Predicting clinician injury prevention counseling for young children
Predicting clinician injury prevention counseling for young children
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DOI：
10.1001/archpedi.153.12.1226
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发表时间：
1999-12-01
影响因子：
--
通讯作者：
Gelberg, L
中科院分区：
文献类型：
--
作者：
Barkin, S;Fink, A;Gelberg, L
背景资料：伤害是儿童发病率和死亡率的主要原因，也是咨询的一个重要课题。目的：描述和解释临床医生在5岁及以下儿童的健康儿童检查期间报告的咨询行为，涉及以下4个伤害预防主题：机动车碰撞、有毒物质摄入、溺水和火器伤。方法：随机抽样的465名儿科医生，家庭医生，儿科护士执业在城市环境收到邮寄问卷，325（69.9%）回答。多变量Logistic回归预测咨询每个伤害预防topicsperformed.Results：大多数报告讨论机动车乘员保护（66.2%）和有毒物质摄入预防（62.1%）在井儿童检查。只有31.8%的人表示他们建议预防溺水，15.7%的人建议预防火器伤害。伤害死亡率和发病率的知识与咨询无关。对于大多数主题，女性受访者比男性受访者更有可能提供咨询（机动车碰撞比值比[OR]，2.24 [P = .03];有毒物质摄入OR，1.82 [P = .05];溺水OR，1.97 [P =.04]）。财富维护组织设置预测伤害预防咨询的大多数主题（机动车碰撞OR，2.52 [P = .04]，有毒物质摄入OR，2.77 [P = .01];火器伤OR，2.97 [P = .001]）。对咨询重视程度较低的临床医生不太可能就溺水和火器伤提供咨询（溺水OR，0.73 [P = .006];火器伤OR，0.58 [P =.005]）。
Background: Injury is the primary cause of morbidity and mortality in children and an important topic for counseling.Objective: To describe and explain clinicians' reported counseling behavior during the well-child examinations for children aged 5 years and younger on the following 4 injury prevention topics: motor vehicle crashes, toxic ingestion, drowning, and firearm injuries.Methods: A random sample of 465 pediatricians, family physicians, and pediatric nurse practitioners in an urban setting received mailed questionnaires; 325 (69.9%) responded. Multivariate logistic regression predicting counseling on each injury prevention topic was performed.Results: Most reported discussing motor vehicle occupant protection (66.2%) and toxic ingestion prevention (62.1%) during the well-child examination. Only 31.8% stated they counseled on drowning prevention and 15.7%, on firearm injury prevention. Knowledge of injury mortality and morbidity rates was not associated with counseling. For most topics, female respondents were more likely to counsel than male respondents (motor vehicle crash odds ratio [OR], 2.24 [P = .03]; toxic ingestion OR, 1.82 [P = .05]; drowning OR, 1.97 [P =.04]). Wealth maintenance organization settings predicted injury prevention counseling for most topics (motor vehicle crash OR, 2.52 [P = .04], toxic ingestion OR, 2.77 [P = .01]; firearm injury OR, 2.97 [P = .001]). Clinicians placing lower importance on counseling were less likely to counsel on drowning and firearm injury (drowning OR, 0.73 [P = .006]; firearm injury OR, 0.58 [P