儿童和护理人员围绕儿童胸痛的焦虑:使用标准化协议进行心脏评估的案例
Ariane T Michelson1, David R Fulton2, Olga Toro-Salazar3
1Department of Cardiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA. ariane.michelson@cardio.chboston.org.
Pediatric cardiology
|January 6, 2026
概括
儿童胸痛 (CP) 评估很少发现心脏原因,但通过更多的测试增加了家庭焦虑. 心脏病专家的保证可以减少焦虑,避免不必要的后续检查和资源使用.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 临床焦虑研究 临床焦虑研究
背景情况:
- 年轻人胸部疼痛 (CP) 是常见的,但通常是良性的,很少表明心脏问题.
- 尽管心脏病发病率低,但患者和家庭对儿科心脏病的焦虑往往很大.
研究的目的:
- 评估儿童患者及其家长/照顾者在心脏病诊所心脏病诊所访问后的焦虑变化.
- 评估访问后焦虑,心脏检查的数量和未计划的回访的可能性之间的相关性.
主要方法:
- 从2010年至2014年评估CP的7至21岁的患者及其父母/照顾者在访问前和后的焦虑 (1-5级) 评级.
- 一个标准化的协议指导CP评估,与心脏测试在提供商的裁量权.
- 分析了焦虑得分,心脏检测数量和回访率.
主要成果:
- 平均访问前焦虑评分为2.6 (患者) 和3.0 (家长/照顾者),访问后降至1.3 (p < 0.0001).
- 心脏检测的增加与患者 (OR=1.9) 和父母/照顾者 (OR=1.8) 的更高的访问后焦虑相关 (p < 0.0001).
- 访问后更高的家长/监护人焦虑增加了未计划的回访的可能性 (OR=2.88,p < 0.0001).
结论:
- 虽然儿科CP的心脏病因是罕见的,但在寻求心脏护理的家庭中,焦虑是普遍存在的.
- 心脏病专家的保证有效地减少了焦虑,而无需进行广泛的测试.
- 增加心脏检测加剧了家庭的焦虑,导致更多的后续访问和潜在的过度使用医疗保健资源.
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