Exploring pre-school vision screening in primary care offices in Alabama.
Exploring pre-school vision screening in primary care offices in Alabama.
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探索阿拉巴马州初级保健办公室的学前视力筛查。
DOI：
10.1097/opx.0b013e318269ca9f
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发表时间：
2012
期刊：
影响因子：
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通讯作者：
Wall,TerryC
中科院分区：
文献类型：
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作者：
Marsh-Tootle,WendyL;Frazier,MarcelaG;Kohler,ConnieL;Dillard,CareyM;Davis,Kathryn;Schoenberger,Yu-Mei;Wall,TerryC
目的。调查儿科初级保健办公室普遍学前视力筛查（PVS）的做法、障碍和促进因素。方法：在9个儿科诊所现场主持焦点小组会议（FGS）。采用半结构化的主题指南来规范和促进FGS。讨论被录下来，文字记录被用来发展主题。结果：fgs包括13名医生和32名护士/注册医疗助理（CMAs），其中82%的人亲自进行了PVS的某些方面。在所有实践中，护士/ cma测试视力（大多数使用非推荐的测试），医生完成视力筛查，包括外部观察、固定/跟踪、红色反射和覆盖测试。推动者包括(1)接受PVS是健康儿童就诊的常规部分，以及(2)使用带有提示记录视力的电子病历（九种做法中的八种）。障碍与学龄前儿童测试困难、办公室环境干扰、时间限制和有限的报销有关。结论：PVS的责任由医生和护士/ cma共同承担；因此，改善PVS的干预措施应该同时针对这两方面。很少有实践意识到新的基于证据的PVS测试；因此，需要积极的转化努力来改变当前的初级保健实践。
Purpose.To investigate practices, barriers, and facilitators of universal pre-school vision screening (PVS) at pediatric primary care offices.Methods.Focus group sessions (FGS) were moderated on-site at nine pediatric practices. A semi-structured topic guide was used to standardize and facilitate FGS. Discussions were audiotaped, and transcriptions were used to develop themes. All authors reviewed and agreed on the resultant themes.Results.FGS included 13 physicians and 32 nurses/certified medical assistants (CMAs), of whom 82% personally conducted some facet of PVS. In all practices, nurses/CMAs tested visual acuity (most using a non-recommended test), and physicians completed vision screening with external observation, fix/follow, red reflex, and cover test. Facilitators included (1) accepting that PVS is a routine part of the well-child visit, and (2) using an electronic medical record with prompts to record acuity (eight of nine practices). Barriers were related to difficulty testing pre-schoolers, distractions in the office setting, time constraints, and limited reimbursement.Conclusions.Responsibility for PVS is shared by physicians and nurses/CMAs; thus, interventions to improve PVS should target both. Few practices are aware of new evidence-based PVS tests; thus, active translational efforts are needed to change current primary care practices.