New consensus definition on defining and measuring care for children with paediatric feeding disorder.

AIM: This study addresses the absence of a definition of care for children with feeding disorders, limited agreement on key performance indicators (KPIs), and the lack of data linked to those KPIs. METHODS: Clinicians, consumers and researchers involved in outpatient feeding care in New South Wales (NSW), Australia were invited to participate in a two-Phase study. In Phase 1, a modified Delphi method was used. Two rounds of voting resulted in a new consensus definition of a multidisciplinary paediatric feeding clinic. Three further rounds voting determined relevant KPIs. In Phase 2, the KPIs were piloted prospectively in 10 clinics. RESULTS: Twenty-six clinicians, consumers and researchers participated in Phase 1. Participation across five voting rounds declined from 92% to 60% and a valid definition and KPI set were created. In Phase 2, the definition and KPIs were piloted in 10 clinics over 6 weeks. Data for 110 patients were collected. The final KPI set of 28 measures proposed covers clinical features, patient demographics and medical issues, parent-child interaction and outcome measures. CONCLUSIONS: A new definition of a multidisciplinary paediatric feeding clinic is now available, linked to a standardised KPI set covering relevant performance measures. These proved viable in baseline data collection for 10 clinics across NSW. This sets a foundation for further data collection, systematic measurement of care provision and outcomes, and research needed to deliver care improvement for children with paediatric feeding disorder.

Fear of needles--nature and prevalence in general practice.

BACKGROUND: The extent to which a fear of needles influences health decisions remains largely unexplored. This study investigated the prevalence of fear of needles in a southeast Queensland community, described associated symptoms, and highlighted health care avoidance tendencies of affected individuals. METHODS: One hundred and seventy-seven participants attending an outer urban general practice responded to a questionnaire on fear of needles, symptoms associated with needles and its influence on their use of medical care. RESULTS: Twenty-two percent of participants reported a fear of needles. Affected participants were more likely than participants with no fear to report vasovagal symptoms, have had a previous traumatic needle experience (46.2 vs. 16.4%, p<0.001) and avoid medical treatment involving needles (20.5 vs. 2.3%, p<0.001). DISCUSSION: Fear of needles is common and is associated with health care avoidance. Health professionals could better identify and manage patients who have a fear of needles by recognising associated vasovagal symptoms and past traumatic experiences.