OBJECTIVE: Clarify the current developmental surveillance and screening practices of one pediatric oncology team.
METHODS: Researchers reviewed charts for patients (n = 66) seen at a pediatric oncology clinic in a suburban academic medical center to determine engagement in developmental screening (including functioning around related areas such as speech, neurocognition, etc.) and referrals for care in these areas.
RESULTS: Developmental histories were collected from all patients through admission history and physical examination (H&P), but there was no routinized follow-up. Physicians did not conduct regular developmental screening per American Academy of Pediatrics guidelines for any patients but identified n = 3 patients with needs while the psychology team routinely surveilled all patients seen during this time (n = 41) and identified n = 18 patients as having delays.
CONCLUSIONS: Physicians did not routinely screen for development needs beyond H&P and were inconsistent in developmental follow-up/referrals. Integrated psychologists were key in generating referrals for developmental-based care. However, many oncology patients were not seen by psychologists quickly or at all, creating a significant gap in care during a crucial developmental period.
CONCLUSIONS: The case is made for further routinization of ongoing developmental screening in pediatric oncology care.
目的:阐明一个儿科肿瘤学团队目前的发展监测和筛查实践。
方法:研究人员回顾了在郊区学术医疗中心的儿科肿瘤诊所看到的患者(n=66)的图表,以确定是否参与发育筛查(包括相关领域的功能,如言语,神经认知,等。)和转介这些地区的护理。
结果:通过入院史和体格检查(H&P)收集所有患者的发展历史,但是没有常规的后续行动。医师没有根据美国儿科学会指南对任何患者进行定期发育筛查,但确定了n=3例有需求的患者,而心理学小组则定期对这段时间内看到的所有患者进行了监视(n=41),并确定n=18例患者有延误。
结论:医生没有常规筛查H&P以外的发育需求,并且在发育随访/转诊方面不一致。综合心理学家是产生基于发展的护理推荐的关键。然而,许多肿瘤患者没有被心理学家迅速或根本没有看到,在关键的发展时期,在护理方面造成了巨大的差距。
结论:在儿科肿瘤学护理中,正在进行的发育性筛查的进一步常规化。