The role of lay health workers in pediatric chronic disease: a systematic review.
The role of lay health workers in pediatric chronic disease: a systematic review.
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外行卫生工作者在小儿慢性病中的作用：系统评价。
DOI：
10.1016/j.acap.2013.04.015
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发表时间：
2013-09
影响因子：
3.1
通讯作者：
Giordano, Thomas P.
中科院分区：
文献类型：
--
作者：
Raphael, Jean L.;Rueda, Anna;Lion, K. Casey;Giordano, Thomas P.
关键词：
患有慢性病的儿童是一个费用高、资源密集的儿童群体。随着慢性病管理方面的持续差距和卫生保健系统的持续分散，利益攸关方正在寻求新的战略来满足这些儿童的需求。系统评估非专业卫生工作者干预措施在改善慢性病儿童的卫生保健利用、症状管理和家庭心理社会结局方面的有效性。PubMed、PsycINFO和Web of Science（1961年1月至2013年2月）。我们开发了一种策略来搜索引文以识别相关文章。检索词包括随机对照试验（RCT）、非专业工作者、家长指导者、同伴指导者、同伴教育者、社区卫生工作者、社区卫生辅助人员、患者倡导者、患者促进者、患者联络员、宣传员、护理大使、患者导航员和非专业人员。通过检索检索文献的参考文献列表并联系临床专家，确定了其他研究。纳入了非专业卫生工作者干预慢性病儿童的随机对照试验。研究仅限于那些集中于0-18岁患有慢性病的儿童的研究。摘要由2名评审员独立筛选。对具有相关摘要的文章进行了全文审查，并对纳入标准进行了评价。使用结构化工具从选定的文章中提取数据。由于干预措施和结果的异质性，我们没有进行荟萃分析。检索得到736篇唯一文献，其中17篇符合纳入标准。所有的干预措施都集中在特定的条件下：哮喘，I型糖尿病，肥胖和未能茁壮成长。非专业卫生工作者和受试者之间的相互作用的频率，模式和持续时间的干预是异质的。一些干预措施是多方面的，包括一对一和小组互动。最常报告的改善结果是减少紧急护理的使用，症状减少，错过工作和上学的日子减少，以及父母生活质量的提高。一项研究表明，非专业卫生工作者的干预具有成本效益。非专业卫生工作者对慢性病儿童的干预可能会导致紧急护理使用、症状和父母心理社会结果的适度改善。这种干预也可能具有成本效益。未来的研究应该集中在针对其他慢性疾病，如镰状细胞病或囊性纤维化和医学复杂的儿童，其条件是非分类的干预。
Children with chronic diseases represent a high-cost and resource-intensive population of children. With continued gaps in chronic disease management and persistent fragmentation in the health care system, stakeholders are seeking new strategies to address the needs of these children. To systematically assess the effectiveness of lay health worker interventions in improving health care utilization, symptom management, and family psychosocial outcomes for children with chronic conditions. PubMed, PsycINFO, and Web of Science (January 1961- February 2013). We developed a strategy to search citations to identify relevant articles. Search terms included randomized controlled trial (RCT), lay worker, parent mentor, peer mentor, peer educator, community health workers, community health aids, patient advocate, patient facilitator, patient liaison, promotoras (es), care ambassadors, patient navigator, and non-professional. Additional studies were identified by searching the reference lists of retrieved articles and contacting clinical experts. RCTs of lay health worker interventions for children with chronic conditions were included. Studies were restricted to those concentrated on children 0–18 years of age with chronic illnesses. Abstracts were independently screened by 2 reviewers. Articles with relevant abstracts underwent full text review and were evaluated for inclusion criteria. A structured tool was used to abstract data from selected articles. Due to heterogeneous interventions and outcomes, we did not conduct a meta-analysis. The search yielded 736 unique articles, of which 17 met inclusion criteria. All interventions focused on specific conditions: asthma, type I diabetes, obesity, and failure to thrive. Interventions were heterogeneous in frequency, mode, and duration of interactions between lay health workers and subjects. Several interventions were multi-faceted, including both one-on-one and group interactions. Improved outcomes most commonly reported were reduced urgent care use, decreases in symptoms, fewer missed work and school days, and increased parental quality of life. One study demonstrated that lay health worker interventions were cost-effective. Lay health workers interventions in children with chronic conditions may lead to modest improvements in urgent care use, symptoms, and parental psychosocial outcomes. Such interventions may also be cost-effective. Future research should focus on interventions targeted toward other chronic conditions such as sickle cell disease or cystic fibrosis and medically complex children whose conditions are non-categorical.
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影响因子：
6.2
作者：
Guadagnolo, B. Ashleigh;Boylan, Amy;Sargent, Michele;Koop, David;Brunette, Deb;Kanekar, Shalini;Shortbull, Vanessa;Molloy, Kevin;Petereit, Daniel G.
通讯作者：
Petereit, Daniel G.
影响因子：
1.1
作者：
Homer, Charles J.;Cooley, W. Carl;Strickland, Bonnie
通讯作者：
Strickland, Bonnie
影响因子：
12.7
作者：
Krieger, JW;Takaro, TK;Weaver, M
通讯作者：
Weaver, M
影响因子：
6.2
作者：
Freeman HP;Rodriguez RL
通讯作者：
Rodriguez RL
影响因子：
5.7
作者：
Greene, Jessica;Hibbard, Judith H.
通讯作者：
Hibbard, Judith H.