MOTHERS PERCEPTIONS OF SEVERE PNEUMONIA IN THEIR OWN CHILDREN - A CONTROLLED-STUDY IN PAKISTAN
MOTHERS PERCEPTIONS OF SEVERE PNEUMONIA IN THEIR OWN CHILDREN - A CONTROLLED-STUDY IN PAKISTAN
复制标题
DOI：
10.1016/0277-9536(94)90429-4
复制
发表时间：
1994-04-01
影响因子：
5.4
通讯作者：
ANJUM, M
中科院分区：
文献类型：
--
作者：
MULL, DS;MULL, JD;ANJUM, M
1992年，320名母亲在拉瓦尔品第的一家医院接受了采访，以确定她们在自己孩子身上看到的哪些体征和症状与肺炎的临床诊断最一致，而不是普通感冒。一个相关的目标是确定母亲是否能够正确判断两个主要肺炎症状的实际存在或不存在-呼吸急促和胸部内陷。这些母亲大多是穷人，43%是文盲。研究样本由四组组成：(1)80名肺炎儿童的母亲，大多数是重症肺炎儿童，在儿童转到病房后接受采访；(2)在讨论肺炎诊断之前，在门诊接受采访的80名儿童的母亲；(3)80名患普通感冒的儿童的母亲；(4)80名病情较好的儿童的母亲。结果显示，当母亲在诊所接受采访时，她们认为儿童呼吸急促和/或胸部内陷与肺炎高度相关(敏感性，特异度90%)。母亲们甚至更有可能在肺炎诊断被传达后说孩子有这些迹象，这表明与医生的互动影响了她们的看法。呼吸急促比胸部内陷更容易被识别，对这两种体征的准确诊断在有儿童肺炎经验的母亲中更好。数据表明，即使在没有正规的ARI教育的情况下，大多数在贫困地区医院就诊的巴基斯坦母亲也能在自己的孩子身上识别出这两个迹象。然而，这些症状的严重性及其与肺炎的联系应该在教育活动中得到强调，因为在被送往医院时，很高比例的儿童已经有胸部内陷(严重疾病的晚期迹象)。
In 1992, 320 mothers were interviewed in a Rawalpindi hospital to identify which of the signs and symptoms they saw in their own children were most consistently linked with a clinical diagnosis of pneumonia as opposed to common cold. A related goal was to determine whether mothers could correctly judge the actual presence or absence of two major pneumonia signs-fast breathing and chest indrawing. The mothers were predominantly poor and 43% were illiterate. The study sample was composed of four matched groups: (1) mothers of 80 children with pneumonia, most with severe disease, interviewed after the child was referred to the ward; (2) mothers of 80 such children interviewed in the outpatient clinic prior to any discussion of the pneumonia diagnosis; (3) mothers of 80 children with common cold; and (4) mothers of 80 'well' children.Results showed that when mothers were interviewed in the clinic, their perception that a child had fast breathing and/or chest indrawing was highly correlated with pneumonia (sensitivity 64%, specificity 90%). Mothers were even more likely to say that a child had these signs after the pneumonia diagnosis had been conveyed, suggesting that interaction with doctors influenced their views. Fast breathing was better recognized than chest indrawing, and accurate diagnosis of both signs was better among mothers having prior experience with childhood pneumonia. The data suggest that even in the absence of formal ARI education, a majority of Pakistani mothers attending hospitals in indigent areas can recognize these two signs in their own children. However, the seriousness of the signs and their connection with pneumonia should be stressed in education campaigns since a high percentage of children had chest indrawing (a late sign of severe disease) by the time they were brought to the hospital.