健使用之间的关联.
- 探索家长的性和邻里剥夺对这个协会的影响.
- 为扩大SCD儿童创伤信息化护理策略提供信息.
主要方法:
- 在阿肯色州儿童医院进行的一项横截面研究,涉及72名儿科SCD患者的护理人员.
- 用ACE-Q和简短的弹性量表来评估家长的ACE和弹性.
- 医疗保健的利用,包括急诊室 (ED) 访问和错过的诊所预约,使用混合回归模型进行分析,考虑邻里贫困 (区域贫困指数).
主要成果:
- 与低风险护理人员相比,高ACE风险的护理人员的急救访问和住院病例显著增加 (回归系数=7.35).
- 较低的家长弹性与ED访问和入院的增加有关 (回归系数=5.69).
- 邻居剥夺 (ADI) 与急救诊所的访问或入院没有显著联系.
结论:
- 父母较高的ACE分数和较低的弹性与状细胞疾病儿童急诊室使用率的增加有关.
- 这些发现强调了查护理人员ACE和弹性的重要性.
- 实施创伤知情护理策略,特别是对边缘化群体,可以帮助改善SCD儿童的健康结果.
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