سال انتشار:
2021
عنوان انگلیسی مقاله:
Recognition and Management of Protracted Bacterial Bronchitis in Australian Aboriginal Children
ترجمه فارسی عنوان مقاله:
شناخت و مدیریت برونشیت باکتریایی طولانی در کودکان بومی استرالیا
منبع:
ScienceDirect- Elsevier- CHEST, 159 (2021) 249-258: doi:10:1016/j:chest:2020:06:073
نویسنده:
Pam Laird BSc
چکیده انگلیسی:
BACKGROUND: Chronic wet cough in children is the hallmark symptom of protracted bacterial
bronchitis (PBB) and if left untreated can lead to bronchiectasis, which is prevalent in
Indigenous populations. Underrecognition of chronic wet cough by parents and clinicians
and underdiagnosis of PBB by clinicians are known.
RESEARCH QUESTION: We aimed to improve recognition and management of chronic wet
cough in Aboriginal children using knowledge translation (KT), a methodologic approach
that can be adapted for use in Indigenous contexts to facilitate effective and sustained
translation of research into practice.
STUDY DESIGN AND METHODS: A mixed-methods KT study undertaken at a remote-based
Aboriginal primary medical service (February 2017 to December 2019). Our KT strategy
included the following: (1) culturally secure (ie, ensuring Aboriginal people are treated
regarding their unique cultural needs and differences) knowledge dissemination to facilitate
family health seeking for chronic wet cough in children, and (2) an implementation strategy
to facilitate correct diagnosis and management of chronic wet cough and PBB by physicians.
RESULTS: Post-KT, health seeking for chronic wet cough increased by 184% (pre ¼ eight of 630
children [1.3%], post ¼ 23 of 636 children [3.6%]; P ¼ .007; 95% CI, 0.7%-4.0%). Physician
proficiency in management of chronic wet cough improved significantly as reflected by
improved chronic cough-related quality of life (P < .001; 95% CI, 0.8-3.0) and improved
physician assessment of cough quality (P < .001; 95% CI, 10.4%-23.0%), duration (P < .001;
95% CI, 11.1%-24.1%), and appropriate antibiotic prescription (P ¼ .010; 95% CI, 6.6%-55.7%).
INTERPRETATION: Health seeking for children with chronic wet cough can be facilitated
through provision of culturally secure health information. Physician proficiency in the
management of PBB can be improved with KT strategies which include training in culturally
informed management, leading to better health outcomes. Comprehensive strategies that
include both families and health systems are required to ensure that chronic wet cough in
children is detected and optimally managed. CHEST 2021; 159(1):249-258
KEYWORDS: bronchiectasis | community health | cough | health-care disparities | pediatrics
قیمت: رایگان
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