西班牙裔儿童以患者和家庭为中心的护理相关因素：一项二级分析。

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics Pub Date : 2025-04-08 DOI:10.1016/j.acap.2025.102828

Jared LeBron MHS, BA , Sarah Ronis MD, PhD

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引用次数: 0

摘要

目的：尽管文献记载了以患者和家庭为中心的护理（PFCC）的益处，但与非西班牙裔儿童相比，西班牙裔儿童的PFCC发生率明显较低。本研究旨在确定与西班牙裔儿童接受PFCC相关的具体因素。方法：使用2020-21年全国儿童健康调查的数据，进行横断面二次分析，检查护理人员报告的临床医生和实践水平对PFCC差异的影响，特别关注美国西班牙裔与非西班牙裔儿童和青少年的家庭中心护理（FCC）和共同决策（SDM）。描述性统计用于描述社会、人口和医疗保健经历。分层多变量logistic回归分析评估了西班牙裔儿童FCC/SDM与关键协变量的关联。所有的分析都被加权，以解释复杂的调查设计。结果：在93,669名受访者中（代表约7270万非机构的美国儿童和青少年，25.7%确定为西班牙裔或拉丁裔），西班牙裔儿童的照顾者如果在保险覆盖范围内存在差距，则报告经历FCC和SDM的可能性显着降低(FCC aOR=0.53, 95% CI: 0.37, 0.76；SDM aOR=0.38, 95% CI: 0.18, 0.80)或生活在英语不是主要语言的家庭(FCC aOR=0.68, 95% CI: 0.52, 0.89；SDM aOR=0.53, 95% CI: 0.33, 0.87)。此外，没有私人医生与报告FCC的几率较低相关（aOR=0.44, 95% CI: 0.34, 0.57）。结论：缺乏与私人医生的稳定关系和有限的语言适当服务与西班牙裔儿童PFCC和SDM的低报告显著相关。这些关联突出了进一步研究和质量改进的潜在目标。

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Factors Associated With Patient- and Family-Centered Care in the Hispanic Pediatric Population: A Secondary Analysis

Objective

Despite the documented benefits of patient- and family-centered care (PFCC), Hispanic children experience significantly lower rates of PFCC compared to non-Hispanic children. This study aimed to identify specific factors associated with the receipt of PFCC among Hispanic children.

Methods

Using data from the 2020–21 National Survey of Children's Health, cross-sectional secondary analyses were conducted to examine caregiver-reported clinician- and practice-level contributors to disparities in PFCC, specifically focusing on family-centered care (FCC) and shared decision-making (SDM) among US Hispanic versus non-Hispanic children and youth. Descriptive statistics were used to characterize social, demographic, and health care experiences. Stratified multivariable logistic regression analyses evaluated, among Hispanic children, associations of FCC/SDM with key covariates. All analyses were weighted to account for the complex survey design.

Results

Among 93,669 respondents (representing approximately 72.7 million noninstitutionalized US children and youth, 25.7% identifying as Hispanic or Latino), caregivers of Hispanic children were significantly less likely to report experiencing FCC and SDM if they had gaps in insurance coverage (FCC adjusted odds ratio [aOR] = 0.53, 95% Confidence Interval (CI): 0.37, 0.76; SDM aOR = 0.38, 95% CI: 0.18, 0.80) or lived in households where English was not the primary language (FCC aOR = 0.68, 95% CI: 0.52, 0.89; SDM aOR = 0.53, 95% CI: 0.33, 0.87). Additionally, not having a personal doctor was associated with lower odds of reporting FCC (aOR = 0.44, 95% CI: 0.34, 0.57).

Conclusions

A lack of stable relationships with personal doctors and limited availability of language-appropriate services were significantly associated with lower reports of PFCC and SDM among Hispanic children. These associations highlight potential targets for further research and quality improvement.

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来源期刊

Academic Pediatrics PEDIATRICS-

CiteScore

4.60

自引率

12.90%

发文量

300

审稿时长

60 days

期刊介绍： Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.