[Influence of maternal anxiety on the frequency of paediatric primary care visits]

[Psychosocial aspects associated with excessive attendance in primary care paediatric clinics]

OBJECTIVE

Hyper-attendance is a significant problem in paediatric Primary Care clinics. The aim of our study was to analyse the level of attendance in these clinics and its relationship with certain psychosocial aspects of the families attending them.

PATIENTS AND METHODS

Observational descriptive study was conducted using questionnaires collected during a period of 6months, as well as recording the frequency of attendance in the previous 6months. A total of 346 questionnaires of children between 6months and 13years of age belonging to 2 urban Primary Care clinics in Madrid were completed. The raw data was analysed, and comparisons between groups and multivariate analysis were performed.

RESULTS

The mean number of consultations in the last 6months, of the total included in the study, was 3.06 in the Primary Care centre, and 0.77 in the emergency services. It was considered over-frequent for those who had attended the Primary Care health centre 6 or more times in this period (>p90), of which there were 33 children (9.53%). In the multivariate analysis, the variables related to being frequent users of Primary Care clinics were: the presence of high level of anxiety in the parents (OR=5.50; 95%CI: 2.49-12.17, P<.0001), and the age of the children (OR=0.73; 95%CI: 0.58-0.91, P=.005). The model presented an area under the curve of 0.761 (95%CI: 0.678-0.945, P<.0001).

CONCLUSIONS

The frequency of visits in paediatric Primary Care clinics is directly related to the high level of anxiety of the parents, and inversely to the age of the children. It would be advisable to detect and, if possible, intervene in cases of high parental anxiety in order to try to reduce the over-frequency in the paediatric primary health care.

[Maternal mental health: a risk factor affecting the social and emotional well-being of Mexican children]

Objectives

To estimate the prevalence of symptoms of depression and anxiety in mothers from three population areas in the state of San Luis Potosí, Mexico, and to analyze the association between these symptoms and the emotional health of their children.

Methods

Assessment was conducted on 173 mother-child pairs from three different population areas: urban, rural, and indigenous rural. Women's symptoms of depression and anxiety were evaluated, together with their children's behavioral problems.

Results

A high prevalence of symptoms of depression and anxiety was found in the three areas included. The proportion of depressive symptoms was highest in the urban and rural areas (38.7% and 38.6%, respectively). The highest prevalence of anxiety symptoms was observed in the rural area (31.8%). The strongest association between maternal anxiety and maternal depression was found in the rural area (odds ratio [OR] = 11.0; 95% CI: 1.3-95.5). The indigenous rural area showed the highest prevalence of behavioral problems among children (61%). An association between such problems and maternal anxiety (OR = 2.2; 95% CI: 1.1-4.3) and maternal depression (OR = 2.5; 95% CI: 1.3-4.6) was noted.

Conclusions

The mental health of mothers can put the social and emotional well-being of their children at risk. This conclusion is supported by the findings, namely high prevalences and an association between symptoms of anxiety and depression and behavioral problems. In Mexico, reliable information on the mental health status of women and children in the three population areas studied is needed in order to implement measures towards expanding coverage for evaluation and prevention.

[Demand for paediatric emergency care in a community hospital]

OBJECTIVE

To study the characteristics of paediatric emergency demand and care delivery in the emergency room of a community hospital.

DESIGN

Analysis of the care demand and medical attention given to pediatric patients in an emergency room during 2006. Retrospective review of patients' medical reports.

SETTING

Emergency room, Hospital da Barbanza, Riveira, A Coruña, Spain.

PARTICIPANTS

Random selection of 1330 patients from 3990 cases attended in 2006.

MAIN MEASUREMENTS

Age, sex, time of arrival at the emergency room, type of pathology, medical-surgical area, destination on discharge, which medical staff signed the discharge, and length of stay in the emergency room.

RESULTS

There were 731 men and 599 women. Demand was greater on the afternoon shift (45%). Discharge destination was mainly to home (94%), with the emergency medical staff signing it in 60.7% of cases and the pediatrician in 34.6%. Children aged 6 or more suffered mainly from trauma; and younger children, from infectious diseases. There were no statistically significant differences between age groups for length of stay in the emergency room, but patients attended by pediatricians stayed longer.

CONCLUSIONS

There was a clear majority of little children, especially boys, in our study. Higher afternoon attendance probably occurs because of greater time availability of parents and children. Main causes of emergency pediatric care are infectious diseases and trauma. The child's home is the most frequent destination on discharge. The fact that most discharges are signed by the emergency doctor, together with the increase in emergency paediatric care in recent years, points to the need for constant updating of this medical area by emergency doctors.