更頻繁的篩檢可以減少兒童的精神健康問題


  2003 年4月10 日(奧蘭多) - KYSS運動的建立者及領導人,同時也是紐約的羅切斯特大護理學學校的副教務長Bernadette Mazurek Melnyk博士,在美國國家兒科護士和從業者協會的會議中(NAPNAP)表示,在4個孩童和青少年之中,就有一個出現身心失調的問題,並且影響他們在家庭或學校中的表現。
  
  Melnyk博士指出,這種問題的發生率其實是被低估的,大部份是因為醫療人員所進行的篩檢不夠充足。儘管發生率如此高,卻只有一小部份的父母或孩子表示曾與他們的醫師或護士人員談論關於身心方面的議題,KYSS運動的設計,便是為了改變這種現象。
  
  KYSS的立場是「讓您的孩子與您自己安全無虞。」KYSS於2001年由NAPNAP建立,KYSS的目標是防止和減少兒童和青年時期的精神疾病問題。這項運動由超過20個專業組織,包括美國兒科學會、美國校院健康協會和青少年醫學學會。
  
  這項運動從一項全國性,包含621名兒童和青少年及603個父母的調查開始,最初發表於兒科醫療保健期刊的2002年九月/十月號中。由兒童、青少年及父母所確認的前五名的精神健康憂慮包括:
  
  •如何應付在他們的生活中的緊張事物
  
  •意志消沉
  
  •焦慮
  
  •自尊
  
  •父母和孩子的關係
  
  實際上,大約25%的孩子幾乎時常擔心如何應付令他們感到緊張的事物。另一個從這項研究所得到的重要發現是,儘管許多孩子和父母有這些憂慮,但是只有非常少數的人與他們的護士或醫師談論過這個話題。
  
  臨床工作者必須意識到這些問題同時提供協助。Melnyk建議,篩檢是強調這些議題中,最重要的第一步。基層的醫護照顧者詢問兒童「你每天感覺到的壓力有多大?」,另外,父母也應該被詢問「您認為您的孩子是否能應付壓力?」
  
  Melnyk博士給予護士和醫師的回家作業,便是經常檢查身心方面的問題,並且與孩子和父母談論關於他們所關心的事。
  
  KYSS的下一步,包括為醫療從業人員提供一個密集的專題研討會、線上教學、一個網站、一項喚醒公眾意識的運動,和一門職業教育計劃的核心課程。
  

More Frequent Screening Recomm

By
Medscape Medical News

Susan Yox

April 10, 2003 (Orlando) — One in 4 children and teenagers has a psychosocial problem that affects their functioning at home or school, Bernadette Mazurek Melnyk, PhD, RN, CPNP, FAAN, founder and director of the KYSS Campaign, and associate dean at the University of Rochester School of Nursing, in New York, said here at the meeting of the National Association of Pediatric Nurse Practitioners (NAPNAP).

"This incidence is believed to be underestimated due, in large part, to inadequate screening by primary care providers," Dr. Melnyk pointed out. Despite the high incidence, only a small percentage of parents or children report talking to their physician or nurse practitioner about psychosocial concerns. The KYSS Campaign is designed to change that.

KYSS stands for "Keep Your Children/Yourself Safe and Secure." Founded in 2001 by NAPNAP, the goal of KYSS is to prevent and reduce psychiatric problems in children and youth. The campaign is now endorsed and/or supported by more than 20 professional organizations, including the American Academy of Pediatrics, the American School Health Association, and the Society for Adolescent Medicine.

The campaign began with a national survey of 621 children and teens and 603 parents, originally reported in the September/October 2002 issue of the Journal of Pediatric Healthcare. The top five mental health worries identified by children/teens and their parents included:

  1. How to cope with stressful things in their lives.
  2. Depression.
  3. Anxiety.
  4. Self-esteem.
  5. Parent-child relationships.

In fact, about 25% of kids worried about how to cope with stressful things often to nearly always. Another important finding from the study is that despite the fact that so many children and parents have these worries, only a very small percentage talked to their nurse practitioner or physician about them.

Clinicians need to be aware of these concerns to be able to help. "Screening is a vital first step in beginning to address these issues," Dr. Melnyk advised. She recommends primary care providers ask children, "How stressed do you feel each day?" Parents should be questioned as well, asking "How well do you think your kids cope with stress?"

Dr. Melnyk's take-home message to nurse practitioners and physicians was to screen more often for psychosocial problems, and then to talk to children and parents about their concerns. Next steps for KYSS include an intensive workshop for primary care providers, online courses, a Web site, a public awareness campaign, and a core curriculum for professional education programs.

NAPNAP Annual Meeting: Concurrent Session. Presented April 10, 2003.

Reviewed by Gary D. Vogin, MD

Susan Yox, RN, EdD, is Editor/Program Director of Medscape Nurses.

    
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