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1.
Front Public Health ; 12: 1377803, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38784583

RESUMO

Introduction: Mild respiratory infections are a common reason for consultation in paediatrics, both in the emergency department and in primary care clinics. These conditions, mostly viral and self-limiting, have a significant impact on the healthcare system, school and work absenteeism, and family routines. Despite being common and banal illnesses from a medical perspective, they involve a significant concern in families. The main objective of the contrast study was to compare the perceptions of parents and paediatricians regarding mild respiratory infections in childhood and their impact on family conciliation. Materials and methods: Two online, cross-sectional surveys were conducted among Spanish paediatricians and parents with children aged 6 months to 12 years, involving 504 paediatricians and 1,447 families, with questions on attitudes towards visits to the paediatric consultation, care burden of minor pathologies, work, and family conciliation, and treatment and prevention of these illnesses. Results: Results showed significant differences in paediatricians' and parents' perceptions in many aspects. According to 34.5% of paediatricians and 27% of parents, families regularly go to the paediatrician without a scheduled visit. Only 4% of parents report having self-medicated their child, while paediatricians raise this percentage significantly to 48%. Regarding the question: "it is normal for a child to have an average of 4 colds a year," only 25.5% of the surveyed families "strongly agree" unlike to 70.2% of paediatricians. 72.8% of paediatricians "strongly agree" with: "in my opinion, it is good for children to get sick to improve their immune system" reduced to 45.9% of parents. Consultations for minor pathologies represent a "high workload" for 60.9% of paediatricians, while this opinion is agreed by only 18.9% of the parents. Conclusion: Mild respiratory infections in childhood are perceived differently by paediatricians and parents. While paediatricians perceive them as a common and manageable phenomenon, parents tend to show higher concern and demand for medical attention. This study underlines the need to improve communication between paediatricians and parents to align perceptions, optimise the use of the health system resources, and improve the efficiency in the management of these common paediatric illnesses.


Assuntos
Pais , Pediatras , Infecções Respiratórias , Humanos , Pais/psicologia , Pediatras/psicologia , Pediatras/estatística & dados numéricos , Estudos Transversais , Masculino , Feminino , Pré-Escolar , Criança , Lactente , Inquéritos e Questionários , Espanha , Adulto , Atitude do Pessoal de Saúde , Pessoa de Meia-Idade , Percepção
2.
Front Public Health ; 12: 1361509, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38756889

RESUMO

Introduction: Gynecologists and pediatricians have an essential duty to prevent cervical cancer. In this study, we compared the compliance of gynecologists (n = 22) and pediatricians (n = 49) with nurse/midwife (n = 66) and non-medical moms (n = 120) with regards to cervical cancer precautions. Methods: A questionnaire was used to gather data on their demographics, personal vaccination and screening practices, children's immunization status, and awareness of cervical cancer prevention. Results: The findings demonstrated that gynecologists and pediatricians were better than others at understanding the risk factors and prevention of cervical cancer. It was noted that compared to other groups, physician mothers and their offspring had higher vaccination rates (n = 13, 18.3%; n = 10, 29.4%, respectively). Medical professionals typically provided thorough and accurate answers to informational questions. More frequent Pap smear tests were performed by gynecologists. It was noted that mothers who worked as pediatricians and nurses/midwives neglected their own screening needs. Discussion: This questionnaire survey sought to ascertain Istanbul's health professionals' present opinions regarding HPV vaccination. Healthcare professionals should be the first to receive information on HPV vaccination and cervical cancer incidence reduction. The public could then readily use them as an example.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Mães , Vacinas contra Papillomavirus , Pediatras , Neoplasias do Colo do Útero , Humanos , Feminino , Turquia , Inquéritos e Questionários , Adulto , Neoplasias do Colo do Útero/prevenção & controle , Mães/estatística & dados numéricos , Mães/psicologia , Vacinas contra Papillomavirus/administração & dosagem , Pediatras/estatística & dados numéricos , Pediatras/psicologia , Enfermeiras e Enfermeiros/estatística & dados numéricos , Enfermeiras e Enfermeiros/psicologia , Infecções por Papillomavirus/prevenção & controle , Pessoa de Meia-Idade , Ginecologia/estatística & dados numéricos , Masculino , Ginecologista
3.
BMC Pediatr ; 24(1): 355, 2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38778341

RESUMO

BACKGROUND: Counselling adolescents with chronic medical conditions (CMCs) can be challenging regarding suitable interviewing skills and clinicians' attitudes toward the patient. Successful communication can be a key element of treatment. Motivational Interviewing (MI) is broadly applicable in managing behavioural problems and diseases by increasing patient motivation for lifestyle changes. However, data concerning the applicability, feasibility and implementation of MI sessions in everyday practice are missing from the physicians' point of view. METHOD: The present study was conducted as a mixed methods design. Twenty paediatricians were randomized to a 2-day MI course followed by MI consultations. Data were collected through a questionnaire one year after MI training. Factors for effective training and possible barriers to successful use of MI were examined. RESULTS: Completed questionnaires were returned by 19 of 20 paediatricians. The paediatricians' experiences with MI demonstrate that MI is regarded as a valuable tool when working with adolescents with CMCs. 95% of all respondents reported that they found MI education necessary for their clinical work and were using it also outside the COACH-MI study context. 73.7% percent saw potential to strengthen the connection to their patients by using MI. The doctors were already using more MI conversation techniques after a 2-day MI course. Obstacles were seen in the short training, the lack of time and missing undisturbed environment (interruptions by telephone, staff, etc.) during clinical flow. CONCLUSIONS: MI techniques are not yet a regular part of medical training. However, a 2-day MI course was rated effective and provided a lasting impact by physicians caring for children and adolescents with chronic medical conditions (CMCs), although booster sessions should be offered regularly. TRIAL REGISTRATION: The study was registered in the German Clinical Trials Register (DRKS00014043) on 26/04/2018.


Assuntos
Atitude do Pessoal de Saúde , Entrevista Motivacional , Pediatras , Humanos , Entrevista Motivacional/métodos , Adolescente , Doença Crônica/terapia , Feminino , Masculino , Pediatras/educação , Pediatras/psicologia , Adulto , Inquéritos e Questionários , Relações Médico-Paciente , Pessoa de Meia-Idade , Pediatria/educação
4.
BMC Health Serv Res ; 24(1): 589, 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38711087

RESUMO

BACKGROUND: Previous studies have identified substantial regional variations in outpatient antibiotic prescribing in Germany, both in the paediatric and adult population. This indicates inappropriate antibiotic prescribing in some regions, which should be avoided to reduce antimicrobial resistance and potential side effects. The reasons for regional variations in outpatient antibiotic prescribing are not yet completely understood; socioeconomic and health care density differences between regions do not fully explain such differences. Here, we apply a behavioural perspective by adapting the Theoretical Domains Framework (TDF) to examine regional factors deemed relevant for outpatient antibiotic prescriptions by paediatricians and general practitioners. METHODS: Qualitative study with guideline-based telephone interviews of 40 prescribers (paediatricians and general practitioners) in outpatient settings from regions with high and low rates of antibiotic prescriptions, stratified by urbanity. TDF domains formed the basis of an interview guide to assess region-level resources and barriers to rational antibiotic prescription behaviour. Interviews lasted 30-61 min (M = 45 min). Thematic analysis was used to identify thematic clusters, and relationships between themes were explored through proximity estimation. RESULTS: Both paediatricians and general practitioners in low-prescribing regions reported supporting contextual factors (in particular good collegial networks, good collaboration with laboratories) and social factors (collegial support and low patient demand for antibiotics) as important resources. In high-prescribing regions, poor coordination between in-patient and ambulatory health services, lack of region-level information on antimicrobial resistance, few professional development opportunities, and regional variations in patient expectations were identified as barriers to rational prescribing behaviour. CONCLUSIONS: Interventions targeting professional development, better collaboration structures with laboratories and clearer and user-friendly guidelines could potentially support rational antibiotic prescribing behaviour. In addition, better networking and social support among physicians could support lower prescription rates.


Assuntos
Antibacterianos , Padrões de Prática Médica , Pesquisa Qualitativa , Humanos , Antibacterianos/uso terapêutico , Alemanha , Padrões de Prática Médica/estatística & dados numéricos , Masculino , Feminino , Adulto , Entrevistas como Assunto , Clínicos Gerais/psicologia , Pediatras/psicologia , Pediatras/estatística & dados numéricos , Prescrição Inadequada/estatística & dados numéricos , Pacientes Ambulatoriais/psicologia , Pacientes Ambulatoriais/estatística & dados numéricos , Assistência Ambulatorial , Pessoa de Meia-Idade
5.
PLoS One ; 19(5): e0302815, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38771818

RESUMO

The Strengthening Care for Children (SC4C) is a general practitioner (GP)-paediatrician integrated model of care that consists of co-consulting sessions and case discussions in the general practice setting, with email and telephone support provided by paediatricians to GPs during weekdays. This model was implemented in 21 general practices in Australia (11 Victoria and 10 New South Wales). Our study aimed to identify the factors moderating the implementation of SC4C from the perspectives of GPs, general practice personnel, paediatricians and families. We conducted a qualitative study as part of the mixed-methods implementation evaluation of the SC4C trial. We collected data through virtual and in-person focus groups at the general practices and phone, virtual and in-person interviews. Data was analysed using an iterative hybrid inductive-deductive thematic analysis. Twenty-one focus groups and thirty-seven interviews were conducted. Overall, participants found SC4C acceptable and suitable for general practices, with GPs willing to learn and expand their paediatric care role. GPs cited improved confidence and knowledge due to the model. Paediatricians reported an enhanced understanding of the general practice context and the strain under which GPs work. GPs and paediatricians reported that this model allowed them to build trust-based relationships with a common goal of improving care for children. Additionally, they felt some aspects, including the lack of remuneration and the work and effort required to deliver the model, need to be considered for the long-term success of the model. Families expressed their satisfaction with the shared knowledge and quality of care jointly delivered by GPs and paediatricians and highlighted that this model of care provides easy access to specialty services without out-of-pocket costs. Future research should focus on finding strategies to ensure the long-term Implementation of this model of care with a particular focus on the individual stressors in general practices.


Assuntos
Medicina Geral , Clínicos Gerais , Humanos , Clínicos Gerais/psicologia , Medicina Geral/organização & administração , Criança , Pediatras/psicologia , Masculino , Feminino , Austrália , Grupos Focais , Pesquisa Qualitativa , Pediatria , Prestação Integrada de Cuidados de Saúde
6.
BMC Palliat Care ; 23(1): 106, 2024 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-38649882

RESUMO

BACKGROUND: As pediatricians play a vital role in pediatric palliative care (PPC), understanding their perspectives toward PPC is important. PPC is established for a long time in Belgium, but has a shorter tradition in China, although it is growing in the last decade. Sampling and comparing the perspectives of these pediatricians could be insightful for both countries. Therefore, we sampled and compared perspectives of pediatricians in China and Belgium toward PPC, and explored factors influencing their perspectives. METHODS: We conducted a cross-sectional online survey using the validated Pediatric Palliative Care Attitude Scale (PPCAS). Over a five-month period, we recruited pediatricians practicing in China (C) and Flanders (F), Belgium. Convenience sampling and snowballing were used. We analyzed data with descriptive statistics, and evaluated group differences with univariate, multivariate and correlation tests. RESULTS: 440 complete surveys were analyzed (F: 115; C: 325). Pediatricians in both regions had limited PPC experience (F: 2.92 ± 0.94; C: 2.76 ± 0.92). Compared to Flemish pediatricians, Chinese pediatricians perceived receiving less unit support (F: 3.42 ± 0.86; C: 2.80 ± 0.89); perceived PPC less important (F: 4.70 ± 0.79; C: 4.18 ± 0.94); and faced more personal obstacles while practicing PPC (F: 3.50 ± 0.76; C: 2.25 ± 0.58). Also, select socio-demographic characteristics (e.g., experiences caring for children with life-threatening condition and providing PPC) influenced pediatricians' perspectives. Correlational analyses revealed that pediatricians' PPC experiences significantly correlated with perceived unit support (ρF = 0.454; ρC=0.661). CONCLUSIONS: Chinese pediatricians faced more barriers in practicing PPC. Expanding PPC experiences can influence pediatricians' perspectives positively, which may be beneficial for the child and their family.


Assuntos
Atitude do Pessoal de Saúde , Cuidados Paliativos , Pediatras , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Bélgica , China , Estudos Transversais , Cuidados Paliativos/métodos , Cuidados Paliativos/psicologia , Cuidados Paliativos/normas , Pediatras/psicologia , Pediatras/estatística & dados numéricos , Pediatria/métodos , Pediatria/normas , Inquéritos e Questionários
7.
Fam Syst Health ; 42(1): 34-49, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38647492

RESUMO

BACKGROUND: Up to 20% of youth have impairing mental health problems as early as age 3. Early identification and intervention of mental health risks in pediatric primary care could mitigate this crisis via prevention prior to disease onset. The purpose of this study was to establish the feasibility and acceptability of implementing a brief transdiagnostic screening instrument in pediatric primary care for irritability and corollary impairment. METHOD: Five pediatric clinicians in a Midwest clinic implemented the Multidimensional Assessment Profiles-Early Assessment Screener of Irritability (MAPS-EASI) for toddlers (24-30 months) and their families. MAPS-EASI (psychometrically derived from the well-validated MAPS-Scales) includes six items (scored 0-5) about symptoms (e.g., tantrums, grumpy mood), context, and frequency and two items (scored 0-3) assessed impairment. Positive screens (MAPS-EASI ≥ 5 plus impairment ≥ 2) were referred to an evidence-based parenting intervention. We assessed reach and outcomes of MAPS-EASI screening. Follow-up interviews with clinicians assessed perspectives on irritability screening and MAPS-EASI implementation. RESULTS: Of 201 eligible families, 100 (49.8%) completed the screener for a 24- or 30-month well-child visit. Mean MAPS-EASI scores were 5.8 (SD = 3.2), mean impairment scores were 0.9 (SD = 0.9), and 24 (24.0%) screened positive. Clinicians indicated that irritability screening for toddlers was aligned with their prevention-oriented, developmentally based practice. MAPS-EASI had face validity and increased clinician decision-making confidence. Finally, clinicians identified barriers and facilitators to large-scale implementation. CONCLUSIONS: MAPS-EASI proved to be feasible and acceptable in pediatric primary care. Further tailoring will be needed as the MAPS-EASI processes are scaled out to new contexts and populations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Humor Irritável , Programas de Rastreamento , Atenção Primária à Saúde , Humanos , Feminino , Pré-Escolar , Masculino , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/estatística & dados numéricos , Atenção Primária à Saúde/normas , Programas de Rastreamento/métodos , Programas de Rastreamento/instrumentação , Programas de Rastreamento/normas , Psicometria/instrumentação , Psicometria/métodos , Pediatras/estatística & dados numéricos , Pediatras/psicologia , Pediatras/normas , Inquéritos e Questionários
8.
Hosp Pediatr ; 14(5): 364-373, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38596849

RESUMO

OBJECTIVE: Examine associations between time spent in academic activities perceived as meaningful and professional well-being among academic pediatrics faculty. METHODS: The sample comprised 248 full-time pediatric faculty (76% female, 81% white, non-Hispanic, 41% instructor or assistant professor) across the United States who completed an online survey in November 2019. Survey items included sociodemographic and professional characteristics, professional well-being measures (Stanford Professional Fulfillment Index; Maslach Burnout Inventory; Intention to Leave Academic Medicine), perceived meaningfulness of academic activities and assigned time to those activities. We defined global career fit as total percentage time assigned to professional activities considered meaningful by individuals, and activity-specific career fit as percentage time assigned to each meaningful professional activity. RESULTS: As global career fit scores increased, professional fulfillment increased (r = 0.45, P < .001), whereas burnout (r = -0.29, P < .001) and intention to leave (r = -0.22, P < .001) decreased. Regarding activity-specific career fit, for individuals who considered patient care meaningful, as assigned time to patient care increased, professional fulfillment decreased (r = -0.14, P = .048) and burnout (r = 0.16, P = .02) and intention to leave (r = 0.26, P < .001) increased. There was no significant correlation between assigned time for teaching, research, or advocacy and professional well-being. Faculty were less likely to intend to leave academic medicine as assigned time increased for administrative or leadership activities if considered meaningful (r = -0.24, P = .01). CONCLUSIONS: Time assigned to meaningful work activities may relate to professional well-being of academic pediatrics faculty. More time assigned to patient care, despite being meaningful, was associated with poor self-reported professional well-being. Effort allocation among diverse academic activities needs to be optimized to improve faculty well-being.


Assuntos
Esgotamento Profissional , Docentes de Medicina , Satisfação no Emprego , Pediatras , Humanos , Feminino , Estados Unidos/epidemiologia , Masculino , Docentes de Medicina/psicologia , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , Pediatras/psicologia , Adulto , Pediatria , Pessoa de Meia-Idade , Inquéritos e Questionários
9.
Curr Opin Pediatr ; 36(3): 315-324, 2024 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-38446153

RESUMO

PURPOSE OF REVIEW: Since the inception of social media, children have used platforms in manners unbeknownst to their parents. Just when parents feel they may finally understand what platform is relevant or trend is "in," the landscape evolves, and children shift to something new. It is therefore critical that pediatricians stay informed about what is popular in youth populations. This enables the recognition of the potential dangers of contemporary social media engagement. RECENT FINDINGS: Short-form content and livestreaming continue to rise in popularity while certain older forms of social media have retained relevancy in youth circles. YouTube is the dominant social media force, with both livestreaming and short-form offerings. Twitch and TikTok provide alternatives to YouTube for livestreaming and short-form content, respectively. Instagram and Snapchat - two social media apps that have existed for over 10 years - remain as the most popular mechanisms for children to interact with their friends online. SUMMARY: Issues related to body image, attention deficits, cyberbullying, and other potential harms have many parents wary of their child's presence on social media. Social media sites have in-place mechanisms to prevent the likelihood of harm, but pediatricians and parents should still counsel children on best social media practices.


Assuntos
Mídias Sociais , Humanos , Criança , Adolescente , Pediatras/psicologia , Pediatria/métodos , Tempo de Tela
10.
J Prim Care Community Health ; 14: 21501319231194148, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37599442

RESUMO

OBJECTIVE: During the surge of the COVID-19 pandemic, burnout among physicians increased significantly. In the spring of 2023, the COVID national emergency was terminated in the U.S. To investigate whether provider burnout rates have returned to pre-pandemic levels, the current study compared dimensions of burnout among pediatricians pre- and post-pandemic. METHOD: As part of 2 separate behavioral health trainings held at a Midwest academic health center in 2019 and virtually in 2023, data on burnout was collected from 52 pediatricians pre-pandemic and 38 pediatricians post-pandemic. Participants completed an online survey during the trainings and responded to items reflecting 3 dimensions of burnout: emotional exhaustion, depersonalization, and personal accomplishment. RESULTS: There were no statistically significant differences in pre- and post-pandemic burnout amongst pediatricians in terms of total scores, number of pediatricians who met the clinical cutoff for each dimension, number of cutoffs met, or number of providers reporting elevated burnout on at least 1 dimension (p > .05 for all comparisons). Participants were 1.77 times more likely to meet the cutoff for emotional exhaustion post-pandemic than pre-pandemic. Over half of providers met this cutoff post-pandemic, compared to only 35% pre-pandemic. CONCLUSIONS: While post-pandemic rates of burnout among pediatricians appear to be statistically similar to pre-pandemic levels, there appear to be clinically significant differences in emotional exhaustion between groups. With 63% of the post-pandemic group meeting the cutoff score for at least 1 dimension, it is imperative for the healthcare system to consider ways to mitigate burnout.


Assuntos
Esgotamento Profissional , COVID-19 , Humanos , Pandemias , COVID-19/epidemiologia , Despersonalização , Pediatras/psicologia , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , Inquéritos e Questionários
11.
Autism ; 27(8): 2407-2421, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37070240

RESUMO

LAY ABSTRACT: Latino parents may choose to use complementary health approaches, such as vitamins, supplements, and special diets, for their autistic children. However, they might not tell their pediatrician about their complementary health approach use if they worry that the pediatrician will disapprove or judge them. This fear, along with pediatricians' lack of autism knowledge, creates barriers to "shared decision-making" between parents and pediatricians. Shared decision-making is a process where families and healthcare providers collaborate and exchange information in order to come to an agreement about treatment options. In our qualitative study with 12 bilingual Latino families of autistic children, we interviewed and observed families to learn about their experiences with both conventional healthcare (their pediatrician) and complementary health approaches. Our study results describe the parents' different pathways to an autism assessment, a process that is sometimes called the "diagnostic odyssey." The parents reported that conventional healthcare met their needs for their child's physical health but not for their child's developmental challenges. The parents who used complementary health approaches for their autistic children were more frustrated about a lack of autism information from pediatricians than those who did not use complementary health approaches. Finally, we describe two examples of successful shared decision-making between parents and pediatricians. We conclude that pediatricians who are able to talk about complementary health approaches with Latino families may help to facilitate shared decision-making and reduce healthcare disparities for Latino autistic children.


Assuntos
Transtorno do Espectro Autista , Terapias Complementares , Tomada de Decisão Compartilhada , Hispânico ou Latino , Pais , Papel do Médico , Criança , Humanos , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/etnologia , Transtorno do Espectro Autista/psicologia , Transtorno do Espectro Autista/terapia , Disparidades em Assistência à Saúde , Hispânico ou Latino/psicologia , Pais/psicologia , Pediatras/psicologia , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Julgamento , Medo , Poder Familiar/etnologia , Poder Familiar/psicologia , Pesquisa Qualitativa , Terapias Complementares/métodos , Terapias Complementares/psicologia , Relações Médico-Paciente
13.
Pediatrics ; 150(3)2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-35739621

RESUMO

Although teenage pregnancy rates have decreased over the past 30 years, many adolescents become pregnant every year. It is important for pediatricians to have the ability and the resources to make a timely pregnancy diagnosis in their adolescent patients and provide them with nonjudgmental counseling that includes the full range of pregnancy options. Counseling includes an unbiased discussion of the adolescent's options to continue or terminate the pregnancy, supporting the adolescent in the decision-making process, and referring the adolescent to appropriate resources and services. It is important for pediatricians to be familiar with laws and policies impacting access to abortion care, especially for minor adolescents, as well as laws that seek to limit health care professionals' provision of unbiased pregnancy options counseling and referrals, either for abortion care or continuation of pregnancy in accordance with the adolescent's choice. Pediatricians who choose not to provide such discussions should promptly refer pregnant adolescent patients to a health care professional who will offer developmentally appropriate pregnancy options counseling that includes the full range of pregnancy options. Pediatricians should be aware of and oppose policies that restrict their ability to provide pregnant adolescents with unbiased counseling that includes the full range of pregnancy options. This approach to pregnancy options counseling has not changed since the original 1989 American Academy of Pediatrics statement on this issue.


Assuntos
Aborto Induzido , Gravidez na Adolescência , Adolescente , Criança , Aconselhamento , Feminino , Humanos , Pediatras/psicologia , Gravidez , Gravidez na Adolescência/psicologia , Estados Unidos
16.
Arch. argent. pediatr ; 120(1): 46-: I-53, III, feb 2022. tab
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-1353491

RESUMO

Introducción. El tratamiento de la diarrea aguda se basa en prevenir la deshidratación, reducir la duración y gravedad de la enfermedad. El objetivo fue conocer los patrones de tratamiento ambulatorio de la diarrea aguda en <5 años. Métodos. Estudio observacional, analítico, mediante encuestas autoadministradas a pediatras de un hospital de niños de la Ciudad Autónoma de Buenos Aires. Se indagó: edad, sexo, lugar de trabajo, fuentes bibliográficas, indicación de tratamientos farmacológicos, no farmacológicos y medidas de prevención e higiene. Se evaluó la asociación entre prescripciones farmacológicas y características de los encuestados. Resultados. Respondieron 182/216 pediatras; la edad media fue 42,4 ± 10,24 años (el 78,6 %, mujeres); el 59,2 %, del sector público; el 22,4 %, de servicios de guardia. El 91,2 % consultaba guías/consensos. El 92,9 % prescribió fórmulas de rehidratación oral; el 46,2 %, antieméticos; el 43,4 %, antiácidos y/o protectores gástricos; el 35,7 %, probióticos, y el 30,7 %, cinc. El 91,7 % indicó realimentación precoz; el 96,7 %, lactancia materna y el 96-100 %, medidas de prevención e higiene. En el análisis multivariado, tener >40 años se asoció con prescribir antiácidos/protectores gástricos (odds ratio [OR] 2,6; 1,22-5,61), probióticos (OR 3,03; 1,34-6,83) y cinc (OR 0,39; 0,17-0,87); trabajar en el sector privado con prescribir probióticos (OR 3,05; 1,56-5,94) y en servicios de guardia, con prescribir antiácidos/ protectores gástricos (OR 2,60; 1,22-5,54). Conclusiones. El tratamiento se basó principalmente en hidratación, alimentación precoz y lactancia. La edad y el lugar de desempeño de los pediatras modifican el patrón de prescripción.


Introduction. The management of acute diarrhea is based on preventing dehydration and reducing disease duration and severity. The study objective was to establish the patterns for the outpatient management of acute diarrhea in children younger than 5 years. Methods. Observational, analytical study using a self-administered survey among pediatricians from a children's hospital in the Autonomous City of Buenos Aires. Age, sex, place of work, bibliographic sources, indication of drug and non-drug therapies, and preventive and hygiene measures were recorded. The association between drug prescription and the characteristics of surveyed pediatricians was assessed. Results. In total, 182/216 pediatricians completed the survey. Their mean age was 42.4 ± 10.24 years; 78.6% were females; 59.2% worked in the public sector; 22.4% worked in the emergency department; and 91.2% consulted guidelines and/or consensuses. Also, 92.9% prescribed oral rehydration solutions; 46.2%, antiemetics; 43.4%, antacids and/or gastric protectors; 35.7%, probiotics; and 30.7%, zinc. Early food reintroduction was indicated by 91.7%; breastfeeding, by 96.7%; and preventive and hygiene measures, by 96-100%. The multivariate analysis showed an association between age > 40 years and prescribing antacids/ gastric protectors (odds ratio [OR]: 2.6; 1.22-5.61), probiotics (OR: 3.03; 1.34-6.83), and zinc (OR: 0.39; 0.17-0.87); between working in the private sector and prescribing probiotics (OR: 3.05; 1.565.94); and between working in the emergency department and prescribing antacids/gastric protectors (OR: 2.60; 1.22-5.54). Conclusions. Treatment was mainly based on hydration, early food reintroduction, and breastfeeding. Age and work sector affected the prescription pattern.


Assuntos
Humanos , Lactente , Pré-Escolar , Adulto , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Padrões de Prática Médica , Pediatras/psicologia , Diarreia/prevenção & controle , Diarreia/terapia , Hospitais Pediátricos
17.
Arch Argent Pediatr ; 120(1): 46-53, 2022 02.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-35068119

RESUMO

INTRODUCTION: The management of acute diarrhea is based on preventing dehydration and reducing disease duration and severity. , Ángela Gentilea INTRODUCTION The study objective was to establish the patterns for the outpatient management of acute diarrhea in children younger than 5 years. METHODS: Observational, analytical study using a self-administered survey among pediatricians from a children's hospital in the Autonomous City of Buenos Aires.Age, sex, place of work, bibliographic sources, indication of drug and non-drug therapies, and preventive and hygiene measures were recorded. The association between drug prescription and the characteristics of surveyed pediatricians was assessed. RESULTS: In total, 182/216 pediatricians completed the survey. Their mean age was 42.4 ± 10.24 years; 78.6% were females; 59.2% worked in the public sector; 22.4% worked in the emergency department; and 91.2% consulted guidelines and/or consensuses. Also, 92.9% prescribed oral rehydration solutions; 46.2%, antiemetics; 43.4%, antacids and/or gastric protectors; 35.7%, probiotics; and 30.7%, zinc. Early food reintroduction was indicated by 91.7%; breastfeeding, by 96.7%; and preventive and hygiene measures, by 96-100%. The multivariate analysis showed an association between age > 40 years and prescribing antacids/ gastric protectors (odds ratio [OR]: 2.6; 1.22-5.61), probiotics (OR: 3.03; 1.34-6.83), and zinc (OR: 0.39; 0.17-0.87); between working in the private sector and prescribing probiotics (OR: 3.05; 1.565.94); and between working in the emergency department and prescribing antacids/gastric protectors (OR: 2.60; 1.22-5.54). CONCLUSIONS: Treatment was mainly based on hydration, early food reintroduction, and breastfeeding. Age and work sector affected the prescription pattern.


Introducción. El tratamiento de la diarrea aguda se basa en prevenir la deshidratación, reducir la duración y gravedad de la enfermedad. El objetivo fue conocer los patrones de tratamiento ambulatorio de la diarrea aguda en<5 años. , Anabella C. Pacchiottia,b , Cómo citar: Castelllano VE, Giglio ND, Pacchiotti AC, Gentile Á. Manejo ambulatorio de la diarrea aguda infantil: encuesta a pediatras de un hospital pediátrico de la Ciudad de Buenos Aires. Arch Argent Pediatr 2022;120(1):46-53. a. División Promoción y Protección de la Salud, Área Epidemiología. b. Departamento de Urgencia. Hospital de Niños Dr. Ricardo Gutiérrez, Ciudad Autónoma de Buenos Aires, Argentina. Correspondencia: Vanesa E. Castellano: vane0108@hotmail.com Financiamiento: Este estudio recibió colaboración irrestricta del laboratorio Sanofi Aventis, utilizada para el material de las encuestas, equipamiento informático y una beca educacional para la Dra. Anabella Pacchiotti. Conflicto de intereses: V. Castellano, N. Giglio y Á. Gentile han participado como disertantes de conferencias auspiciadas por el laboratorio Sanofi Aventis en congresos y jornadas. Recibido: 11-5-2021 Aceptado: 15-9-2021 Métodos. Estudio observacional, analítico, mediante encuestas autoadministradas a pediatras de un hospital de niños de la Ciudad Autónoma de Buenos Aires. Se indagó: edad, sexo, lugar de trabajo, fuentes bibliográficas, indicación de tratamientos farmacológicos, no farmacológicos y medidas de prevención e higiene. Se evaluó la asociación entre prescripciones farmacológicas y características de los encuestados. Resultados. Respondieron 182/216 pediatras; la edad media fue 42,4 ± 10,24 años (el 78,6 %, mujeres); el 59,2 %, del sector público; el 22,4 %, de servicios de guardia. El 91,2 % consultaba guías/consensos. El 92,9 % prescribió fórmulas de rehidratación oral; el 46,2 %, antieméticos; el 43,4 %, antiácidos y/o protectores gástricos; el 35,7 %, probióticos, y el 30,7 %, cinc. El 91,7 % indicó realimentación precoz; el 96,7 %, lactancia materna y el 96-100 %, medidas de prevención e higiene. En el análisis multivariado, tener >40 años se asoció con prescribir antiácidos/protectores gástricos (odds ratio [OR] 2,6; 1,22-5,61), probióticos (OR 3,03; 1,34-6,83) y cinc (OR 0,39; 0,17-0,87); trabajar en el sector privado con prescribir probióticos (OR 3,05; 1,56-5,94) y en servicios de guardia, con prescribir antiácidos/ protectores gástricos (OR 2,60; 1,22-5,54). Conclusiones. El tratamiento se basó principalmente en hidratación, alimentación precoz y lactancia. La edad y el lugar de desempeño de los pediatras modifican el patrón de prescripción.


Assuntos
Diarreia/terapia , Pacientes Ambulatoriais , Pediatras/psicologia , Padrões de Prática Médica , Adulto , Pré-Escolar , Diarreia/prevenção & controle , Feminino , Hospitais Pediátricos , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade
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