Do school-based health centers provide adequate asthma care?
Do school-based health centers provide adequate asthma care?
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学校健康中心是否提供足够的哮喘护理？
DOI：
10.1111/j.1746-1561.2003.tb03601.x
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Ozuah,Phillip
中科院分区：
文献类型：
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作者：
Oruwariye,Tosan;Webber,MayrisP;Ozuah,Phillip
以学校为基础的健康中心（SBHC）越来越多地负责提供包括哮喘护理在内的初级保健服务。本研究评估了SBHC提供者对国家心肺血液研究所（NHLBI）哮喘护理指南的依从性以及提供者依从性、患者特征和哮喘结局之间的相关性。采用横断面研究设计，评估来自纽约布朗克斯市中心4所小学（K-5）的415名哮喘儿童的SBHC图表数据。分别有60%、51%、22%和3%的受试者在图表中记录了哮喘症状、峰值流量使用、随访访视和转诊至哮喘专家。33%的图表有SBHC临床医生记录的严重程度分类，其中70%有适当的药物处方。分别有18%和10%的图表记录了哮喘教育和哮喘计划。71%和49%的图表分别记录了环境触发因素和烟草暴露。年龄较大的儿童（> 8岁）更有可能记录峰值流量用于哮喘管理，哮喘教育，随访和书面哮喘计划，而年龄较小的儿童（< 8岁）更有可能缺课更多天（所有p <0.05）。总体而言，供应商遵守NHLBI指南是不够的，坚持稍好的年龄较大的儿童。
School‐based health centers (SBHCs) are increasingly charged with providing primary care services including asthma care. This study assessed SBHC provider adherence to the National Heart, Lung, and Blood Institute (NHLBI) asthma care guidelines and the association among provider adherence, patient characteristics, and asthma outcomes. A cross‐sectional study design was used to assess SBHC chart data from 415 children with asthma attending four inner‐city elementary schools (K‐5) in the Bronx, NY. Asthma symptoms, peak flow use, follow‐up visits, and referrals to asthma specialists were documented in the charts of 60%, 51%, 22%, and 3% of subjects, respectively. Thirty‐three percent of charts had SBHC clinician‐documented severity classifications, of which 70% had appropriate medications prescribed. Asthma education and an asthma plan were documented in 18% and 10% of charts, respectively. Environmental triggers and tobacco exposures were documented in 71% and 49% of charts, respectively. Older children (> 8 years) were more likely to have documentation of peak flow use for asthma management, asthma education, follow‐up visits, and written asthma plans, whereas younger children (< 8 years) were more likely to miss more days of school (all p < .05). Overall, provider adherence to NHLBI guidelines was inadequate, with adherence somewhat better for older children.