Psychosocial risk and health care utilization in pediatric sickle cell disease.
Psychosocial risk and health care utilization in pediatric sickle cell disease.
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DOI：
10.1002/pbc.29139
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发表时间：
2021-08
影响因子：
3.2
通讯作者：
Sil S
中科院分区：
文献类型：
--
作者：
Woodward KE;Johnson YL;Cohen LL;Dampier C;Sil S
与儿童镰状细胞病（SCD）相关的疼痛和并发症与较高的医疗保健利用率相关。在其他儿科慢性疾病中，社会心理筛查可以帮助识别有增加卫生保健利用风险的儿童和家庭，以指导资源分配，解决治疗需求并改善护理。本研究旨在探讨心理社会筛查在预测青少年SCD患者医疗保健使用率增加方面的应用。从综合SCD诊所招募SCD青年（n = 74, 8-18岁）及其父母。家长完成了心理社会评估工具（PAT），该工具将家庭心理社会风险分为三类：普遍（最小痛苦），目标（高痛苦）和临床（持续痛苦）。青年报告了他们的疼痛特征，并从病历回顾中提取了医疗保健利用情况。采用方差分析（ANOVA）和调节分析评估卫生保健利用的差异。基于PAT风险，家庭被分为通用（56.8%）、目标（29.7%）和临床（13.5%）风险组，人口统计学变量之间没有显著的组间差异。Targeted组患者疼痛频次明显高于Universal组（F[2,66] = 3.7, p < 0.05）。在心理社会风险的基础上，疼痛频率与医疗保健利用之间的关系存在显著差异，临床心理社会风险强化了疼痛频率与医疗保健利用之间的联系（β = 0.2, t = 2.1, p < 0.05）。将PAT纳入常规临床护理可能有助于卫生保健提供者确定需要更多社会心理或医疗支持的家庭，以进一步优化SCD管理。
Pain and complications related to pediatric sickle cell disease (SCD) are associated with higher health care utilization. In other pediatric chronic conditions, psychosocial screening can help identify children and families at risk of increased health care utilization to guide resource allocation, address treatment needs, and improve care. This study aimed to investigate the utility of psychosocial screening in predicting increased health care utilization among youth with SCD. Youth with SCD (n = 74, 8–18 years) and their parents were recruited from comprehensive SCD clinics. Parents completed the Psychosocial Assessment Tool (PAT), which categorized family psychosocial risk into one of three categories: Universal (minimal distress), Targeted (elevated distress), and Clinical (persistent distress). Youth reported on their pain characteristics, and health care utilization was extracted from medical chart review. Differences in health care utilization were evaluated using analysis of variance (ANOVA) and moderation analyses. Based on PAT risk, families were categorized into Universal (56.8%), Targeted (29.7%), and Clinical (13.5%) risk groups, with no significant group differences across demographic variables. Patients in the Targeted group reported significantly higher pain frequency than those in the Universal group (F[2, 66] = 3.7, p < .05). The association between pain frequency and health care utilization significantly varied on the basis of psychosocial risk, such that Clinical psychosocial risk strengthened the connection between pain frequency and health care utilization (β = .2, t = 2.1, p < .05). Integrating the PAT into routine clinical care may help health care providers identify families in need of greater psychosocial or medical support to further optimize SCD management.
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DOI：
10.3205/psm000089
发表时间：
2012
期刊：
Psycho-social medicine
影响因子：
--
作者：
Babitsch B;Gohl D;von Lengerke T
通讯作者：
von Lengerke T
影响因子：
158.5
作者：
PLATT, OS;BRAMBILLA, DJ;KLUG, PP
通讯作者：
KLUG, PP
影响因子：
5.4
作者：
Hayes, Andrew F.;Matthes, Joerg
通讯作者：
Matthes, Joerg
影响因子：
3.6
作者：
Logan, DE;Radcliffe, J;Smith-Whitley, K
通讯作者：
Smith-Whitley, K
影响因子：
158.5
作者：
PLATT, OS;THORINGTON, BD;KINNEY, TR
通讯作者：
KINNEY, TR