父母接受健康教育对首发精神分裂症康复后复发的影响

目的 探讨随访5年中康复后首发精神分裂症患者父母接受健康教育对复发率的影响.方法 对111例首发住院的精神分裂症患者随机分为教育组(56例,10例脱落)和对照组(55例,12例脱落),对教育组患者父或母在患者住院和出院后的5年中有计划地进行健康教育;对照组仪采用常规的复诊或一般性随访;2组均进行为期5 a的随访,比较治疗依从性和复发情况.结果 2组出院后5 a随访治疗各时段依从性比较,差异有统计学意义(P＜0.05或P＜0.01);教育组各年PANSS量表总分明显低于对照组(P＜0.05或P＜0.01);教育组和对照组第5年复发率,2组比较,差异有统计学意义(P＜0.01).但随着时间的推移2组复发率均呈上升趋势.结论 对父母实施健康教育在首发精神分裂症抗复发中具有积极的意义,但随着时间的推移健康教育只能加强不能削弱,否则治疗的依从性就会下降,复发率就会逐年上升.     

Quality assurance in day surgery: do we do enough for the parents to prevent stress?

In order to identify and analyse the factors associated with stress for the parents during day surgery, we performed a survey analysis of 568 parents whose children underwent surgery consecutively during an 18-month period. Of 368 parents who returned the questionnaire, (follow up rate=65%), 16% experienced the stress associated with day surgery as moderate to severe. The following factors had a significant positive association with the amount of stress: feeling of insufficient preparation (odds ratio; 95% confidence interval) 3.34 (1.36–8.26; P=0.002), insecurity in nursing care at home 3.36 (1.43–11.01; P=0.01), problems at home such as fever, vomiting, sleep disorders and others 3.15 (1.72–5.8; P=0.0007), problems with postoperative pain at home 2.43 (1.38–4.3); P=0.008), speaking a foreign language 2.28 (1.08–4.78); P < 0.0001) and no previous surgery 1.31 (0.76–2.27); P=0.03). Analysing these factors showed that often not the problems per se, but rather the insecurity in dealing with them contributed to the experienced stress. Conclusion In order to improve the quality of health care, more pronounced attention has to be given to the parents needs and expectations. Received: 5 January 1999 / Accepted in revised form: 23 June 1999     

A two-year prospective study of the health-related quality of life of children with chronic illness – the parents’ perspective

The aim of this study was to assess prospectively changes in the health-related quality of life (HRQL) of children and adolescents with diabetes, asthma or cystic fibrosis (CF). One hundred and twenty-two parents of children aged 10–16 years with asthma, diabetes, or CF were recruited from specialist paediatric clinics. Parents described their childrens HRQL using the Child Health Questionnaire (PF98) at baseline, 6, 12, 18 and 24 months post-baseline. They reported that the general health of children with CF was significantly worse than that of children with asthma and diabetes at baseline. In other domains there were few differences between the HRQL of children in the three groups. In several domains, the HRQL of children with asthma or diabetes improved over the 2years of the study. This improvement was less evident for children with CF.     

A comparison of the effects of parental risk markers on pre- and perinatal variables in multiple patient cohorts with fetal alcohol syndrome, autism, Tourette syndrome, and sudden infant death syndrome: an enviromic analysis

The prevalence and magnitude of effect of individual risk markers for specific developmental disorders vary widely across diagnostic category. The four study cohorts for this project were patients from four diagnostic registries in North Dakota for fetal alcohol syndrome (FAS), autism, sudden infant death syndrome (SIDS), and Tourette syndrome. These four cohorts were used to estimate prevalence and magnitude of effect of parental risk markers in patients with developmental disabilities. Cases with North Dakota birth certificates were matched with controls. Using birth certificate data, we then examined five parental risk markers for each cohort and estimated direct and indirect effects for each risk marker by cohort. The authors found two significant paternal risk markers (age in SIDS and education in FAS). Significant maternal markers were age in SIDS, education in FAS, autism, and SIDS. Marital status was a significant risk marker in FAS. Effect sizes were estimated using paired t tests, odds ratios, and population attributable risk (PAR) for both direct and indirect effects for each marker. We estimated both direct and indirect effects to allow for direct comparisons of the differential effect estimates of each of these markers. The direct effect of parental markers differs across diagnostic cohorts of patients. Use of cohorts from similar denominator populations obtained from prevalence studies is a useful methodological tool for estimating the prevalence and magnitude of effect of risk markers.     

Small bowel capsule biopsy in children: parents' opinions on children's discomfort

This questionnaire study asked the parents of 62 children undergoing small bowel capsule biopsy for their reactions to the discomfort experienced by their children. The children were randomized to receive sedation with midazolam either intravenously or intranasally. With regard to the biopsy procedure the parents of 94% of the children had no objections. The parents of 3% of the children found the biopsy very unpleasant and another 3% suggested that the biopsy should be performed under general anaesthesia. The proportion of parents with negative reactions to the biopsy procedure did not differ significantly between the intravenously and intranasally sedated children. With regard to the sedation given, the parents of 79% of the children did not think that their children were in any discomfort at all. Ten percent of the children had obvious signs of nasal discomfort using the intranasal administration. In the remaining 11% of the children the parents reported various symptoms.     

浅谈家长参与听觉口语康复

近年来,听觉口语法的康复模式逐渐得到国内专业机构和家长的认可。随着这一模式的出现,家长的角色地位也在发生改变。本文从听觉口语法的原则出发,讨论了家长作为拥护者和伙伴参与听觉口语康复的重要意义。     

青少年及其家长生殖健康知识、交流技能培训效果评价

目的评估学生及其家长进行生殖健康知识、交流技能培训的效果。方法采用整群抽样方法选取天津市3所中学的初二学生及其家长分别进行生殖健康知识、交流技能培训,在培训前后采用定量和定性方法(问卷调查和焦点人群座谈)分别进行调查,并与对照组(家长未培训)进行比较。结果培训后,学生和家长的生殖健康知识、交流能力有明显提高,与对照组比较有统计学意义(P<0.05)。结论对青少年开展性与生殖健康教育的同时,组织家长进行性与生殖健康知识、、交流技能的培训效果更显著。     

Assessment of mother and father concern in childhood hydrocephalus

Introduction Parental concern can play an important role in overall management of children with serious chronic illness. We quantitatively assessed the concerns of parents of children with hydrocephalus, using the Hydrocephalus Concerns Questionnaire for parents (HCQ-P). Methods Over a 12-month study period, parents of 332 children with hydrocephalus (mean age 11.7 years, SD 3.8) attending a routinely scheduled out-patient clinic at the Hospital for Sick Children, Toronto, completed the HCQ-P. Results HCQ-P scores were widely distributed, with mean maternal (N = 283) and paternal (N = 137) scores of 0.53 (SD 0.30) and 0.51 (SD 0.29), respectively (0 = least concerned, 1 = most concerned). Based on a multivariable regression model (adjusted R ² = 0.49), important associations with greater maternal concern were: Worse child cognitive health (p < 0.001) and worse child social-emotional health (p < 0.001). Identified important associations with greater paternal concern based on a multivariable model (adjusted R ² = 0.45) were: Worse child cognitive health (p = 0.03), worse child social-emotional health (p = 0.03), frequent child seizures (p < 0.001), younger child age at first surgery (p = 0.03) and having had an endoscopic procedure for the child’s hydrocephalus treatment (p = 0.04). Based on the adjusted multivariable models, less than 5% of parents were considered to have extreme levels of concern (either very high or very low). Conclusion This study confirms that parental concern is highly variable in this population. Much of the parental concern can be appropriately explained by child health factors.     

重庆市农村未婚年轻成人父母对给未婚青年提供生殖健康服务的态度调查

目的：通过向未婚年轻成人的父母了解未婚年轻成人未得到生殖健康需求服务的成因，以确定给未婚年轻成人提供生殖健康服务的最佳途径和可行方法。方法：采用小组访谈法，对重庆市农村地区18-24岁有婚前性行为年轻成人的父母分别访谈，讨论的内容包括父母对未婚年轻成人婚前性行为的态度，父母对婚前性行为和人工流产影响未婚年轻成人健康的认识，父母对给未婚年轻成人提供教育和服务的态度等。结果：农村父母也给子女提一些忠告，但对子女因婚前性行为导致未婚先孕，普遍采取事后补救等被动措施表现出极大忧虑。父母赞成向子女提供有针对性的相关教育和服务，希望政府和社会机构给予重视，结论：农村未婚年轻成人婚前性行为和人工流产的普遍，与其自身文化水平和科学知识不足，家庭观念落后，如父母，教师和社会相关人员生殖健康知识水平不高及社会未重视有关，建议成立青少年生殖健康促进中心，制订相应的媒体法规及将青少年生殖健康教育和生殖健康服务纳入计划生育服务范畴，将有利于保障青少年生殖健康的需求。