Bernadette Sobczak, Gregory Jennings, Rochelle Henderson, Frank Lyerla
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引用次数: 0
Abstract
Background: Guatemala, a country with high rates of pediatric malnutrition, has significant challenges including food and potable water insecurity and a lack of health care providers.
Purpose: This study examined the impact of telehealth clinic attendance on pediatric malnutrition scores.
Methodology: A sample of 42 Guatemalan children aged 6-59 months with malnutrition were recruited to participate in eight clinic events, including two in-person and six telehealth clinics. Six telehealth clinics were held at 4- to 6-week intervals, bookended by an initial and concluding in-person event. Nonparametric tests were used to analyze changes between baseline and last visit z-scores for height, weight for length, mid-upper arm circumference (MUAC), and body mass index (BMI) and to examine the relationship between the number of telehealth visits and z-score measurements at baseline and last visit.
Results: The number of children with severe malnutrition at baseline by weight for length, BMI, and MUAC decreased by the last visit. A decrease occurred in the number of children with stunted height. Changes in z-scores for height, weight for length, BMI, and MUAC between study onset and last visit did not reach statistical significance. Statistically significant relationships existed between clinic attendance and baseline and last visit weight for height/length z-scores and baseline MUAC z-scores.
Conclusions: Positive improvements in nutritional status occurred, especially among children with severe malnutrition. Children with severe malnutrition had significantly better telehealth attendance.
Implications: Studies with larger sample sizes are needed. Study results indicate that telehealth may be a tool to battle global pediatric malnutrition.
背景:危地马拉是一个儿科营养不良发病率较高的国家,面临着粮食和饮用水不安全以及缺乏医疗服务提供者等重大挑战。目的:本研究探讨了远程保健门诊对儿科营养不良评分的影响:招募了 42 名 6-59 个月大的危地马拉营养不良儿童样本,让他们参加八次门诊活动,包括两次面对面门诊和六次远程保健门诊。六次远程保健门诊每隔 4-6 周举行一次,首次和最后一次为面对面门诊。采用非参数检验分析基线和最后一次就诊时身高、身长体重、中上臂围(MUAC)和体重指数(BMI)的 Z 值变化,并研究远程保健就诊次数与基线和最后一次就诊时 Z 值测量之间的关系:结果:在最后一次就诊时,按身长体重、体重指数和上臂伸展量计算的基线严重营养不良儿童人数有所减少。身高发育不良的儿童人数有所减少。从研究开始到最后一次就诊期间,身高、身长体重、体重指数和MUAC的Z值变化未达到统计学意义。就诊率与基线和最后一次就诊的身高/身长体重 z 值和基线 MUAC z 值之间存在统计学意义上的重要关系:结论:营养状况得到了积极改善,尤其是严重营养不良的儿童。严重营养不良儿童参加远程保健的情况明显好转:启示:需要进行样本量更大的研究。研究结果表明,远程保健可能是解决全球儿科营养不良问题的一种工具。
期刊介绍:
The Journal of the American Association of Nurse Practitioners (JAANP) is a monthly peer-reviewed professional journal that serves as the official publication of the American Association of Nurse Practitioners.
Published since 1989, the JAANP provides a strong clinical focus with articles related to primary, secondary, and tertiary care, nurse practitioner education, health policy, ethics and ethical issues, and health care delivery. The journal publishes original research, integrative/comprehensive reviews, case studies, a variety of topics in clinical practice, and theory-based articles related to patient and professional education. Although the majority of nurse practitioners function in primary care, there is an increasing focus on the provision of care across all types of systems from acute to long-term care settings.