Evaluation of a model for improving emergency medical and trauma services for children in rural areas
Evaluation of a model for improving emergency medical and trauma services for children in rural areas
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DOI：
10.1016/s0196-0644(97)70224-5
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发表时间：
1997-04-01
影响因子：
6.2
通讯作者：
Haley, KJ
中科院分区：
文献类型：
--
作者：
Smith, GA;Thompson, JD;Haley, KJ
研究目的：评价农村急救医疗和创伤服务项目在提高急救人员对急性患病和受伤儿童管理的知识和信心方面的效果。方法：这项前瞻性、准实验研究采用未经治疗的对照组设计，对俄亥俄州中部两个农村县的院前和医院急救人员进行前测和后测。项目评价比较了干预县的50名急救服务提供者和对照县的43名急救服务提供者。比较这些人员在评估和管理儿科急诊方面的知识和信心的变化。结果：干预县的医疗服务提供者在儿科急诊知识方面的测试分数显著高于对照县的医疗服务提供者（P=.001）。当分别对现场（P=.02）和医院（P=.03）急救人员的测试分数进行比较时，也看到了显著更大的改善。在视觉模拟量表上的自我报告表明，当呈现一个孩子经历呼吸骤停的场景时，项目干预县的提供者比对照组的受试者显著更大地减少了焦虑（P= 0.01）。在李克特五点评分的基础上，干预县的急救人员对儿童气道管理的信心增加（P= 0.0003），并且在参与项目后，他们相信自己接受了足够的儿科培训（P= 0.000001）的信心增加（P= 0.000001）。结论：农村儿科急诊医疗与创伤服务项目有效提高了急诊人员对急病损伤儿童管理的知识和信心。这个项目提供了一个可以在全国其他农村地区复制的模式。
Study objective: To evaluate the effectiveness of a rural emergency medical and trauma services project in increasing the knowledge and confidence of emergency care personnel in the management of acutely ill and injured children.Methods: This prospective, quasi-experimental study used an untreated control group design with pretest and posttest of prehospital and hospital-based emergency care personnel in two rural counties in central Ohio. Project evaluation compared 50 emergency care providers from the intervention county with 43 emergency care providers from the control county. Changes in knowledge and confidence of these personnel in the assessment and management of pediatric emergencies were compared.Results: Providers in the intervention county demonstrated a significantly greater increase in test scores regarding knowledge of pediatric emergencies than did providers in the control county (P=.001). Significantly greater improvement was also seen when comparisons of test scores were made for field (P=.02) and hospital (P=.03) emergency care personnel separately. Self-reports on a visual analog scale indicated that providers in the project intervention county had a significantly greater decrease in anxiety than did control subjects when presented a scenario of a child experiencing a respiratory arrest (P=.01). On the basis of scores from a five-point likert scale, emergency personnel in the intervention county had a greater increase in confidence regarding management of the pediatric airway (P=.0003) and a greater increase in the belief that they had adequate pediatric training (P=.000001) after participating in the project than emergency personnel in the control county.Conclusion: The rural pediatric emergency medical and trauma services project was effective in increasing the knowledge and confidence of emergency care personnel in the management of acutely ill and injured children. This project offers a model that can be replicated in other rural areas nationally.