佛山市南海区高危儿随访及失访原因和干预效果分析

Causes of follow-up and loss to follow-up of high-riskinfants in nanhai district of foshan and the intervention effects

目的:了解南海区高危儿疾病特征、随访现状及其影响因素。方法:收集2016年1月至2017年12月高危儿857例,对高危因素特征和随访情况进行分析;采用自制调查问卷,进行12月龄以内随访依从性及失访原因调查。针对主要的失访原因干预后,收集2018年1月至2018年12月共563例高危儿的随访情况并进行对比。结果:857例高危儿中前5位高危因素分别是早产低出生体重儿、颅内出血、高胆红素血症、窒息、新生儿呼吸窘迫综合征。随访依从性与高危儿家长文化程度、就医路程、主要带养人等有关。失访的主要原因是家长主观因素,对随访重要性认识不足;其次是客观性因素如工作忙碌。干预后,高危儿的失访率明显降低。结论:完善高危儿系统管理,促进高危儿社区管理模式完善,强化高危儿家长宣教力度,可降低失访率,减少高危儿后遗症发生。

Objective: To understand the disease characteristics in high-risk infants in Nanhai District, the follow-up condition and its influencing factors. Methods: 857 children with high risk diseases were collected from January of 2016 to December of 2017, and the characteristics of high-risk diseases and the follow-up conditions were analyzed. A self-designed questionnaire was used to investigate the compliance and causes for the loss to follow-up among infants within 12 months of age. The follow-up situation of 563 high-risk children from January 2018 to December 2018 was collected after the intervention for the main reasons of the loss of follow-up. Results: The top 5 risk factors of 857 high risk infants were preterm low birth weight, intracranial hemorrhage, hyperbilirubinemia, asphyxia and neonatal respiratory distress syndrome. Follow-up compliance was related to the education level of the parents of high-risk infants, the distance of medical treatment and the main caregivers. The loss to follow-up was caused by the subjective factors of parents, the insufficient awareness of the importance of follow-up, followed by such objective factors as busy work. After intervention, the rate of loss to follow-up visit to high-risk infants was significantly reduced. Conclusion: It is important to improve the systematic management of high-risk infants, promote the improvement of the community management mode of high-risk infants, strengthen the publicity and education of high-risk infants’ parents and reduce the rate of loss of follow-up visits in order to reduce the sequelae of high-risk infants.