摘要
【目的】通过专科医院和区妇幼保健院分别对早产儿系统管理和干预,探索实施高危儿早期干预的有效模式。【方法】分别由复旦大学附属儿科医院和卢湾区妇幼保健院定期随访早产儿共90例。每次随访对早产儿行发育评估、给予家长针对性干预指导、记录家长的依从性。统计依从性和失访率,比较不同模式下早期干预参与率的差异。【结果】专科模式管理的早产儿失访率较高(39.4%),社区模式失访率较低(12.5%),两种模式失访率差异有统计学意义(P<0.05)。早产儿失访和家长依从性、双亲文化程度呈显著负相关;而家长依从性和双亲文化程度呈显著正相关。失访原因以家长认为"没必要随访"最多,占总失访数的34.5%;其次为"居住距离远"、"去了外地"和"太忙没时间随访"。【结论】依托三级妇幼保健网络的社区早期干预模式更有效,失访率较低,管理更系统;但还存在参与率较低、家长不重视随访干预等问题。
[Objective] To investigate effective systematic operational mode of early intervention（El） for high-risk infants. [Methods] Pediatricians in Department of Child health, Children＇s Hospital of Fudan University （upper firstclass hospital） and Luwan District Maternity and Child Health Hospital （second-class hospital） included preterm infants, assessed their growth and development, and adopted EI approaches to train their parents on every follow-up visit respectively. 90 preterm infants were followed up regularly and received El monthly. Those were recorded and analyzed that parents ＇ compliance, the drop-out rate in follow-ups and the rate of participation in EI services. [Results] The drop-out rate of developmental follow-up was significantly higher in the upper first-class hospital （39.4% ） than that in the second-class hospital （12.5%）. Infants with better educated parents were more likely to attend follow-up and have higher compliance with El parents training （followed up： university-college versus losing follow-up： high school-middle school）. Parents who were not aware of the EI importance, the distance between infants residency and the hospital, floating population were important factors of drop-out. Compliance with EI parents training and parents＇ education were positively correlated with follow-up at- tendance. The infant gender, gestational age did not effect follow up rates. [Conclusions] The operational mode of Luwan District Maternity and Child Health Hospital, which is a community-based, family-centered and three-tiered medical- care network coordinated system, was more effective. The mode had lower drop-out rate, close contact with preterm infants in the community. However, problems still exist in this mode, such as lower rate of EI participation and a lack of recognitions of the importance of EI.
出处
《中国儿童保健杂志》
CAS
2010年第11期870-873,共4页
Chinese Journal of Child Health Care
基金
上海市教育科学研究项目(B07048)
关键词
高危儿
早期干预
模式
high-risk infant
early intervention
mode
