儿童保健门诊婴幼儿发生营养性缺铁性贫血的危险因素及门诊指导

目的 探讨分析儿童保健门诊婴幼儿发生营养性缺铁性贫血的危险因素及门诊指导。方法 择取本院儿童保健门诊在2019年6月-2022年6月接收的60例营养性缺铁性贫血患儿为研究对象,观察分析患儿发生营养性缺铁性贫血的危险因素,并且分析实施门诊指导干预后的效果。结果 6个月至1岁婴儿的贫血发生率要高于1～3岁幼儿;足月儿的贫血发生率要低于未足月儿;母孕期贫血的婴幼儿贫血发生率要高于母孕期未贫血的发生率;4～6个月龄时未按时添加辅食的贫血发生率要高于按时添加辅食的婴幼儿;低出生体重儿的贫血发生率要高于非低出生体重儿;挑食厌食儿童的贫血发生率高于不挑食厌食儿童;留守儿童的贫血发生率要高于非留守儿童。但是人工喂养、母乳喂养以及混合喂养贫血与不同性别贫血等发生营养性缺铁性贫血的发生率差异无统计学意义（P>0.05）。结论 婴幼儿发生营养性缺铁性贫血主要和年龄、足月情况以及母孕期贫血、挑食厌食、未按时添加辅食、低出生体重儿、留守儿童等多种因素有关,通过对其实施相应的儿童保健门诊指导干预,能够有效改善患儿的贫血严重程度,促进婴幼儿的健康成长。     

儿童保健门诊婴幼儿营养性缺铁性贫血监测

儿童贫血是小儿时期常见的疾病,以营养性缺铁性贫血最为常见.贫血可导致体格及智力发育障碍,免疫力低下,继之并发多种疾病.对其发病原因和相关因素的分析,制定有效的预防措施是儿童保健工作的重点.本文对443名健康婴幼儿进行缺铁性贫血患病情况分析如下.     

儿童保健门诊婴幼儿营养性缺铁性贫血的临床效果观察

目的:观察儿童保健门诊婴幼儿营养性缺铁性贫血的临床效果.方法:随机选择我院保健门诊部门的婴幼儿,共100例,收集时间在2015年12月~2016年2月期间,以此作为研究对象,对所有婴幼儿的临床资料进行回顾性分析,并对其实施定期的血常规检查,以此查明婴幼儿营养性缺铁性贫血的发生率,以此对造成营养性缺铁性贫血的相关原因进行分析和总结.结果:在100例婴幼儿中,共有30例婴幼儿发生了营养性缺铁性贫血情况,其发生率为30.00%,其中,与1~2岁的婴幼儿相比,6个月~1岁的婴幼儿营养性缺铁性贫血发生率明显更高,有统计学意义,p<0.05;与及时添加了辅食的婴幼儿相比,没有添加辅食的婴幼儿营养性缺铁性贫血发生率明显更高,有统计学意义,p<0.05.结论:对婴幼儿进行定期的临床检测,可以及早发生婴幼儿是否存在营养性缺铁性贫血,对其及时添加辅食,可以有效降低该类贫血的发生率.     

婴幼儿缺铁性贫血与喂养方式的探讨

缺铁性贫血是婴幼儿常见病之一，我国6个月至2岁婴幼儿中较多见，患病率约为20％～30％，农村高于城市。主要原因与喂养不当、未及时补充铁质有关。指导喂养、预防及及时纠正婴幼儿缺铁性贫血是儿保工作者的一项重要任务。     

闵行区婴幼儿贫血现状调查分析

缺铁性贫血是小儿的一种常见病,也是儿童保健重点预防四大疾病之一。近年来,我区学龄前儿童贫血发病率一直较难控制,尤以6个月~3岁的婴幼儿发病最多。为了寻求各方面原因,制定对策,积极防治本病,我们对闵行区12个乡镇散居贫血患儿的发病及治疗过程中的相关因素进行了调查,现汇总如下。1资料与方法采用问卷调查的方法收集资料,贫血调查表由我科设计。由我区12个乡镇的儿保医生对各自地段门诊患儿的家长进行调查,共调查出贫血患儿262名。2结果2·1贫血常见病因分布。喂养史中母乳喂养107例占40·8%;混合喂养114例占43·6%;人工喂养41例占15·6…     

口服铁剂结合营养保健治疗婴幼儿营养性缺铁性贫血的效果观察

目的 探讨在常规口服铁剂的基础上,配合儿童保健治疗婴幼儿营养性缺铁性贫血的临床效果.方法 选取医院儿童保健门诊在2017年1月到2018年12月期间内收治的婴幼儿营养性缺铁性贫血患儿122例作为研究对象.按照患儿的入院顺序并结合组间匹配的原则将患儿分为常规组与保健组两组,每组61名患儿.常规组患儿采用常规口服铁剂联合维...     

社区儿童保健医生营养喂养知识指导对婴幼儿营养的干预效果

目的 分析社区儿童保健医生对婴幼儿营养与喂养指导的干预效果。方法 选取2020年12月-2021年12月社区卫生服务中心的婴幼儿80例,依据对营养与喂养指导方式分成观察组及对照组,各40例。观察组给予营养喂养知识指导,对照组进行常规健康教育。对比分析两组婴幼儿的营养状况、发育商营养与喂养知识掌握率、睡眠质量等情况。结果 干预后,与对照组相比,观察组的睡眠质量评分明显较低,差异有统计学意义（P<0.05）;对照组的营养与喂养知识掌握率为80.00%,观察组为97.50%,差异有统计学意义（P<0.05）;与对照组发生的婴幼儿的不良营养状况比较,观察组的贫血、肥胖、营养不良等发生率较低,差异有统计学意义（P<0.05）;观察组的发育商高于对照组,差异有统计学意义（P<0.05）。结论 针对社区卫生服务中心的婴幼儿,通过营养与喂养知识指导,能够改善婴幼儿的睡眠质量,提升家长对营养与喂养知识掌握率,明显改善营养不良的情况,减少相关疾病的发生,改善婴幼儿发育商。     

济南市4个月至3岁婴幼儿缺铁性贫血调查分析

目的 了解济南市药山社区婴幼儿缺铁性贫血现状,探讨影响济南市儿童缺铁性贫血的影响因素,促进小儿健康成长.方法 对2007年10月至2010年12月来山东黄河医院儿保门诊健康查体的1 094例4个月至3岁健康足月婴幼儿进行研究,查末梢血血常规,分析各年龄段贫血患病率,进一步分析贫血与6个月内喂养方式、母亲文化程度、喂养习惯与缺铁性贫血的关系.结果 药山社区4个月至3岁婴幼儿缺铁性贫血总患病率为37.9%(415/1 094),其中轻度贫血占88.2%(366/415),中度贫血占11.8%(49/415).贫血的患病率与月龄、母亲文化程度、6个月内喂养方式、是否合理添加辅食有关,6个月~<12月婴儿患病率明显高于其他组(χ2=14.95~31.93,P<0.01);母亲文化程度高者贫血的患病率低(χ2=10.86~47.02,P<0.01);人工喂养者的患病率明显高于母乳和混合喂养者(χ2=15.26~23.38,P<0.01);合理添加辅食者贫血的患病率明显下降(χ2=31.18,P<0.01).结论 药山社区婴幼儿贫血总患病率仍较高,贫血现状不容乐观,应采取有效措施大力改善婴幼儿营养性缺铁性贫血.     

社区健康教育防治婴幼儿贫血的效果评价

目的 :探索社区健康教育对防治婴幼儿贫血效果。方法 :于 2 0 0 2年 8～ 12月收集丹阳市云阳镇 6～ 12月的婴幼儿贫血资料 ,进行健康教育干预。结果 :干预前后健康教育组与对照组贫血率统计学分析有显著性差异。结论　婴幼儿健康的生长发育与家长的儿童保健知识有关。     

儿童保健门诊就诊情况分析

<正> 随着社会文明的进步,家长越来越重视优生优育,这就给儿童保健工作提出了更高的要求。而儿保门诊就诊情况的分析,可以反映相应阶段内本地区儿童保健需求的变化,以指导儿保门诊临床工作的开展,医院及儿保医生必须适应新的形势,在儿保工作中实行全方位,多层次的服务,才能拓宽和深入做好儿童保健门诊工作。本文收集了2001年9月     

The substitutability of outpatient primary care in rural community health centers for inpatient hospital care.

To determine whether outpatient medical care obtained at federally funded rural community health centers (CHCs) in Maine acts primarily as a substitute or as a complement to inpatient care, a study of 36 communities served by CHCs was conducted. The hospital use of CHC users (age- and sex-adjusted admissions, days, and length of stay) was compared with that of nonusers from the same communities in 1980. Statistically lower rates of hospital admissions and days were observed for all CHC patients and for selected groups based on their age, sex, and insurance status (specifically Medicaid or Medicare). Hospital use of CHC community populations was then compared with that of 24 comparison communities without access to CHCs, using multiple linear regression in a pre/post design. The model tested, which included rates of health center use, insurance penetration, poverty, and hospital availability, among other factors, did not detect any differences in hospital use between CHC community and comparison populations. These results and additional data presented on selected hospital diagnoses and insurance coverage suggest that treatment, and hospitalization incentives, of CHC providers may reduce hospitalization. Clinic providers lack the economic, professional, and institutional incentives to hospitalize. Additional study to determine the actual substitutability effect is indicated.     

Mothers' health beliefs and children's clinic visits

This paper reports results from a prospective study of the relationship between mothers' health attitudes and beliefs and their utilization of pediatric clinic services for their children. Attitudinal data were obtained in interviews with a random sample of mothers attending the Children and Youth clinic of a large teaching hospital; data about children's clinic visits during a period of 3 1/2 years subsequent to the interview were abstracted from their medical records. Four aspects of clinic utilization were examined: visits for well-child care; acute-illness visits; accident-related visits; and appointment keeping. Health attitudes were found to be associated with both preventive and illness/accident visits, but in opposite directions. Mothers with an active, interventionist orientation towards health care and mothers who attributed good health and low illness-susceptibility to their children were high users of preventive services and generated few illness/accident visits. Conversely, more passive mothers, and mothers who perceived their children to be in poor health and susceptible to illness, were responsible for fewer well-child and more illness/accident visits. Mothers' agreement with the physician's diagnosis at the index visit was an additional strong predictor of use of well-child services, while disagreement was associated with more visits for illness and accidents. The convenience of appointment times and general satisfaction with the clinic were the best predictors of appointment keeping.These results indicate the importance of distinguishing between different dimensions of health care utilization in studies that attempt to account for this behavior; they also suggest that modification of health attitudes may prove to be an effective way to bring about positive changes in patterns of health services use.Drs. Becker and Kirscht are Professors, Department of Health Behavior and Health Education, School of Public Health, The University of Michigan, 1420 Washington Heights, Ann Arbor, Michigan 48109; Dr. Nathanson is Associate Professor, Department of Population Dynamics, School of Hygiene and Public Health, and Dr. Drachman is Associate Professor, School of Medicine, The Johns Hopkins University, Baltimore, Maryland. This research was supported by grant HD-00061 from the National Institute of Child Health and Human Development.     

Reported cessation advice given to African Americans by health care providers in a community health clinic

Physician smoking cessation advice has been shown to be effective in encouraging patients to attempt cessation. Few studies have examined factors associated with patient-reported physician advice in an inner city community health clinic. Smokers identified via chart review and provider referral met with a study smoking specialist. Eligible participants self-identified as African American, smoked at least 1 cigarette per day in the prior 7 days, were 18 or older, had access to a telephone, and agreed to consider blood testing for genetic susceptibility to lung cancer. Of the 869 smokers identified, 487 were eligible and completed a brief in-person and a more extensive follow-up telephone survey within one week after their visit. Patient reports of smoking cessation advice by providers were regressed on patient demographic, smoking, health, and social support variables. Seventy percent of participants reported that they had been advised to quit smoking. Smokers who were older, did not smoke menthol cigarettes, were in poorer health, and who had a regular health care provider were most likely to report having received advice. Patients in this community health setting reported high rates of provider advice to quit smoking. Yet, even in this optimal condition, young healthy smokers did not report receiving advice, even when they were ready to quit smoking. Providers may need additional training and prompting to counsel young healthy smokers about the importance of cessation.     

高危儿分类转诊对社区儿童保健工作的影响

目的分析高危儿分类转诊模式对社区儿保工作的影响。方法 2014年4月在交通社区实行高危儿分类转诊,观察分类转诊后社区高危儿的分布情况,并对分类转诊前后社区高危儿转诊情况及高危儿家长转诊态度调查情况进行分析。结果分类转诊前共建档395人,高危儿110例,分类转诊后共建档478人,高危儿143例,Ⅰ类高危儿108例,Ⅱ类高危儿35例。分类转诊后转诊率明显低于分类前(P0.01);分类后转诊依从率明显高于分类前(P0.01);分类转诊前后高危儿筛查率、阳性率、专案管理率差异无统计学意义(P0.05)。Ⅱ类高危儿家长对高危儿转诊必要性、依从性、了解程度明显高于I类高危儿家长(P0.01)。结论高危儿分类转诊是高危儿系统管理的重要环节,能提高高危儿随访依从性,促进高危儿社区管理模式完善,可在社区儿童保健中推广。     

The impact of a complex care clinic in a children's hospital

Background The number of medically complex and fragile children (MCFC) cared for in children's hospitals is growing, necessitating the need for optimal care co‐ordination. The purpose of this study was to describe the impact of a nurse practitioner/paediatrician‐run complex care clinic in a tertiary care hospital on healthcare utilization, parental and primary care provider (PCP) perceptions of care and parental quality of life. Methods MCFC and their parents were recruited for ambulatory follow‐up by the hospital team to complement care provided by the PCP in this mixed methods single centre pre‐ or post‐evaluative study. Parents participated in semi‐structured interviews within 48 h of discharge; further data were collected at 6 and 12 months. Healthcare utilization was compared with equal time periods pre‐enrolment. Parental health was assessed with the SF‐36; parental perceptions of care were assessed using the Larsen's Client Satisfaction Questionnaire and the Measure of Processes of Care; PCPs completed a questionnaire at 12 months. Parental and PCP comments were elicited. Comparisons were made with baseline data. Results Twenty‐six children and their parental caregivers attended the complex care clinic. The number of days that children were admitted to hospital decreased from a median of 43 to 15 days, and outpatient visits increased from 2 to 8. Mean standardized scores on the SF‐36 increased (improved) for three domains related to mental health. A total of 24 PCPs responded to the questionnaire (92% response); most found the clinic helpful for MCFC and their families. Parents reported improvements in continuity of care, family‐centredness of care, comprehensiveness and thoroughness of care, but still experienced frustrations with access to services and miscommunication with the team. Conclusion A collaborative medical home focused on integrating community‐ and hospital‐based services for MCFC is a promising service delivery model for future controlled evaluative studies.