Do Subspecialists Ask About and Refer Families with Psychosocial Concerns? A Comparison with General Pediatricians.
Objectives Calls for pediatricians to tend to children's psychosocial concerns have existed for decades because they are known to negatively impact child health. Children with chronic illnesses frequently have child- and family-level psychosocial concerns that complicate the care provided by their p...
| Published in: | Maternal & Child Health Journal Vol. 23; no. 1; pp. 61 - 72 |
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| Main Authors: | , , , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Springer Nature
Jan2019
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=134038393&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 134038393 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10927875 N9J jtl: Maternal & Child Health Journal issn: 10927875 maglogo: N pubinfo: dt: Jan2019 vid: 23 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 134038393 134038393 134038393 10.1007/s10995-018-2594-y 134038393 ppf: 61 ppct: 11 formats: fmt: @attributes: type: P tig: atl: Do Subspecialists Ask About and Refer Families with Psychosocial Concerns? A Comparison with General Pediatricians. aug: au: Green, Cori Stein, Ruth E. K. Storfer-Isser, Amy Garner, Andrew S. Kerker, Bonnie D. Szilagyi, Moira Hoagwood, Kimberly E. Horwitz, Sarah M. affil: General Academic Pediatrics, Weill Cornell Medical College/NewYork Presbyterian Hospital, New York, NY, USA sug: subj: Professional Practice Referral and Consultation Chronic Disease Psychosocial Factors Health Personnel Pediatricians Professional-Family Relations Mental Health In Infancy and Childhood Funding Source Human Specialties, Medical Cross Sectional Studies Questionnaires Health Screening Child Univariate Statistics Bivariate Statistics Multivariate Analysis Odds Ratio Descriptive Statistics Logistic Regression Structured Questionnaires Chi Square Test Linear Regression Confidence Intervals Male Female Bullying Substance Abuse Depression Marital Status Parents Child Abuse, Sexual Exposure to Violence Food Security Adult Middle Age Job Experience Child: 6-12 years Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Objectives Calls for pediatricians to tend to children's psychosocial concerns have existed for decades because they are known to negatively impact child health. Children with chronic illnesses frequently have child- and family-level psychosocial concerns that complicate the care provided by their pediatric subspecialists. This study compares pediatricians who exclusively practice general pediatrics with subspecialists regarding their inquiring/screening and referring for psychosocial concerns. Physician and practice characteristics associated with these behaviors were examined. Methods We conducted a cross-sectional study using the 2013 American Academy of Pediatrics Periodic Survey of Fellows. Respondents included 304 pediatricians who exclusively practice general pediatrics and 147 subspecialists. The primary analysis compared the current practices of generalists vs. subspecialists with regard to inquiring/screening and referring children with 10 different psychosocial concerns. Covariates included socio-demographics, practice characteristics, and training experiences. Weighted univariate, bivariate and multivariable analyses were performed. Results Less than half of all pediatricians in the sample reported routinely inquiring/screening for most psychosocial concerns, and 2/3 of subspecialists failed to routinely inquire/screen for most of these conditions. Pediatricians who practice general pediatrics exclusively were more likely to inquire/screen (incident rate ratio (IRR) 1.41, p < .05) and refer (IRR 1.59, p < .001) for a greater number of psychosocial concerns than subspecialists, after adjusting for provider and practice characteristics. Having attended a child or adolescent mental health (MH) lecture/conference in the past 2 years was also related to inquiring/screening (IRR 1.24, p < .05). Conclusions Pediatricians infrequently inquire/screen and refer psychosocial concerns, with subspecialists addressing these concerns even less frequently. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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