儿科和育儿

电子视觉模拟量表应用程序对症状性运动过度儿童和青少年疼痛评估的有效性:横断面研究

2022 - 10 - 26 - t09:15:24内

背景:用于疼痛评估的临床数据收集的移动应用程序的快速发展导致了比传统的纸质方法更有效的数据处理和分析。由于基于纸张的视觉模拟量表(p-VAS)评分通常用于评估疼痛水平，因此在对有症状的儿童和青少年进行临床应用之前，需要对新出现的应用程序进行验证。目的:本研究旨在通过移动健康(mHealth) App评估电子视觉模拟量表(e-VAS)方法在被诊断为高运动谱系障碍/高运动埃勒-丹洛斯综合征(HSD/HEDS)的儿童和青少年中与传统p-VAS方法的有效性和可靠性。方法:从悉尼(澳大利亚新南威尔士州)的一个运动医学中心招募5-18岁诊断为HSD/HEDS的儿童。自愿受试者被随机分配到e-VAS和p-VAS平台，被要求表明他们当前的下肢疼痛水平，并在一个时间点完成疼痛评估e-VAS或p-VAS。通过类内相关系数(ICC)和Bland-Altman分析确定两种方法之间的工具一致性。结果:共招募了43名11岁(SD 3.8岁)的HSD/HEDS患儿，并完成了本研究。2个VAS平台的中值差异为0.20。Bland-Altman分析结果显示差异为0.19 (SD 0.95)，一致性范围为-1.67至2.04。ICC为0.87 (95% CI为0.78-0.93)表示可靠性较好。 Conclusions: These findings suggest that the e-VAS mHealth App is a validated tool and a feasible method of collecting pain recording scores when compared with the traditional paper format in children and adolescents with HSD/HEDS. The e-VAS App can be reliably used for pediatric pain evaluation, and it could potentially be introduced into daily clinical practice to improve real-time symptom monitoring. Further research is warranted to investigate the usage of the app for remote support in real clinical settings.

母乳喂养App功能评价:内容分析研究

2022 - 10 - 26 - t09:15:03内

虽然各种各样的健康应用程序比比皆是，但据报告，美国只有不到一半的成年人使用健康应用程序，尽管智能手机在18至49岁的用户中无处不在。几项研究调查了母乳喂养应用程序的使用情况;然而，人们对这些应用上的功能类型以及影响应用评级的因素知之甚少。本文旨在描述母乳喂养应用程序，评估用户评分高的应用程序与用户评分低的应用程序在跟踪和非跟踪功能上是否不同，分析功能的类型和数量是否预测用户评分，以及应用程序的评分是高还是低。通过横断面设计，我们从苹果App Store (iOS)和谷歌Play Store (Android)中挑选了母乳喂养应用的便利样本。对82个应用程序进行内容分析，使用87个项目的模式，然后编译成9个主题指数，包括母乳喂养、奶瓶喂养、固体食品、婴儿健康、婴儿护理、技术特征、信息学、信息特征和交互性。分析包括描述性统计、曼-惠特尼U检验和斯皮尔曼等级相关性。线性回归和二元逻辑回归分析用于确定哪些特征预测用户星级评级。结果:平均而言，用户给母乳喂养app的评分为4.4(满分5星)。三分之二的应用程序(n=54)评分较高(≥4.5星)，三分之一(n=28)评分较低(<4.5星)。 Higher-rated apps offered more tracking features for breastfeeding, bottle feeding, solid foods, infant health, and infant care than lower-rated apps. The breastfeeding, solid-food, and technical indices explained 17% of user star ratings. For each additional breastfeeding and solid-food feature, we can expect to see a 27% and 35% increase, respectively, in user star ratings. Additionally, as the number of solid-food features increased, the odds that the app is higher rated increased 1.58 times. Conclusions: Our findings suggest user ratings are driven in part by tracking features, specifically those related to breastfeeding and solid foods. The proliferation of mobile health apps offers opportunities for parents and caregivers to track behaviors associated with infant feeding and other health metrics in a dynamic, detailed, and comprehensive manner. Hence, breastfeeding apps have the potential to promote and support breastfeeding among users.

中国青少年问题性网络使用与家庭关系问题的关系:来自大规模调查的发现

2022 - 10 - 24 - t09:15:03内

背景:问题互联网使用(PIU)在中国青少年中普遍存在。有必要更好地了解亲子关系质量与青少年PIU之间的关系，以指导制定有效的预防和早期干预方案。本研究旨在评估父母-青少年冲突和养育方式作为与青少年PIU相关的潜在危险因素。来自中国广东22所学校的6552名学生(年龄10-19岁)被招募为样本。参与者完成了自我报告问卷，测量他们对与父母的冲突(包括言语冲突、情感虐待和身体虐待)的感知，以及他们对父母教育方式的感知(包括父母的照顾和父母的控制，通过父母关系量表测量)，以及使用青少年病态互联网使用量表的PIU。年级水平和性别被视为这些关联的调节因子。结果:通过多元回归分析，我们发现母亲-青少年冲突、父亲-青少年冲突、父母控制和较低的父母照顾水平与较高的青少年PIU水平相关(P<.001)。母亲-青少年冲突与PIU的相关性在高年级学生中强于低年级学生(P=.04)，而在男生中父亲-青少年冲突与PIU的相关性强于女生(P=.02)。与那些没有母亲-青少年冲突的参与者相比，经历过母亲言语冲突和情感虐待，但没有遭受过母亲身体虐待的参与者报告了更高的PIU水平(P<.001)。与未报告父亲与青少年发生冲突的参与者相比，经历过父亲言语冲突、情感虐待和身体虐待的参与者PIU水平显著更高(P<001年,<我> P < / i > & lt;。001, and P=.02, respectively). Conclusions: These findings point to the value of interventions to reduce parental verbal conflict, emotional abuse, and physical abuse, and to increase positive parenting styles, to lower the risk of PIU in Chinese adolescents.

使用数字支持工具MeeToo的经验:混合方法研究

2022 - 10 - 20 - t09:30:02内

数字同伴支持是一种越来越多地用于青少年心理健康支持的形式。然而，还需要更多的研究数字同伴支持的影响以及为什么它有影响。本研究的目的是调查年轻人使用数字同伴支持工具MeeToo的经历。在写这篇文章的时候，MeeToo已经改名为Tellmi。MeeToo是一个匿名的、完全有节制的同伴支持工具，面向11-25岁的年轻人。有两个研究问题:(1)使用MeeToo对年轻人有什么影响?(2)为什么使用MeeToo会对年轻人产生这些影响?方法:进行了混合方法研究。它涉及对常规收集的反馈问卷的二次分析，在两个时间点(T1和T2)完成相隔2-3个月。问卷询问了年轻人(N=876)使用MeeToo、心理健康赋权和福祉的经验。 Primary data were collected from semistructured interviews with 10 young people. Results: Overall, 398 (45.4%) of 876 young people completed the T1 questionnaire, 559 (63.8%) completed the T2 questionnaire, and 81 (9.2%) completed both. Descriptive statistics from the cross-sectional analysis of the questionnaires identified a range of positive impacts of using MeeToo, which included making it easier to talk about difficult things, being part of a supportive community, providing new ways to help oneself, feeling better, and feeling less alone. Subgroup analysis (paired-sample t test) of 58 young females who had completed both T1 and T2 questionnaires showed a small but statistically significant increase in levels of patient activation, one of the subscales of the mental health empowerment scale: time 1 mean=1.83 (95% CI 1.72-1.95), time 2 mean=2.00 (95% CI 1.89-2.11), t₅₉=2.15, and P=.04. Anonymity and the MeeToo sense of community were identified from interviews as possible reasons for why using MeeToo had these impacts. Anonymity helped to create a safe space in which users could express their feelings, thoughts, and experiences freely without the fear of being judged by others. The MeeToo sense of community was described as a valuable form of social connectedness, which in turn had a positive impact on young people’s mental health and made them feel less isolated and alone. Conclusions: The findings of this research showed a range of positive impacts and possible processes for young people using MeeToo. Future research is needed to examine how these impacts and processes can be sustained.

加拿大大麻使用和生育、怀孕和哺乳资源:范围审查

2022 - 10 - 19 - t09:30:03内

加拿大育龄人群中大麻的使用正在增加，但我们对其对生育、怀孕和母乳的影响的理解仍在不断发展。尽管有许多基于网络的资源，但知情的决策和耐心的咨询对预期的家庭和提供者都是挑战。我们的目的是对加拿大公开的网络资源进行范围审查，以提供大麻对生育、怀孕和母乳的影响的信息。根据PRISMA-ScR(用于范围审查的系统审查和元分析扩展的首选报告项目)，我们系统地搜索了2010年1月1日至2020年11月30日之间的8个数据库，以及71个加拿大产科、政府和公共卫生组织的网页。我们包括了讨论大麻对生育、怀孕、哺乳或暴露的胎儿和婴儿的影响的英语资源。提取和总结流行病学特征、可读性和内容信息。结果:总共有183个资源满足我们的纳入标准。资源包括面向公众观众的内容(163/ 183,89.1%)和面向保健提供者的内容(HCPs;31/183, 16.9%)。资源由国家级(46/ 183,25.1%)、省或地区(65/ 183,35.5%)和区域(72/ 183,39.3%)组织撰写。 All provinces and territories had at least one resource attributed to them. The majority (125/183, 68.3%) were written at a >10 grade reading level, and a few (7/183, 3.8%) were available in languages other than English or French. The breadth of content on fertility (55/183, 30.1%), pregnancy (173/183, 94.5%), and breast milk or breastfeeding (133/183, 72.7%) varied across resources. Common themes included citing a need for more research into the effects of cannabis on reproductive health and recommending that patients avoid or discontinue cannabis use. Although resources for providers were consistent in recommending patient counseling, resources targeting the public were less likely to encourage seeking advice from HCPs (23/163, 14.1%). Conclusions: Canadian resources consistently identify that there is no known safe amount of cannabis that can be consumed in the context of fertility, pregnancy, and breastfeeding. Areas of improvement include increasing readability and language accessibility and encouraging bidirectional communication between HCPs and patients.

利用人群出院数据评估产后抑郁症的种族和社会经济差异:纵向回顾性研究

2022 - 10 - 17 - t09:00:26内

背景:在美国，每年有360万例分娩。根据美国疾病控制与预防中心(Centers for Disease Control and Prevention)的数据，其中高达20%(约70万)的女性患有产后抑郁症(PPD)。缺乏准确的报告和诊断使得PPD患者的表型鉴定非常困难。已有文献表明，种族、社会经济地位和药物滥用史等因素与PPD的差异风险相关。然而，有限的研究考虑了不同的时间与结果的关系。本研究旨在评估不同种族和社会经济背景的患者在PPD风险和诊断时间上的差异。这是一项纵向回顾性研究，使用马里兰州全州医院出院数据。我们确定了从2017年到2019年在医院分娩的16066人。我们应用逻辑回归和考克斯回归研究不同种族和社会经济阶层的PPD风险。采用多项回归估计产后不同阶段产后抑郁的风险。 Results: The cumulative incidence of PPD diagnosis was highest for White patients (8779/65,028, 13.5%) and lowest for Asian and Pacific Islander patients (248/10,760, 2.3%). Compared with White patients, PPD diagnosis was less likely to occur for Black patients (odds ratio [OR] 0.31, 95% CI 0.30-0.33), Asian or Pacific Islander patients (OR 0.17, 95% CI 0.15-0.19), and Hispanic patients (OR 0.21, 95% CI 0.19-0.22). Similar findings were observed from the Cox regression analysis. Multinomial regression showed that compared with White patients, Black patients (relative risk 2.12, 95% CI 1.73-2.60) and Asian and Pacific Islander patients (relative risk 2.48, 95% CI 1.46-4.21) were more likely to be diagnosed with PPD after 8 weeks of delivery. Conclusions: Compared with White patients, PPD diagnosis is less likely to occur in individuals of other races. We found disparate timing in PPD diagnosis across different racial groups and socioeconomic backgrounds. Our findings serve to enhance intervention strategies and policies for phenotyping patients at the highest risk of PPD and to highlight needs in data quality to support future work on racial disparities in PPD.

2019冠状病毒病大流行期间妇女对远程卫生服务的满意度:横断面调查研究

2022 - 10 - 14 - t09:15:03内

自2020年3月以来，为减少患者对COVID-19的接触，需要大规模转向远程卫生服务提供。尽管研究报告称，在大流行期间，孕妇普遍对产前远程保健体验感到满意，但对产后妇女的远程保健满意度了解较少。本研究调查了COVID-19大流行期间孕妇和刚怀孕妇女的远程卫生满意度，以确定人口统计学因素(即种族、年龄、婚姻状况、教育水平、家庭收入和就业状况)是否与该人群的远程卫生满意度相关。一项基于网络的横断面调查旨在获取美国孕妇和近期孕妇的健康相关行为和保健经验数据，该调查于2022年春季发布。符合条件的参与者至少18岁，被确认为女性，目前怀孕或过去3年曾怀孕。在N=403的最终分析样本中，远程保健满意度平均得分为3.97 (SD 0.66;分数范围1 - 5)。在调整后的线性回归模型中，年龄35-44岁(vs 18-24岁)，年收入≥10万美元(vs <5万美元)，最近(与目前)怀孕与更高的远程保健满意度相关(P≤.049)。尽管围产期妇女普遍对远程保健感到满意，但存在差异。 Specifically, being aged 18-24 years, having an annual income of < US $50,000, and being currently pregnant were associated with lower telehealth satisfaction. It is critical that public health policies or programs consider these factors, especially if the expanded use of telehealth is to persist beyond the pandemic.

美国大型儿科医院拥有的移动应用程序现状:对谷歌Play和苹果应用程序商店的系统搜索与分析

2022 - 10 - 06 - t09:15:20内

背景:美国的儿科医院越来越多地利用面向患者的移动应用程序作为其面向患者、家属和护理人员的数字前门。这些移动健康应用程序是由儿科医院批准的，用于向公众或人群提供有关儿科护理的个性化信息，以加强沟通，并改善患者体验。然而，这些医院手机app的功能和用户反馈还没有得到系统的调查。我们的目的是了解大型儿科医院提供的医院自有移动app的现状，比较分析和报告所提供的服务，并发现潜在的差距，以通知开发者和提供商。美国医院协会(American Hospital Association)将大医院定义为拥有400张床位以上的医院。我们在谷歌Play和Apple App Store上进行了系统搜索，以确定我们审查中包括的所有大型儿科医院的医院自有移动应用程序。我们的入选标准是:(1)大型儿科医院提供的app;(2)在Apple App Store和谷歌Play中提供的医院自有应用;(3)为普通人群提供的应用程序。服务于教育、远程保健、特定条件或程序的特定用户群体或人群的专业应用程序，或用于研究或临床医生使用的应用程序被排除在外。 The features and functionality of the included apps were examined. Results: Of the 16 pediatric hospitals included in our review, 4 (25%) had no general patient-facing apps, 4 (25%) had one app, and 8 (50%) had more than one app available on Google Play or Apple App Store. The 12 hospitals with at least one mobile app had a combined total of 72 apps. Of these 72 apps, 61 (85%) were considered specialty and were excluded from our review, leaving a total of 11 (15%) apps to analyze. Among the 11 apps analyzed, the most common feature was appointment scheduling or reminder (n=9, 82%). Doctor search (n=8, 73%) and patient resources (n=8, 73%) were the second most common, followed by payment, billing, or claims (n=7, 64%), patient portal integration (n=6, 55%), personal health management (n=6, 55%), hospital way finding (n=5, 45%), message a provider (n=4, 36%), urgent care wait times (n=4, 36%), video chat (n=4, 36%), and health information access (n=4, 36%). Parking information (n=3, 27%) was the least common. Conclusions: Out of the 16 pediatric hospitals identified for our review, 75% (n=12) offer mobile apps. Based on the most common features, these apps were intended to help improve accessibility for patients and families in terms of finding providers, scheduling appointments, and accessing patient resources. We believe the findings will inform pediatric hospital administrators, developers, and other stakeholders to improve app feature offerings and increase their impact on service accessibility and patient experience.

儿童早期健康促进的移动健康技术设计与评价:系统文献综述

2022 - 10 - 06 - t09:15:03内

最近，服务不足人群中智能手机拥有量的增加，启发了医学、计算和卫生信息学领域的研究人员设计和评估移动卫生(mHealth)干预措施，特别是那些支持儿童发育和生长的干预措施。尽管这些干预措施在更大范围内显示出可能的有效性，但很少有干预措施得到评估，以解决种族差异和卫生公平问题，这些是影响目标人群的相关性、吸收和遵守的已知因素。在本研究中，我们旨在确定和记录当前促进儿童早期健康的移动卫生技术的设计和评估实践，并特别关注这些过程解决健康差异和健康公平的机会。我们完成了一项系统的研究文献综述，旨在设计和评估用于促进儿童早期健康的移动健康干预措施。然后，我们分析了这些研究，以确定在早期和后期过程中解决种族差异的机会，并了解这些干预措施的潜在效果。在医学、计算和健康信息学领域的文献中，我们确定了15篇文章，它们提出了面向父母的健康干预的设计或评估。我们发现，使用基于移动的系统提供健康干预措施被5岁儿童的父母普遍接受。我们还发现，通过测量，父母对儿童早期健康话题的知识和参与健康促进行为的信心都有所提高。设计和评估方法在学科内部保持一致(例如，实验研究设计是医学文献中最普遍的，而计算研究人员在计算领域使用以用户为中心的设计方法)。然而，跨领域的设计或评估方法缺乏一致性。 Conclusions: To support more interventions with a comprehensive design and evaluation process, we recommend attention to design at the intervention (eg, reporting content sources) and system level; interdisciplinary collaboration in early childhood health intervention development can lead to large-scale deployment and success among populations. Trial Registration: PROSPERO CRD42022359797; https://tinyurl.com/586nx9a2

父母对他们与青少年网瘾儿童关系的看法:调查研究

2022 - 10 - 05 - t09:30:03内

背景:有网瘾青少年的父母每天都要面对孩子的网络问题。父母可能会注意到，成瘾的青少年也可能有情感和行为问题，包括冲动和暴力。研究发现，父母的教育方式与网瘾有关。本研究的目的是调查父母对自己的育儿方式、与孩子的关系以及孩子的网络成瘾程度和情感和行为问题的看法。一项网络调查于2021年10月14日至18日在日本各地对600名12至17岁儿童的父母进行了调查。调查对象由一家互联网研究公司招募，并被要求完成一份匿名的在线问卷。这项调查被分为两组:300名家长在“你认为你的孩子依赖网络吗?”以及300名回答“否”的家长。收集问卷直到每组有300名参与者。问卷包括(1)亲子网络成瘾测试(PCIAT)、(2)每日使用网络的时间、(3)优点和困难问卷(SDQ)、(4)育儿方式和维度问卷(PSDQ)、(5)测量自我报告依恋风格原型的关系问卷(RQ)。结果:潜在网络成瘾组的PCIAT平均分和每日上网时间显著高于潜在网络成瘾组(50%; P<.001). The total difficulties score from the SDQ for the group with probable internet addiction (mean 10.87, SD 5.9) was significantly higher than that for the group without probable internet addiction (mean 8.23, SD 5.64; P<.001). The mean score for authoritarian parenting from the PSDQ for the group with probable internet addiction (mean 2.1, SD 0.58) was significantly higher than that for the group without probable internet addiction (mean 2.1, SD 0.58; P<.001). Regarding the RQ, there were no significant differences between the two groups. Conclusions: Our findings suggest that parents who think their child is addicted to the internet may recognize emotional and behavioral problems of the child and have an authoritarian parenting style.