福建省0~6岁儿童心理保健筛查路径及三级管理平台的应用

doi:10.11852/zgetbjzz2023-0645

中国儿童保健杂志 ›› 2023, Vol. 31 ›› Issue (12): 1386-1392.DOI: 10.11852/zgetbjzz2023-0645

• 适宜技术 • 上一篇

福建省0~6岁儿童心理保健筛查路径及三级管理平台的应用

黄欣欣, 缪崇, 徐立波, 欧萍

福建省妇幼保健院,福建医科大学妇儿临床医学院,福建福州 350001

收稿日期:2023-07-03 修回日期:2023-10-06 发布日期:2023-12-04 出版日期:2023-12-10
通讯作者: 欧萍,E-mail:1876299746@qq.com
作者简介:黄欣欣(1980-),女,副主任医师,主要研究方向为儿童心理保健。
基金资助:
福建省科技厅引导性项目(2023Y0056)

Application of mental health screening pathway and three-level management platform for 0- to 6-year-old children in Fujian Province

HUANG Xinxin, MIAO Chong, XU Libo, OU Ping

Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian 350001, China

Received:2023-07-03 Revised:2023-10-06 Online:2023-12-10 Published:2023-12-04
Contact: OU Ping, E-mail: 1876299746@qq.com

摘要/Abstract

摘要： 目的研发并验证适合基层使用的儿童心理发育筛查路径,搭建县-市-省儿童心理保健的监测平台。方法 2019年1月—2020年3月,在福建九地市开展分层整群抽样研究,遴选相应条目构建儿童心理发育筛查模式,进行真实性和可靠性验证。2020年4月起,将筛查路径构建监测平台,进行日常管理。结果分别纳入3 526、3 568、3 553例0~6岁儿童样本用于构建智能、运动协同及社会交往与生活能力的筛查模式。智能、运动协调、社会交往与生活能力筛查模式的AUC分别为0.872~0.993、0.902、0.914~0.990(P<0.05);Cronbach's α系数分别为0.731~0.938、0.767、0.784~0.837(P<0.05);结构效度分别为0.692~0.829、0.672~0.793、0.736~0.864(P<0.05)。经统计学检验,其信效度良好;灵敏度、特异度分别为84.73%、89.26%;82.77%、92.16%;91.84%、96.93%。将筛查模式搭建区域性信息平台,智能化生成筛查报告。共筛查29 355人,发现初筛阳性儿童8 513人,已有8 183例儿童转专科进一步诊疗,高危管理率96.12%。结论本项目探索出可供基层使用的儿童心理保健路径,监测平台与儿童心理筛查技术有效融合可提升工作效率,可提高儿童心理保健的覆盖面,提升高危儿管理率,促进个案闭环管理及分级诊疗,实现二级预防。

关键词: 心理保健, 筛查, 区域性, 监测平台

Abstract: Objective To develop and validate a screening pathway for children's mental development suitable for primary care, in order to establish a monitoring platform for children's mental health care at the county, city, and province levels. Methods From January 2019 to March 2020, a stratified cluster sampling study was conducted in nine cities of Fujian province. Relevant items were selected to construct the screening model of children's mental development, and the validity and reliability were verified. Since April 2020, a monitoring platform has been built for routine management of the screening pathway. Results A total of 3 526, 3 568 and 3 553 samples of 0- to 6-year-old children were collected to construct the screening model of intelligence, motor cooperation, social interaction and life ability. The screening models for intelligence, motor coordination, social interaction, and life ability showed AUCs of 0.872 - 0.993, 0.902, and 0.914-0.990, respectively (P<0.05). The Cronbach's α coefficient of three dimensions was 0.731 - 0.938, 0.767 and 0.784 - 0.837, respectively (P<0.05). The construct validity was 0.692 - 0.829, 0.672 - 0.793 and 0.736 - 0.864, respectively (P<0.05). The statistical test showed that the model had good reliability and validity. The sensitivity and specificity were 84.73% and 89.26% for intelligence, 82.77% and 92.16% for motor coordination, and 91.84% and 96.93% for social interaction, respectively. A regional information platform was created to digitize the screening reports. A total of 29 355 children were screened, and 8 513 children tested positive for the initial screening. Among them, 8 183 children were referred to specialists for further treatment, resulting in a high-risk management rate of 96.12%. Conclusion The effective integration of monitoring platform and children's psychological screening technology can improve work efficiency, increase the coverage of children's mental health care, enhance the management rate of high-risk children, promote case closed-loop management and hierarchical diagnosis and treatment, and achieve secondary prevention.

Key words: mental healthcare, screening, regional, monitoring platform

中图分类号:

R179

黄欣欣, 缪崇, 徐立波, 欧萍. 福建省0~6岁儿童心理保健筛查路径及三级管理平台的应用[J]. 中国儿童保健杂志, 2023, 31(12): 1386-1392.

HUANG Xinxin, MIAO Chong, XU Libo, OU Ping. Application of mental health screening pathway and three-level management platform for 0- to 6-year-old children in Fujian Province[J]. Chinese Journal of Child Health Care, 2023, 31(12): 1386-1392.

参考文献

[1] Chawanpaiboon S, Vogel JP, Moller AB, et al. Global, regional, and national estimates of levels of preterm birth in 2014:A systematic review and modelling analysis[J]. Lancet Glob Health,2019,7(1):e37-e46.
[2] Balasundaram P, Avulakunta ID. Bayley Scales of Infant and Todder Development[M]//StatPearls. Treasure Island (Fl): StatPearls Publishing, 2021.
[3] Qiu S, Lu Y, Li Y, et al. Prevalence of autism spectrum disorder in Asia: Asystematic review and meta-analysis[J]. Psychiatry Res, 2020, 284:112679.
[4] 国家卫生健康委会.国家卫生健康委关于印发健康儿童行动提升计划(2021—2025年)的通知(国卫妇幼发〔2021〕33号)[EB/OL].[2020-11-29]http://www.nhc.gov.cn/fys/s3585/202111/554a64ff0eff4971a37db413a00083a6.shtml.
[5] 毛鹏远.以“一体化”为导向的三级妇幼保健机构卫生服务提供协同模式研究[D].南京:南京中医药大学,2019.
Mao PY. Research on the collaborative mode of health servicedelivery in three-level maternal and child health care[D]. Nanjing:Nanjing University of Chinese Medicine,2019. (in Chinese)
[6] 黄发云,曹华,陈良万.我院“一动力三循环”医疗质量管理模式的构建与实施[J].中华医院管理杂志,2018,34(6):469-473.
Hauang FY, Cao H, Chen LW." One driver & three-cycle" management model of medical quality: Building and application[J].Chin J HospAdmin,2018,34(6):469-473. (in Chinese)
[7] 张诗.GESELL发育量表与 Griffiths精神发育量表对2岁自闭症儿童的应用价值[J].现代诊断与治疗,2020,31(8):1202-1204.
Zhang S.The application value of Gesell Development Scale and GriffithsPsychological Development scale to 2-year-old children with autism[J].Modern Diagnosis and Therapy,2020,31(8):1202-1204. (in Chinese)
[8] 任少波.幼儿感觉统合评估量表的编制[D].沈阳:沈阳师范大学,2020.
Ren SB. Development of sensory integration assessment scale for toddlers [D]. Shenyang:Shenyang Normal University, 2020.
[9] 郑梅珍.蒙台梭利教育模式对幼儿社会适应行为发展影响的实验研究[D].长沙:湖南大学,2003.
Zhang MZ.Experimental research on the influence of Montessori education model on the development of children's social adaptive behavior [D]. Changsha: Hunan University, 2003. (in Chinese)
[10] Sheldrick RC, Marakovitz S, Garfinkel D, et al.Comparative accuracy of developmental screening questionnaires[J].JAMA Pediatr, 2020,174(4):366-374.
[11] 谈芳,吴爽,周驰,等. 浙江省医共体内基层医务人员健康管理服务能力自评分析[J].中华医院管理杂志,2020,36(8):664-667.
Tan F, Wu S, Zhou C, et al. Analysis on self-evaluation health management service capability of primary medical staff in Zhejiang's county-level medical alliances[J].Chin J Hosp Admin,2020,36(8):664-667. (in Chinese)
[12] 陈慧.市级妇幼保健机构0-6岁儿童健康服务管理现状与优化策略研究[D].杭州:浙江中医药大学,2023.
Chen H. Research on the Status and Optimization Strategy of 0-6 Years Old Children's Health Service Management in Municipal Maternal and Child Health Institution[D].Hangzhou:Zhejiang Chinese Medical University,2023. (in Chinese)
[13] 中国优生优育协会婴幼儿发育专业委员会.高危新生儿行为神经发育早期干预专家共识[J].中国儿童保健杂志,2022,30(3):233-236.
[14] 田园,陈津津,于广军.NICU出院高危儿0～3岁生长发育随访管理技术的专家共识[J].中国儿童保健杂志,2021,29(8):809-814.
Tian Y, Chen JJ,Yu GJ. Expert consensus on the follow-upmanagement technologies of growth and development from 0 to 3 years old in high-risk infants discharged from neonatal intensive care unit[J].Chin J Child Health Care, 2021,29(8):809-814. (in Chinese)
[15] 梁爱玉.全面两孩政策下己育育龄妇女生育意愿的影响因素及其对策研究[J].国际生殖健康/计划生育杂志, 2019, 38(1):5-10.
Liang AY. Study on the influencing factors and countermeasures of fertility intention of women of childbearing age under the universal two-child policy[J]. International Journal of Reproductive Health/Family Planning,2019, 38(1):5-10. (in Chinese)
[16] 孙敏.移动医疗平台在高危儿健康管理中的应用研究[D].镇江:江苏大学,2020.
Sun M. Research on application of mobile medical platform in health management of high-risk children[D].Zhenjiang:Jiangsu University, 2020.(in Chinese)
[17] 王云霞,李达,谈婷.互联网+结合优化层级管理方法在医院临床管理中的应用[J].齐鲁护理杂志,2023,29(19):163-165.
Wang YX, Li D, Tan T. Application of Internet + combined with optimized hierarchical management method in hospital clinical management[J]. Qilu Journal of Nursing, 2023,29(19):163-165. (in Chinese)
[18] 朱文俊,莫凤逸,丁欢欢,等.基于县域妇幼专科联盟分级诊疗的实践探索[J].中国医疗管理科学,2023,13(5):103-107.
Zhu WJ, Mo FY, Ding HH, et al. Practice of hierarchical diagnosis and treatment in a county-level maternal and child speciality alliance[J].Chinese Medical Management Science,2023,13(5):103-107. (in Chinese)

福建省0~6岁儿童心理保健筛查路径及三级管理平台的应用

Application of mental health screening pathway and three-level management platform for 0- to 6-year-old children in Fujian Province

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

[1]	韦萍, 韦霁珊, 黄旭华, 张宇星, 刘湘红, 何仲彪, 莫靖媛, 黄增帅, 玉群. 心脏听诊、血氧饱和度检测联合吸氧情况在广西新生儿先天性心脏病筛查中的应用[J]. 中国儿童保健杂志, 2024, 32(9): 1034-1039.
[2]	刘畅, 张立琴, 杜玮, 刘婷廷. 2023年美国儿科学会先天性甲状腺功能减低症筛查与管理指南解读[J]. 中国儿童保健杂志, 2024, 32(6): 637-642.
[3]	陈巧玲, 陆韦. 住院患儿营养风险筛查的研究进展[J]. 中国儿童保健杂志, 2024, 32(6): 653-660.
[4]	刘振寰. 发育性运动协调障碍儿童的早期筛查与干预[J]. 中国儿童保健杂志, 2024, 32(5): 475-479.
[5]	卢凌亚, 程薇, 吕兰秋. 宁波市2017—2021年儿童先心病流行特征和趋势研究[J]. 中国儿童保健杂志, 2024, 32(2): 202-207.
[6]	干凯滟, 黄安琪, 张子一, 关陆阳, 王菲, 柯晓燕. M-CHAT筛查阳性对孤独症谱系障碍早期诊断稳定性的前瞻性研究[J]. 中国儿童保健杂志, 2024, 32(10): 1076-1079.
[7]	宋捷, 黄林娟, 郭碧丹. 学龄前营养不良儿童血清25-(OH)D₃、白蛋白、铁蛋白与STAMP评分的相关性及对临床结局的预测价值[J]. 中国儿童保健杂志, 2024, 32(1): 39-44.
[8]	李亦诚, 张媛媛, 霍言言, 吴丹, 马玲, 仇晓艳, 马晨欢, 王健, 罗洁鸣, 李天舒, 徐敬, 周洁, 孙婷婷, 沈红英, 徐蕾, 王瑜, 陈津津. 应用移动端开展孤独症谱系障碍居家早期筛查的初步研究[J]. 中国儿童保健杂志, 2023, 31(9): 963-968.
[9]	崔明明, 随光辉, 张浩, 吕岩玉, 杨素红, 王琳. 安徽淮北地区1 390名2~6岁儿童屈光筛查现状分析[J]. 中国儿童保健杂志, 2023, 31(9): 1028-1032.
[10]	曹爱华. 儿童学习障碍的早期筛查、诊断与干预[J]. 中国儿童保健杂志, 2023, 31(6): 590-594.
[11]	王洪安, 禹东川, 刘福临, 池霞. 基于机器学习探索数字划消测验用于学习障碍快速筛查的研究[J]. 中国儿童保健杂志, 2023, 31(6): 595-600.
[12]	刘安南, 姜志梅. 孤独症谱系障碍各年龄段筛查工具研究进展[J]. 中国儿童保健杂志, 2023, 31(6): 645-649.
[13]	柯晓燕. 孤独症谱系障碍早期识别与早期诊断的现状与挑战[J]. 中国儿童保健杂志, 2023, 31(3): 238-240.
[14]	王慧冉, 罗荣, 胡文玲. 2019年3所妇幼保健院早产儿视网膜病变筛查及随访分析[J]. 中国儿童保健杂志, 2023, 31(1): 105-108.
[15]	严明明, 罗淑颖, 张耀东. 郑州市城区7~15岁儿童青少年中心性肥胖流行现况[J]. 中国儿童保健杂志, 2022, 30(9): 1000-1004.