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1.
Semin Pediatr Neurol ; 50: 101137, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38964818

RESUMO

Previously known as Munchausen syndrome by proxy, medical child abuse is a form of child maltreatment whereby the caregiver creates an environment in which medical care harms or threatens the wellbeing of a child. Approximately 40-50 % of medical child abuse cases involve neurological symptoms, with fabricated or induced seizures accounting for a significant proportion. Identifying fictitious seizures is often difficult even for the most experienced clinicians. Therefore, having a low threshold for clinical suspicion is essential in the timely diagnosis of medical child abuse. This article provides a review of the epidemiology, diagnosis, and management of medical child abuse when it involves seizures.


Assuntos
Maus-Tratos Infantis , Neurologistas , Convulsões , Humanos , Convulsões/diagnóstico , Convulsões/terapia , Criança , Síndrome de Munchausen Causada por Terceiro/diagnóstico , Pediatras , Pediatria
2.
Ital J Pediatr ; 50(1): 126, 2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-38987808

RESUMO

BACKGROUND: Influenza represents a serious public health threat, especially for the management of severe cases and complications of the disease, requiring the implementation of control measures. We aimed to assess the acceptance and impact of qLAIV vaccination among a representative sample of family paediatricians (FPs) operating in Palermo Local Health Authority (LHA). To this end we evaluated vaccination coverage rates, comparing it with that observed in Sicilian context, while actively monitoring possible adverse reactions and their severity. METHODS: An observational descriptive non-controlled study was conducted in two phases, from September 2022 to June 2023. The first phase involved a formative and educational intervention with a pre-intervention questionnaire to assess the knowledge and attitudes of FPs on paediatric influenza vaccination. The second phase consisted of an active surveillance on qLAIV safety and acceptance among the paediatric population assisted by the participating FPs, from October 2022 to April 2023. Frequencies, chi-squared tests, and comparisons statistics were performed using Stata/MP 14.1. RESULTS: The overall coverage rate among the paediatric population involved in the intervention was 13.2%, with an I.M./qLAIV ratio of vaccine administered of 1/4.25. This coverage rate was significantly higher (p-value <0.001) when compared to the average values reported in the population under the Palermo Local Health Authority (LHA) (6.7%) and in the entire Sicily (5.9%). Adverse events in the qLAIV group were mild, with only 3.3% experiencing them, primarily presenting as a feverish rise (3.2%). No severe adverse reaction was reported. CONCLUSIONS: The educational intervention significantly raised paediatric influenza vaccination rates among the participating FPs, and in general improved influenza vaccination coverage rates in the Palermo's LHU. Minimal, non-serious adverse events underscored the vaccine's safety. Training sessions ensured paediatricians stayed informed, enabling them to provide comprehensive information to parents for secure and informed vaccination decisions in their practices.


Assuntos
Vacinas contra Influenza , Influenza Humana , Pediatras , Humanos , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Masculino , Feminino , Itália , Vacinação , Conhecimentos, Atitudes e Prática em Saúde , Fidelidade a Diretrizes , Inquéritos e Questionários , Adulto , Cobertura Vacinal/estatística & dados numéricos , Sicília , Criança , Atitude do Pessoal de Saúde
3.
Acad Pediatr ; 24(5S): 19-24, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38991797

RESUMO

The ability to exercise autonomy in achieving reproductive health goals necessitates access to contraceptive and reproductive health information and medical care. Finding trusted, comprehensive, consistent and affordable reproductive care is particularly challenging for immigrants living in the United States, especially for those without legal immigration status and for those who prefer a language other than English. In immigrant communities, sexual and reproductive health (SRH) knowledge, contraceptive choice, and family planning are influenced by many factors including tension between traditional and adopted cultural norms, limited English proficiency, restricted health care access, and structural racism. The family-centered model and longitudinal nature of relationships in pediatric primary care pose a unique opportunity to support immigrant families across the lifespan in obtaining SRH information and achieving reproductive health goals. Here, we present the unique vulnerabilities faced by immigrants seeking SRH services in the United States including both the upstream and downstream health effects of immigration status on family health. We then describe four time points across the lifespan where pediatricians can support SRH, including examples of existing SRH programming designed or adapted for immigrant families. Finally, we discuss opportunities to advance research, policy, education, and clinical care related to SRH equity for immigrant families.


Assuntos
Emigrantes e Imigrantes , Saúde Reprodutiva , Saúde Sexual , Humanos , Estados Unidos , Feminino , Acessibilidade aos Serviços de Saúde , Masculino , Serviços de Saúde Reprodutiva , Pediatras , Adolescente , Criança , Adulto
4.
Pediatr Ann ; 53(7): e269-e271, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38949875

RESUMO

Fragile X syndrome is the most commonly inherited form of intellectual disability. Identifying fragile X syndrome at a young age can be quite challenging because the classical physical features usually present in late childhood or early adolescence; therefore, it is important to consider genetic testing for all males with unexplained developmental delays, intellectual disability, and autism, females with developmental delays, intellectual disability or autism, and a family history of fragile X gene disorders. There is no specific treatment to manage fragile X syndrome. Still, a prompt referral for early intervention is essential to help maximize the child's learning potential, as well as a referral to child psychology if any behavioral concerns are present. It is of paramount importance for families with a history of fragile X syndrome to have access to genetic counseling as it can aid in future reproductive decisions and the risk of future recurrences of this condition. [Pediatr Ann. 2024;53(7):e269-e271.].


Assuntos
Síndrome do Cromossomo X Frágil , Síndrome do Cromossomo X Frágil/diagnóstico , Síndrome do Cromossomo X Frágil/genética , Humanos , Criança , Masculino , Testes Genéticos/métodos , Feminino , Aconselhamento Genético/métodos , Pediatras , Adolescente , Pediatria/métodos
5.
MedEdPORTAL ; 20: 11408, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38957524

RESUMO

Introduction: Patient encounters perceived to be challenging are common and contribute to both suboptimal patient health outcomes and provider burnout. A trauma-informed care (TIC) approach to these encounters is critical, as many of the characteristics associated with challenging patient encounters can be linked to a history of trauma exposure. Methods: Our team created and delivered a 1-hour synchronous virtual session intended to bolster provider knowledge of TIC principles and their application to challenging adolescent encounters. Participants were all faculty and staff engaged in pediatric primary care at an urban academic center, including physicians, nurse practitioners, psychologists, and social workers. The content was rooted in adult learning principles and included didactic components anchored to case-based learning with facilitated group discussions and opportunities for reflection. We used paired pre- and postsession self-assessments of provider knowledge, confidence, and practice related to TIC using Likert-scale and free-text questions. Descriptive statistics and a paired t test were used to determine the impact of the session on these metrics. Results: In 24 paired surveys, there were statistically significant increases (p ≤ .001) in participant perceived knowledge, confidence, and practice, with 100% of participants having a statistically significant improvement in one or more of these domains. There were also strongly positive Likert-scale and free-text responses regarding content relevance and delivery. Discussion: We demonstrate that a brief session can create improvement in pediatric providers' perceived knowledge about the application of TIC principles to challenging adolescent encounters as well as confidence in their ability to put these into practice.


Assuntos
Pediatras , Humanos , Adolescente , Inquéritos e Questionários , Pediatras/psicologia , Desenvolvimento de Pessoal/métodos , Feminino , Masculino , Pediatria/métodos , Ferimentos e Lesões/terapia
8.
BMC Womens Health ; 24(1): 348, 2024 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-38886697

RESUMO

BACKGROUND: As global immigration from countries with a high prevalence of female genital mutilation and cutting (FGM/C) has grown in the United States (US), there is need for pediatricians to have adequate training to care for these patients. The objective of this study is to determine the level of knowledge and attitudes of child abuse pediatricians (CAPs) towards FGM/C in the US. METHODS: This cross-sectional study distributed a peer-reviewed survey to US CAPs-members of the Helfer Society-to assess their attitudes, knowledge, clinical practice, and education about FGM/C. Data was analyzed using descriptive statistics, Kruskal-Wallis tests, and Fisher's exact test. RESULTS: Most of the 65 respondents were aware that FGM/C is illegal (92%) and agreed that it violated human rights (99%). Individuals reporting previous training related to FGM/C were significantly more likely to correctly identify World Health Organization types of FGM/C (p < 0.05) and report confidence in doing so (p < 0.05). Only 21% of respondents felt comfortable discussing FGM/C with parents from countries with a high prevalence of FGM/C. Sixty-three percent were not aware of the federal law, and 74% were not aware of their own state's laws about FGM/C. CONCLUSIONS: US CAPs have high rates of training related to FGM/C; however, they need additional training to increase confidence and ability to identify FGM/C. FGM/C remains a topic that CAPs find difficult to discuss with families. With culturally sensitive training, CAPs have the opportunity to help manage and prevent the practice by serving as educators and experts for general pediatricians.


Assuntos
Maus-Tratos Infantis , Circuncisão Feminina , Conhecimentos, Atitudes e Prática em Saúde , Pediatras , Humanos , Circuncisão Feminina/psicologia , Circuncisão Feminina/estatística & dados numéricos , Feminino , Estudos Transversais , Maus-Tratos Infantis/estatística & dados numéricos , Pediatras/estatística & dados numéricos , Pediatras/psicologia , Estados Unidos , Criança , Masculino , Adulto , Inquéritos e Questionários , Atitude do Pessoal de Saúde , Pessoa de Meia-Idade
9.
Ital J Pediatr ; 50(1): 114, 2024 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-38853266

RESUMO

BACKGROUND: The aim of this exploratory survey is to describe the current state of US (ultrasound) technique across different pediatric settings nationwide. METHODS: A questionnaire was emailed to all members of the Italian Society of Pediatrics, including pediatric residents. The survey was open from December 2021 to March 2022. RESULTS: There were 1098 respondents. Seven hundred and seven pediatricians (84.1%) reported any use of US, while 51 (44.3%) residents denied it. The majority of participants (n = 956, 87.1%) reported to have a US machine available within the department, mostly cart-based (n = 516, 66.9%) and provided from 1 to 5 years prior to the survey (n = 330, 42.8%). Lung and neonatal cerebral regions were the most frequently scanned (n = 289, 18.7% and n = 218, 14.1%, respectively). The suspicion of pneumonia or respiratory distress represented the main reasons for performing US in emergency room (n = 390, 78% and n = 330, 66%, respectively). The majority of family pediatricians reported to scan lung and kidney/urinary tract regions (n = 30, 16.9%, and n = 23,12.9%, respectively). Regarding US training, the majority of respondents (n = 358, 34.6%) declared an experience-based education, with a deficient certification enabling the use of US in 71.6% (n = 552) of cases. The most common barriers included the lack of a well-defined training program (n = 627, 57.1%), unavailability of the US machine (n = 196, 17.9%) and legal responsibility concern (n = 175, 15.9%). CONCLUSIONS: Despite the growing interest on pediatric US nationally, significant barriers still limit widespread adoption. These obstacles may be addressed through the dissemination of a specific US education plan and providing additional resources.


Assuntos
Pediatria , Padrões de Prática Médica , Ultrassonografia , Itália , Humanos , Inquéritos e Questionários , Padrões de Prática Médica/estatística & dados numéricos , Feminino , Masculino , Criança , Pediatras
10.
Soc Sci Med ; 351: 116964, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38823376

RESUMO

Parents and pediatricians play pivotal roles in promoting a nurturing environment for children's growth and development, especially during the critical first thousand days of life. Given the challenges involved in infant care and rearing, parents often rely on pediatricians' professional support in a wide range of daily caregiving practices as diverse as complementary feeding, hygiene management, pacifier use, or sleep routines. Nevertheless, little attention has been devoted to the in vivo observation of how parents actually request advice on babies' everyday care, and how pediatricians attend to such requests. By adopting a conversation analysis approach to a corpus of 23 videorecorded Italian pediatric well-child visits, the article explores the different ways through which parents navigate the face-threatening activity of soliciting the pediatrician's advice on infants' everyday care and management. The analysis illustrates that parents overall display (different degrees of) prior knowledge and competence on the topics brought to the pediatrician's attention while, at the same time, acknowledging the pediatrician's expertise and professional role. In this way, I argue that parents display themselves as competent, knowledgeable, caring, and therefore "good parents". After discussing the results, in the concluding remarks I point to what seems to be a cultural change in parent-healthcare provider interactions.


Assuntos
Pais , Humanos , Pais/psicologia , Lactente , Feminino , Masculino , Itália , Relações Profissional-Família , Cuidado do Lactente/métodos , Pediatras/psicologia , Adulto , Recém-Nascido , Conhecimentos, Atitudes e Prática em Saúde
11.
Recenti Prog Med ; 115(6): 271-275, 2024 Jun.
Artigo em Italiano | MEDLINE | ID: mdl-38853729

RESUMO

The excessive, often unconfirmed suspicions of beta-lactam allergy affect up to 10% of the general population, improperly denying a significant percentage of individuals the opportunity to be treated with first-line antibiotics, forcing clinicians to resort to second-line choices that are not always equally effective, safe, and contribute to the increase in antibiotic resistance. Pediatricians and general practitioners can play a crucial role in recognizing and addressing weak suspicions of beta-lactam allergy, actively participating in removing the "label" of being allergic. The article, based on Who AWaRe Manual recommendations, presents current evidence on the issue with practical guidance to promote accurate interpretation and management of an overestimated problem that does not encourage a culture of optimal and prudent antibiotic use.


Assuntos
Antibacterianos , Hipersensibilidade a Drogas , beta-Lactamas , Humanos , beta-Lactamas/efeitos adversos , Antibacterianos/efeitos adversos , Antibacterianos/administração & dosagem , Hipersensibilidade a Drogas/etiologia , Hipersensibilidade a Drogas/diagnóstico , Clínicos Gerais , Guias de Prática Clínica como Assunto , Padrões de Prática Médica , Farmacorresistência Bacteriana , Medicina Geral , Papel do Médico , Pediatras , Resistência Microbiana a Medicamentos , Antibióticos beta Lactam
12.
Hosp Pediatr ; 14(7): 507-513, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38832448

RESUMO

OBJECTIVES: Gender-based disparities in salary exist in multiple fields of medicine. However, there is limited data examining gender inequities in salary in pediatric hospital medicine (PHM). Our primary objective was to assess whether gender-based salary differences exist in PHM. The secondary objective was to assess if, among women, the differences in salary varied on the basis of leadership positions or self-identified race and ethnicity. METHODS: We conducted a survey-based, cross-sectional study of pediatric hospitalists in December 2021. Our primary outcomes were base and total salary, adjusted for the reported number of average weekly work hours. We performed subanalyses by presence of a leadership position, as well as race. We used a weighted t test using inverse probability weighting to compare the outcomes between genders. RESULTS: A total of 559 eligible people responded to our survey (51.0%). After propensity score weighting, women's mean base salary was 87.7% of men's base (95% confidence interval [CI] 79.8%-96.4%, P < .01), and women's total salary was 85.6% of men's total (95% CI 73.2%-100.0%, P = .05) salary. On subgroup analysis of respondents with a leadership position, women's total salary was 80.6% of men's total salary (95% CI 68.7%-94.4%, P < .01). Although women who identified as white had base salaries that were 86.6% of white men's base salary (95% CI 78.5%-95.5%, P < .01), there was no gender-based difference noted between respondents that identified as nonwhite (88.4% [69.9%-111.7%] for base salary, 80.3% [57.2% to 112.7%]). CONCLUSIONS: Gender-based discrepancies in salary exists in PHM, which were increased among those with leadership roles. Continued work and advocacy are required to achieve salary equity within PHM.


Assuntos
Hospitais Pediátricos , Salários e Benefícios , Humanos , Salários e Benefícios/estatística & dados numéricos , Feminino , Masculino , Estudos Transversais , Hospitais Pediátricos/economia , Fatores Sexuais , Adulto , Médicas/economia , Médicas/estatística & dados numéricos , Inquéritos e Questionários , Liderança , Pediatras/estatística & dados numéricos , Pediatras/economia , Médicos Hospitalares/economia , Médicos Hospitalares/estatística & dados numéricos , Sexismo/estatística & dados numéricos
14.
Pediatrics ; 154(1)2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38903051

RESUMO

OBJECTIVE: To develop guidance for pediatric clinicians on how to discuss race and racism in pediatric clinical settings. METHODS: We conducted a modified Delphi study from 2021 to 2022 with a panel of pediatric clinicians, psychologists, parents, and adolescents with expertise in racism and child health through scholarship or lived experience. Panelists responded to an initial survey with open-ended questions about how to talk to youth about race and racism. We coded the responses using qualitative methods and presented them back to the panelists. In iterative surveys, panelists reached a consensus on which themes were most important for the conversation. RESULTS: A total of 29 of 33 panelists completed the surveys and a consensus was reached about the concepts pediatric clinicians should consider before, during, and after conversations about race and racism and impediments clinicians may face while having these discussions. Panelists agreed that it was within the pediatric clinician's role to have these conversations. An overarching theme was the importance of having background knowledge about the systemic nature of racism. Panelists agreed that being active listeners, learning from patients, and addressing intersectionality were important for pediatric clinicians during conversations. Panelists also agreed that short- and long-term benefits may result from these conversations; however, harm could be done if pediatric clinicians do not have adequate training to conduct the conversations. CONCLUSIONS: These principles can help guide conversations about race and racism in the pediatric clinical setting, equipping clinicians with tools to offer care that acknowledges and addresses the racism many of their patients face.


Assuntos
Comunicação , Técnica Delphi , Pediatria , Racismo , Humanos , Criança , Relações Médico-Paciente , Adolescente , Pediatras/psicologia , Grupos Raciais , Feminino , Masculino
15.
Adv Pediatr ; 71(1): 69-86, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38944490

RESUMO

Eating Disorders are psychiatric conditions that can manifest clinically as malnutrition due to restrictive eating and weight control behaviors or obesity due to binge eating. Eating disorders such as anorexia and bulimia nervosa have peak onset during adolescence and young adulthood. This population is at the highest risk due to psychosocial changes surrounding identity development and body image that occurs during this life-stage. Though binge eating disorder and avoidant/restrictive food intake disorder are not characterized by body image overvaluation, peak onset is also during adolescence and young adulthood.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos , Humanos , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/etiologia , Adolescente , Criança , Pediatras/psicologia , Imagem Corporal/psicologia , Feminino
16.
Adv Pediatr ; 71(1): 17-27, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38944482

RESUMO

A primer for pediatric providers on understanding stigma in health care, the terminology and types of stigma, the conditions commonly faced with stigma in pediatrics, the components of evidence-based anti-stigma initiatives, and guidance to effect change within a pediatric practice. The authors outline the negative effects of stigma in pediatrics and how to combat the problem at the source, and explore self-stigma, public stigma, and structural stigma and how it applies to weight, diabetes, disability, HIV, mental health, and substance use in pediatrics.


Assuntos
Estigma Social , Humanos , Criança , Pediatria , Pediatras/psicologia , Estereotipagem
17.
Pediatr Obes ; 19(8): e13146, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38880989

RESUMO

BACKGROUND: Recent pediatric guidelines recommend clinicians offer anti-obesity medication (AOM) as an adjunct to intensive lifestyle intervention. OBJECTIVE: To investigate pediatricians' perspectives about prescribing AOM, including barriers and facilitators. METHODS: An investigator-developed survey was emailed to primary care pediatric physicians (n = 187) and advanced practice providers (n = 190) within an academic-affiliated network. The survey evaluated how willing clinicians were to prescribe AOM and their agreement with 25 statements about barriers and facilitators. Three vignettes explored AOM decision-making. Multinomial logistic regression was used to determine relative risk ratios for willingness to prescribe by agreement with each statement. RESULTS: Among 74 respondents (20% response rate), 24% were willing, 42% uncertain and 34% unwilling to prescribe. Most (64%) agreed that AOM should be managed only by specialists. Willingness to prescribe was associated with clinician motivation and belief in guideline practicality and applicability. Unwillingness was associated with beliefs that patients would not continue AOM long enough for benefit and that there was insufficient time or resources to implement. In vignettes, 52% were willing to prescribe AOM for a patient with severe obesity and metabolic complications, versus 11% for a patient with obesity and possible disordered eating. CONCLUSIONS: Willingness to prescribe AOM was low and was associated with perceived practicality and appropriateness for patients.


Assuntos
Fármacos Antiobesidade , Atitude do Pessoal de Saúde , Obesidade Infantil , Padrões de Prática Médica , Atenção Primária à Saúde , Humanos , Obesidade Infantil/tratamento farmacológico , Fármacos Antiobesidade/uso terapêutico , Feminino , Masculino , Adolescente , Padrões de Prática Médica/estatística & dados numéricos , Adulto , Pediatras/psicologia , Pediatras/estatística & dados numéricos , Inquéritos e Questionários , Pessoa de Meia-Idade
18.
Ital J Pediatr ; 50(1): 118, 2024 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-38902744

RESUMO

Food supplements are defined as foodstuffs the purpose of which is to supplement the normal diet and which are concentrated sources of nutrients or other substances with a nutritional or physiological effect, often referred to as nutraceuticals, may exert benefit to the human body. Their use is increasing worldwide, including Europe and in Italy. However, some doctors are skeptical about their effectiveness and safety. This reluctance may depend on poor knowledge of the mechanisms of action and clinical evidence in literature. The Italian Society of Pediatric Allergy and Immunology (SIAIP) promoted the institution of an ad hoc Committee. The first initiative performed by this Committee was the administration of a questionnaire to the members of SIAIP.The results of this survey provided interesting results. Most pediatricians know the food supplement concept but frequently need help understanding the mechanisms of action. Most prescribe food supplements, mainly for preventing infections or enhancing immune defense. In addition, they prefer to use food supplements as cycles or add-on therapy. Finally, most participants like to attend events on this issue and contribute to new evidence through trials.In conclusion, this survey underscores the relevance of food supplement issues and attests to interest in this topic. However, there is a need to provide information and promote studies on this matter.


Assuntos
Suplementos Nutricionais , Sociedades Médicas , Humanos , Itália , Inquéritos e Questionários , Atitude do Pessoal de Saúde , Criança , Alergia e Imunologia , Pediatria , Padrões de Prática Médica , Masculino , Pediatras , Feminino
20.
Arch. argent. pediatr ; 122(3): e202310204, jun. 2024. tab, gráf
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-1554934

RESUMO

Introducción. El descenso de las coberturas de vacunación fue muy significativo en la última década. Los pediatras son una pieza fundamental para recuperar coberturas y aumentar la confianza en la vacunación. Objetivos. Describir la percepción de los pediatras acerca del conocimiento y prácticas sobre vacunas, e identificar barreras en el acceso. Métodos. Estudio analítico observacional, mediante encuesta en línea. Se incluyeron variables del perfil del profesional, capacitación y barreras en inmunizaciones. Resultados. Participaron 1696 pediatras (tasa de respuesta: 10,7 %), media de 50,4 años. El 78,7 % fueron mujeres. El 78,2 % contaba con ≥10 años de ejercicio profesional. El 78,4 % realizaba atención ambulatoria y el 56,0 % en el subsector privado. El 72,5 % realizó una capacitación en los últimos 2 años. Se manifestaron "capacitados" para transmitir a sus pacientes los beneficios de las vacunas: 97,2 %; objetivos de campañas: 87,7 %; contraindicaciones: 82,4 %; efectos adversos: 78,9 %; recupero de esquemas: 71,2 %; notificación de ESAVI: 59,5 %. La proporción fue estadísticamente superior, en todos los aspectos, en pediatras con ≥10 años de ejercicio y en aquellos con capacitación reciente (p ≤ 0,01). Barreras identificadas en el acceso a la vacunación: falsas contraindicaciones (62,3 %); falta temporaria de vacunas (46,4 %); motivos culturales (41,4 %); horario restringido del vacunatorio (40,6 %). Conclusiones. La percepción del grado de capacitación fue variable según el aspecto de la vacunación. Aquellos con mayor tiempo de ejercicio profesional y con actualización reciente se manifestaron con mayor grado de capacidad. Se identificaron múltiples barreras frecuentes asociadas al acceso en la vacunación.


Introduction. The decline in vaccination coverage has been very significant in the past decade. Pediatriciansplay a key role in catching-up coverage and increasing confidence in vaccination. Objectives. To describe pediatricians' perceptions of vaccine knowledge and practices and to identify barriers to access. Methods. Observational, analytical study using an online survey. Variables related to professional profile, training and barriers to vaccination were included. Results. A total of 1696 pediatricians participated (response rate: 10.7%). Their mean age was 50.4 years; 78.7% were women; 78.2% had ≥ 10 years of experience; 78.4% provided outpatient care and 56.0%, in the private subsector; and 72.5% received training in the past 2 years. Respondents described themselves as "trained" in convey the following aspects to their patients: benefits of vaccines: 97.2%; campaign objectives: 87.7%; contraindications: 82.4%; adverse effects: 78.9%; catchup vaccination: 71.2%; reporting of events supposedly attributable to vaccination or immunization: 59.5%. The proportion was statistically higher in all aspects, among pediatricians with ≥ 10 years of experience and those who received training recently (p ≤ 0.01). The barriers identified in access to vaccination were false contraindications (62.3%), temporary vaccine shortage (46.4%), cultural reasons (41.4%), and restricted vaccination center hours (40.6%). Conclusions. The perception of the level of training varied depending on the vaccination-related aspect. Pediatricians with more years of professional experience and those who received recent updates perceivedthemselves as more trained. Multiple barriers associated with access to vaccination were identified.


Assuntos
Humanos , Pessoa de Meia-Idade , Vacinas , Vacinação , Percepção , Argentina , Inquéritos e Questionários , Pediatras
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