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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Evaluation of covert video surveillance in the diagnosis of munchausen syndrome by proxy: lessons from 41 cases.
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Evaluation of covert video surveillance in the diagnosis of munchausen syndrome by proxy: lessons from 41 cases.

机译：通过代理评估秘密视频监控对孟克豪森综合征的诊断：41例经验教训。

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OBJECTIVE: In 1993, Children's Healthcare of Atlanta at Scottish Rite (formery Scottish Rite Children's Medical Center, Atlanta, GA) added facilities to perform inpatient covert video surveillance (CVS) of suspected cases of Munchausen syndrome by proxy (MSBP). Forty-one patients were monitored from 1993 to 1997. This study was performed to review our experience with these cases. How useful was video surveillance in making the diagnosis? What were the characteristics of families with children who were victims of MSBP? METHODOLOGY: Medical, social work, security, and administrative records of all children who underwent covert video monitoring at Children's Healthcare of Atlanta at Scottish Rite from 1993 through 1997 were reviewed retrospectively by a team of physicians, risk managers, and social workers. RESULTS: A diagnosis of MSBP was made in 23 of 41 patients monitored. CVS was required to make the diagnosis in 13 (56.1%) of these 23, and supportive of the diagnosis in 5 (21.7%) cases. In 4 patients, this surveillance was instrumental in establishing innocence of the parents. MSBP was more common in Caucasian patients than in other ethnic groups seen at our hospital. Fifty-five percent of mothers gave a history of health care work or study, and another 25% had previously worked in day care. Although many of caretakers fit the profile of MSBP, such as excessive familiarity with medical staff, eagerness for invasive medical testing, and history of health care work, these characteristics were not sensitive indicators of MSBP in our study. Even when present, they were not sufficiently compelling to make the diagnosis. CONCLUSIONS: CVS is required to make a definitive and timely diagnosis in most cases of MSBP. Without this medical diagnostic tool, many cases will go undetected, placing children at risk. All tertiary care children's hospitals should develop facilities to perform CVS in suspected cases.
机译：目的：1993年，位于苏格兰礼拜堂的佐治亚州亚特兰大儿童保健中心（佐治亚州亚特兰大的苏格兰礼拜堂儿童医学中心）增加了设施，可以通过代理人（MSBP）对疑似Munchausen综合征病例进行住院秘密视频监视（CVS）。从1993年至1997年，对41例患者进行了监测。本研究旨在回顾我们在这些病例中的经验。视频监视在做出诊断时有多大用处？有MSBP受害儿童的家庭的特点是什么？方法：由一组医生，风险管理人员和社会工作者回顾性回顾了1993年至1997年在Scottish Rite的亚特兰大儿童保健中心接受秘密视频监控的所有儿童的医疗，社会工作，安全和行政记录。结果：监测的41例患者中有23例诊断为MSBP。其中23例中有13例（56.1％）需要进行CVS诊断，而5例（21.7％）则需要CVS进行诊断。在4例患者中，这种监视有助于建立父母的清白。在白种人患者中，MSBP比在我们医院看到的其他种族中更为常见。 55％的母亲有保健工作或学习经历，另有25％的母亲以前从事过日托工作。尽管许多护理人员符合MSBP的特征，例如对医务人员过度熟悉，渴望进行侵入性医学测试以及医疗保健工作的历史，但这些特征在我们的研究中并不是MSBP的敏感指标。即使存在，他们也不足以做出诊断。结论：在大多数MSBP病例中，需要CVS做出明确及时的诊断。没有这种医疗诊断工具，许多病例将无法被发现，从而使儿童处于危险之中。所有的三级儿童医院都应开发可疑病例进行CVS的设施。

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