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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Medical evaluation of overweight children and adolescents: reports from pediatricians, pediatric nurse practitioners, and registered dietitians.
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Medical evaluation of overweight children and adolescents: reports from pediatricians, pediatric nurse practitioners, and registered dietitians.

机译：超重儿童和青少年的医学评估：儿科医生，儿科护士和注册营养师的报告。

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OBJECTIVE: The primary aim of this study was to determine how pediatric health care providers identify overweight in children and adolescents and how they evaluate obesity-related medical complications. This information can guide development of programs to help providers improve their evaluation practices. A secondary objective was to examine the association of certain provider characteristics with recommended evaluation practices. METHODS: A random sample of pediatricians, pediatric nurse practitioners (PNPs), and registered dietitians received a questionnaire about their evaluation of overweight children and adolescents. Results were compared with published recommendations. Associations between respondent characteristics and adherence to published recommendations were examined. RESULTS: A total 940 providers responded (response rate: 19%-33%). Among all 3 groups a majority frequently used clinical impression, weight-for-age percentile, weight-for-height percent, and weight-for-height percentile to assess degree of overweight. Nearly all pediatricians and PNPs routinely evaluated blood pressure, but a minority routinely looked for orthopedic problems, insulin resistance, and sleep disorders. Less than 10% followed all recommendations for history and physical examination. Two thirds of pediatricians and PNPs routinely tested for lipid abnormalities. Most providers asked about family history of overweight, hypertension, cardiovascular disease, and diabetes, but only one third asked about gallbladder disease. In general, the provider's specialty, years in practice, gender, and body mass index were not associated with adherence to recommended practices. CONCLUSIONS: Medical evaluation of overweight children and adolescents fell short of recommended practices. These results point to the need for educational efforts to increase awareness of medical risks and for tools to facilitate more complete evaluation during office visits.
机译：目的：本研究的主要目的是确定儿科医疗保健提供者如何确定儿童和青少年的超重以及他们如何评估与肥胖相关的医疗并发症。这些信息可以指导程序的开发，以帮助提供者改善其评估实践。第二个目标是检查某些提供者特征与建议的评估实践之间的关联。方法：随机抽取儿科医生，儿科护士执业医师（PNP）和注册营养师作为样本，对他们对超重儿童和青少年的评估进行问卷调查。将结果与已发布的建议进行了比较。考察了受访者特征与对已发布建议的依从性之间的关联。结果：共有940个提供者进行了答复（答复率：19％-33％）。在这三组中，大多数人经常使用临床印象，年龄加权体重，体重加权体重和体重加权百分比来评估超重程度。几乎所有的儿科医生和PNP例行评估血压，但是少数例行例行检查骨科问题，胰岛素抵抗和睡眠障碍。不到10％遵循了所有有关病史和身体检查的建议。三分之二的儿科医生和PNP例行检测脂质异常。大多数提供者询问了超重，高血压，心血管疾病和糖尿病的家族病史，但只有三分之一的人询问了胆囊疾病。通常，提供者的专业，执业年限，性别和体重指数与遵守推荐做法无关。结论：对超重儿童和青少年的医学评估未达到推荐的做法。这些结果表明，需要进行教育努力以提高人们对医疗风险的认识，并需要使用工具来促进在就诊期间进行更全面的评估。

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