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首页> 外文期刊>Journal of the Canadian Academy of Child and Adolescent Psychiatry >Identification of Preschool Children with Mental Health Problems in Primary Care: Systematic Review and Meta-analysis
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Identification of Preschool Children with Mental Health Problems in Primary Care: Systematic Review and Meta-analysis

机译：初级保健中精神健康问题的学龄前儿童的鉴定：系统评价与荟萃分析

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Objective Primary care practitioners determine access to care for many preschool children with mental health (MH) problems. This study examined rates of mental health (MH) problem identification in preschoolers within primary healthcare settings, related service use, and MH status at follow-up. The findings may inform evidence-based policy and practice development for preschool MH. Method For this systematic review, MEDLINEsup?/sup, EMBASEsup?/sup, PsycInfosup?/sup, and ERIC sup?/sup were searched from inception to March 7, 2018 for reports in which a screening measure was used to identify MH problems in children aged 24–72 months, seen in primary and community health care settings. Meta-analyses, using random effects models to provide pooled estimates, were used when three or more studies examined identification rates. Findings on service use and persistence of disorders are summarized. Results Thirty-five publications representing 21 studies met the inclusion criteria. MH problems were identified in 17.6% of preschoolers (95% Confidence Interval (CI): 11.1–24.1), Q = 4.9, p 0.1 by primary/community healthcare practitioners. Psychiatric diagnoses were identified in 18.4% of preschoolers (95% CI: 12.3 – 24.4), Q= 1.6, p 0.1. Based on three studies, parents of 67–72% of identified children received advice and 26–42% received specialist referrals. In the subset of studies examining persistence of MH disorders, 25–67% of identified children had MH disorders after one to three years. Conclusion While the identification rate by primary/community practitioners is similar to the diagnostic rate, these may not consistently be the same children. Substantial variability in management and outcomes indicate need for more rigorous evaluation of primary care services for this population.
机译：客观的小主教从业者决定了对具有心理健康（MH）问题的许多学龄前儿童的护理。本研究检测了初级医疗环境，相关服务使用和后续行动状态的学龄前儿童中的心理健康（MH）问题识别。调查结果可能会为学前班MH提供基于证据的政策和实践发展。该方法的方法，Medline ？，Embase ？，psycinfo ？和eric ？被从初开始搜索到2018年3月7日，报告用于筛查措施鉴定24-72个月儿童的MH问题，在初级和社区医疗保健环境中看到。使用随机效果模型来提供池化估计的Meta-Analys，当检查识别率时，使用了汇集估计。总结了服务使用和障碍持久性的调查结果。结果三十五个出版物代表21项研究达到了纳入标准。 MH问题是在17.6％的学龄前儿童（95％置信区间（CI）：11.1-24.1），Q = 4.9，P> 0.1，由主要/社区医疗保健从业人员提供。在18.4％的学龄前儿生（95％CI：12.3-24.4）中鉴定精神诊断，Q = 1.6，p> 0.1。基于三项研究，父母的67-72％所识别的儿童获得建议，26-42％获得专业推荐。在研究MH障碍持续存在的研究中，25-67％的已识别的儿童在一到三年后患有MH障碍。结论虽然初级/社区从业者的识别率类似于诊断率，但这些可能不会一直是同一个孩子。管理和结果的大量可变性表明需要对该人群进行更严格的初级保健服务评估。

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