家庭报告的复杂慢性疾病儿童住院后结果
Patrick W Brady1,2,3, Marie Pfarr1,3,4, Barbara K Giambra2,3,5,6
1Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Pediatrics
|December 3, 2025
概括
患有复杂慢性疾病 (CCD) 的儿童的家庭发现,医院到家庭过渡的新措施是有效的. 许多儿童在30天内没有恢复到基线健康,这凸显了改善过渡支持的必要性.
科学领域:
- 儿科医疗保健 儿科医疗保健
- 医疗保健服务研究 医疗服务研究
- 患者报告的结果
背景情况:
- 患有复杂慢性疾病 (CCD) 的儿童在从医院到家庭的过渡期间面临重大挑战,导致高率的非计划医疗保健使用.
- 现有的过渡有效性措施往往缺乏CCD儿童家庭的投入,限制了它们的相关性和适用性.
- 发展以家庭为中心的结果对于改善这种脆弱人群的护理过渡至关重要.
研究的目的:
- 为了确定患者和家庭报告的结果 (PROs),这些结果对患有慢性病的儿童的家庭在医院到家庭过渡的有效性方面最有意义.
- 评估这些家庭识别的PRO的可行性,可接受性和可变性,在最近出院的患有CCD的儿童中.
- 开发和验证新的PRO措施,以提高儿科复杂慢性疾病的过渡效率.
主要方法:
- 患有CCD儿童的家庭成员参加了设计会议,以开发和完善PRO措施,以提高过渡的有效性.
- 一项前性队列研究对102名患有CCD的住院儿童进行,收集出院7天后的过渡措施.
- 过渡措施与30天计划外再接收率进行了比较,使用相关性分析来评估预测有效性.
主要成果:
- 家庭支持现有的过渡措施,并共同创建了"回归基线"措施,评估医院入院前状态的进展.
- 在队列研究中,家庭对过渡措施表示高度满意,尽管许多儿童 (64.7%在7天,62.4%在30天) 没有恢复到基线健康.
- 关于儿童健康,日常生活,工作和睡眠的早期恢复到基线 (7天后) 与减少30天的无计划再入院的中等相关性.
结论:
- 一些以家庭为中心的过渡措施得到了CCD儿童家庭的支持,表明它们的相关性和可接受性.
- 许多患有CCD的儿童在住院7天或30天后没有达到基线健康状况,这凸显了过渡困难.
- 对于患有CCD儿童的医院到家庭过渡干预措施的未来研究应该纳入PRO和健康利用结果,以评估有效性.
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