Tag: pubmed

Zhonghua Yu Fang Yi Xue Za Zhi. 2025 Jun 6;59(6):877-883. doi: 10.3760/cma.j.cn112150-20250309-00187.

ABSTRACT

Objective: To analyze the epidemiological characteristics and infection sources of cholera in China from 2005 to 2024. Methods: A total of 2 066 cholera cases were included in the study, which were obtained from the China Disease Control and Prevention Information System (CDPCIS) of China CDC. The information on cholera clusters was downloaded from the National Public Health Emergency Event Surveillance System (PHEESS) of China CDC. A total of 128 cholera clusters were included and analyzed in this study. The epidemiological characteristics and infection sources of cholera were analyzed. The Jointpoint model was applied to analyze the incidence trend, and annual percentage change (APC) was also quantified. Results: From 2005 to 2024, a total of 2 066 cholera cases were reported, with an average of 103 cases reported annually. Specifically, the incidence showed a marked downward trend from 2004 to 2015 (APC=-26.78%, P=0.006). During 2015-2024, the disease remained at low endemic levels, with an average of 18 reported cases annually (APC=-2.68%, P=0.807). Cholera peak season was from May to October. A total of 24 provinces reported cholera cases, which were mainly distributed in Zhejiang, Fujian, Beijing, Jiangsu, Anhui, Guangdong, and Hainan provinces, accounting for 78.03% of the total cases. Pathogen surveillance indicated an alternating prevalence of Vibrio cholerae serogroups O1 and O139 among laboratory-confirmed cases between 2005 and 2024. There was a disparity in the dominant serogroup of Vibrio cholerae by region. The results from 128 cholera clusters indicated that cholera outbreaks frequently occurred in rural banquets (64.84%), followed by regular restaurants (13.28%). Among these, 63 clusters (49.22%) with identified infection sources indicated that foodborne transmission (95.24%) was the primary mode of cholera transmission, which mainly through seafood and aquatic products, such as soft-shelled turtles, shrimp and shellfish. The characteristics of cholera clusters caused by Vibrio cholerae serogroups O1 and O139 showed statistically significant differences in scale, attack rate, place of residence, setting, and infection source (P<0.05). Conclusion: Cholera incidence has remained consistently low since 2015 in China, mainly in sporadic cases. Rural gatherings (e.g., wedding banquets) are the main settings for cholera clusters. The main infection sources are predominantly caused by cross-contamination due to improper processing practices of aquatic products, such as soft-shelled turtles.

PMID:40518420 | DOI:10.3760/cma.j.cn112150-20250309-00187

Zhonghua Yu Fang Yi Xue Za Zhi. 2025 Jun 6;59(6):857-863. doi: 10.3760/cma.j.cn112150-20241011-00805.

ABSTRACT

To investigate the distribution of common inhalant and food allergens test results in children in Suzhou by gender, age and disease group, and to analyse the changes in allergen distribution in the different years, to provide theoretical guidance for the diagnosis, treatment and monitoring of children’s allergic diseases in Suzhou City. A retrospective cross-sectional study was conducted to analyze the 2 736 children (1 654 males and 1 082 females) who were diagnosed and tested serum content of specific immunoglobulin E (sIgE) antibodies to inhalant and food allergens in the Children’s Hospital of Soochow University between October 2017 and June 2024. The allergen sIgE positive rates epidemiological characteristics were statistically analyzed by Chi square test by grouping based on different year, gender, age and disease. The results showed that a total of 2 736 children screened for allergens, with an overall positive allergen sIgE rate of 73.06%(1 999/2 736), and the top five allergen sIgE positive rates were Dermatophagoides farinae (40.75%, 1 115/2 736), Dermatophagoides pteronyssinus (38.78%, 1 061/2 736), milk (34.65%, 948/2 736), egg whites (32.68%, 894/2 736) and molds and yeasts mixes (mx2) (24.82%, 679/2 736). The positive rates of food allergen sIgE were higher in the 2017-2019 (60.46%, 370/612) than the 2020-2022 (53.79%, 149/227) and after the 2023-2024 (48.46%, 895/1 847) (χ²=27.059,P<0.001); The positive rates of inhaled allergen sIgE were lower in the 2017-2019 (40.03%, 245/612) than the 2020-2022 (52.71%, 146/227) and the 2023-2024 (56.04%, 1 035/1 847)(χ²=47.223, P<0.001). The positive rates of inhaled allergen sIgE in males (54.96%, 909/1 654) were higher than those in females (47.78%, 517/1 082) (χ²=13.497, P<0.001). The total positive rate for the food allergen sIgE was highest at 1-3 years of age (67.55%, 589/872) and then gradually decreased with age (χ²=194.095, P<0.001); The total positive rate of inhaled allergen sIgE was lowest at the age of less than 1 year (8.33%, 22/206) and then gradually increased with age (χ²=300.329, P<0.001). The positive rates of food allergen sIgE, in descending order from high to low were asthma (59.40%), atopic dermatitis and eczema (48.10%), other groups (48.02%), allergic rhinitis (45.73%) and urticaria (40.00%); The positive rates of inhaled allergen sIgE were asthma (71.05%), allergic rhinitis (63.57%), atopic dermatitis and eczema (62.17%), urticaria (40.00%) and other groups (49.76%), and the difference between disease subgroups were statistically significant(χ² were 64.841 and 19.055, P<0.05). In conclusion, the top four allergen sIgE positive rates for children in the Suzhou area were Dermatophagoides farinae, Dermatophagoides pteronyssinus, milk and egg white. Total sIgE positive rates for food allergens decreased progressively in the 2017-2019, 2020-2022 and 2023-2024, and total positive rates for inhalant allergens increased progressively in the 2017-2019, 2020-2022 and 2023-2024. The distribution of allergen positive varies with gender, age and disease.

PMID:40518417 | DOI:10.3760/cma.j.cn112150-20241011-00805

Zhonghua Yu Fang Yi Xue Za Zhi. 2025 Jun 6;59(6):844-856. doi: 10.3760/cma.j.cn112150-20241216-01008.

ABSTRACT

Objective: To explore the clinical distribution characteristics and changes of common inhalant allergens and food allergens in all outpatient and inpatient children visiting Shanghai Children’s Hospital from 2020 to 2024, and to provide a basis for the diagnosis, treatment and prevention of allergic diseases in children. Methods: A retrospective cohort study was conducted to retrospectively enroll all outpatient and inpatient children who visited Shanghai Children’s Hospital and underwent serum allergen-specific IgE (sIgE) antibody testing from January 2020 to August 2024, and the characteristics and changing trends of allergens in the past 5 years were analyzed. A total of 127 310 tests were included. There were 76 776 male tests (60.31%) and 50 534 female tests (39.69%). There were 27 392 tests (21.52%) aged 0-3 years (infant group), 51 596 tests (40.53%) aged 4-6 years (preschool group), 44 574 tests (35.01%) aged 7-12 years (school-age group), and 3 748 tests (2.94%) aged 13-18 years (adolescent group). The χ2 test was used for statistical analysis. Results: The difference in total positivity rate between different years was statistically significant (χ2=2 907.478, P<0.001). The positive rates of inhalant allergens such as house dust, Dermatophagoides pteronyssinus/Dermatophagoides farinae, cockroach, cat dander, mugwort, Humulus scandens, mold fungi mix, and food allergens such as beef and mutton increased significantly with age (The χ2 values were 649.496, 3 414.686, 303.247, 1 277.408, 40.477, 189.952, 600.737, 203.198, and 15.301, respectively, and the P values were <0.001, <0.001, <0.001, <0.001, <0.001, <0.001,<0.001,<0.001, and 0.002, respectively). The positive rates of inhalant allergen such as Ambrosia elatior (1.59%) and food allergens such as egg white (17.36%), milk (30.48%), shrimp (8.27%), crab (8.13%), codfish (2.61%), salmon (0.66%), mytilus edulis (2.89%), lobster/scallop (5.27%), cashew nuts (5.09%), peanuts (3.54%), and soybean (1.73%) were highest at the age of 0-3 years and decreased significantly with age (The χ2 values were 10.365, 2 407.443, 139.085, 872.548, 870.245, 106.823, 47.674, 47.244, 559.422, 369.800, 384.788, 153.660, respectively, and the P values were 0.016, 0.000,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001, respectively). Inhaled allergens mainly have a greater impact on children with respiratory-related diseases such as allergic rhinitis and asthma, while food allergens mainly have a greater impact on children with atopic dermatitis/eczema. The positive rate of sIgE of various allergens in the allergic rhinitis combined asthma group were higher than that of allergic rhinitis alone, and the sIgE positive rate of total allergens and inhaled allergens was significantly higher than that of allergic rhinitis alone (χ2=20.851, 39.155, the P values were both<0.001). Among them, the sIgE positive rate of Ambrosia elatior and cashew nuts showed significant difference (χ2=5.044, 8.420, P=0.025, 0.004); and the sIgE positive rate of Dermatophagoides pteronyssinus/Dermatophagoides farinae, cat dander, grass pollens mix and mold fungi mix had extremely significant difference (χ2=26.409, 25.990, 21.283, 16.411, the P values were all <0.001). The inhaled allergens and food allergens with the highest positive rates in the 5 years were Dermatophagoides pteronyssinus/Dermatophagoides farinae (56.21%) and milk (47.47%), and as time went by, the positive rates gradually decreased. There is a moderate correlation between the three allergens of Ambrosia elatior, Amaranthus retroflexus, and tree pollens mix (0.55, 0.70, 0.63), and there is a moderate correlation between mango and tree pollens mix (0.50). Conclusion: Dermatophagoides pteronyssinus/Dermatophagoides farinae, cat dander, dog dander, egg white, and milk may be important allergens for children in Shanghai City from 2020 to 2024. The positive rates vary among different genders, age groups, and disease groups, but the positive rates of Dermatophagoides pteronyssinus/Dermatophagoides farinae, milk and cat dander allergens remain in the top three.

PMID:40518416 | DOI:10.3760/cma.j.cn112150-20241216-01008

Zhonghua Yu Fang Yi Xue Za Zhi. 2025 Jun 6;59(6):834-843. doi: 10.3760/cma.j.cn112150-20241029-00859.

ABSTRACT

Objective: To investigate, for multi-sensitized allergic rhinitis (AR) patients allergic to dust mites combined with other allergens (pollen, mold, animal dander, etc.), whether the single dust mite subcutaneous immunotherapy (SCIT) can improve the specific symptoms caused by other allergens in the patients, and to analyze the relationship between the effectiveness of symptom improvement in these patients and the type, quantity and severity of the allergens. Methods: A multicenter retrospective study was conducted to collect mul-sensitized AR patients from allergy or respiratory departments of 5 hospitals who received house dust mite allergen preparation SCIT for 12 to 36 months and met other inclusion and exclusion criteria from February to July 2024. General clinical data were collected and the perennial or seasonal symptoms before and after treatment were evaluated with visual analogue scale (VAS) to assess whether there was an perennial or allergen-specific symptom improvement (VAS score decrease ≥30%), by which the patients were divided into effective group and ineffective. R software was used to analyze the differences between groups by using Fisher’s exact test and Mann-Whitney U test. Results: A total of 62 patients were enrolled, and the treatment were effective in 39 of them, with an effective rate of 62.9%. For allergen-specific symptoms, the median age of the effective group was higher than that of the ineffective group (12 years old vs. 8 years old, P=0.039), and the effective rate in dust mite specific immunoglobin E (sIgE) grade ≤5 group was higher than that in sIgE grade >5 group (81.6% vs. 45.5%, P=0.008), and the effective rate of mold sIgE grade ≤2 group was higher than that of sIgE grade >2 group (83.3% vs. 28.6%, P=0.045), and there was no statistically significant correlation between the other allergen grades and the effective rate (P>0.05). For perennial symptoms, the effective rate in the mold grade ≤2 group was higher than that in the sIgE grade >2 group (91.3% vs. 28.6%, P=0.010), and there was no statistically significant correlation between the other allergen grades and the effective rate (P>0.05). There was no significant correlation between the treatment effectiveness of perennial or allergen-specific symptoms and the number of combined allergens, the grade of skin test, and the difference between the grade of combined allergens and that of dust mites (P>0.05). Conclusion: Among the patients with multi-sensitized AR allergic to dust mites included in this study, single dust mite SCIT is effective in some of them, and for allergen-specific symptoms, the effective group was elder, and dust mite sIgE grade 6 and mold sIgE grade ≥2 was related to the low effective rate of SCIT. The present results are insufficient for selecting single or multiple AIT in any type of multi-sensitized patients.

PMID:40518415 | DOI:10.3760/cma.j.cn112150-20241029-00859

Zhonghua Yu Fang Yi Xue Za Zhi. 2025 Jun 6;59(6):825-833. doi: 10.3760/cma.j.cn112150-20241007-00791.

ABSTRACT

Objective: To investigate clinical efficacy and safety of dupilumab in the treatment of moderate to severe atopic dermatitis (AD) complicated with asthma. Methods: A self-controlled study before and after treatment was conducted to retrospectively analyze 45 patients with moderate to severe atopic dermatitis combined with asthma who received dupilumab in the respiratory allergy clinic of North Theater Command General Hospital from January 2021 to May 2024, which age ≥12 years, including 27 males, 18 females. The treatment period was 4 to 12 months. All patients were treated with dupilumab combined with inhaled glucocorticoids and long-acting beta2-receptor agonists, as well as symptomatic drugs for atopic dermatitis. Analyze the clinical data of the patients before and after treatment, including lung function, asthma and AD-related assessment scales. Generalized estimation equation was used to analyze the simple effect of time on the repeated measurement data following non-normal distribution, and Wilcoxon signed rank test was used to compare the differences of each observation index before and after treatment. Results: Among 45 patients with moderate to severe atopic dermatitis complicated with asthma, after treatment with dupilumab, the FEV₁ increased from 2.39 (1.87, 2.83) L at baseline to 2.50 (1.84, 2.97) L 3 months after treatment (Z=2.417, P=0.016), 2.60 (1.95, 3.14) L 6 months after treatment (Z=2.896, P=0.004); the FEV₁pred% increased from 74.10% (67.70%, 78.75%) at baseline to 77.09% (68.40%, 80.24%) at 3 months after treatment (Z=2.574, P=0.010), and 77.20% (71.10%, 80.72%) at 6 months after treatment (Z=2.861, P=0.004). Meanwhile, there were statistically significant differences in the ACT and Mini-AQLQ scales at 3, 6, and 12 months after treatment compared with those before treatment (ACT score Z=3.170, 4.216, 5.723; Mini-AQLQ score Z=3.231, 4.133, 5.826; all P<0.05). The EASI scale decreased from baseline 25.90 (18.95, 33.45) to 6.20 (1.15, 8.35) at 4 months after treatment (Z=5.842, P<0.05) and 4.90 (2.75, 8.35) at 6 months after treatment (Z=5.841, P<0.05), 4.00 (3.15, 5.05) at 12 months after treatment (Z=5.841, P<0.05); The scores of each scale of IGA, NRS and DLQI decreased significantly compared with the baseline after 4 months, 6 months and 12 months of treatment, and this trend became more obvious with the extension of treatment time. The differences were statistically significant (IGA score Z=6.247, 6.070, 5.946; NRS score Z=5.960, 5.893, 5.879; DLQI score Z=5.880, 5.850, 5.848; all P<0.05). During treatment, 1 patient had local adverse reactions at the injection site and 1 patient had conjunctivitis. Conclusion: Dupilumab may have a positive effect on improving the clinical efficacy of patients with moderate to severe atopic dermatitis complicated with asthma. During the 12-month observation period, this biological agent generally demonstrated good safety characteristics.

PMID:40518414 | DOI:10.3760/cma.j.cn112150-20241007-00791

Zhonghua Liu Xing Bing Xue Za Zhi. 2025 Jun 10;46(6):1051-1057. doi: 10.3760/cma.j.cn112338-20240914-00577.

ABSTRACT

Objective: The clinical symptoms of children with global developmental delay (GDD) were analyzed to provide the scientific basis for the intervention of children with GDD. Methods: The results of the neuro-psychobehavioral scale were collected from 32 511 children with GDD from June 2020 to November 2023. Inclusion criteria: Children diagnosed with GDD according to the Diagnostic and Statistical Manual of Mental Disorders-V, ages 0.0 to 4.9 years. Exclusion criteria: children with common hearing impairment and visual impairment. The Chi-square tests were used for statistical analysis. Results: There were more boys than girls with GDD in outpatient clinics (68.2% vs. 31.8%). Among the children, the proportion of developmental delay in 5, 4, 3, and 2 domains was 31.1%, 23.4%, 22.9% and 22.6% respectively. The rate of delay in 2-3 domains was lower in boys (41.9%) than in girls (53.1%). The rate of delay in 4-5 domains was higher in boys (58.1%) than in girls (46.9%) (χ²=352.11, P<0.001). Overall, outpatient GDD decreased with age. From 1.0-1.9 to 4.0-4.9 years of age, the proportion of children with developmental delay in 5 domains increased with age (18.2%, 36.4%, 43.9%, 52.4%). Among children aged 0.0-0.9 years, the proportion of 2 domains of developmental delay was higher (33.4%).Among children aged 1.0-1.9 years, the proportion of 2-3 domains of developmental delay was higher (30.7%). Among children aged 2.0-, 3.0-, 4.0-4.9 years, the proportion of developmental delay in 5 domains was higher (36.4%, 43.9%, 52.4%). In children with GDD, the fine motor delay occurred most frequently (85.1%), followed by social self-care (83.9%), language (79.0%), adaptation (62.3%), and gross motor (52.8%). The frequency of developmental delays in fine motor, adaptability, language, and social self-care in boys was higher than that in girls (χ²=161.37, χ²=41.10, χ²=320.90, χ²=238.54, all P<0.001). The age groups with the highest delay incidence of gross motor, fine motor, adaptability, language, and social self-care were: 4.0-4.9 years (70.6%), 3.0-3.9 years (97.4%), 4.0-4.9 years (81.2%), 2.0-2.9 years (90.9%),2.0-2.9 years (95.4%). The proportions of fine motor delay in GDD children aged 0.0-0.9, 3.0-3.9 and 4.0-4.9 years were (74.5%, 97.4%, 96.8%) and the proportions of social self-care delay in GDD children aged 1.0- and 2.0-2.9 years were (92.1%, 95.4%). Peripheral and mild developmental delays were predominant in children with GDD. The proportion of severe language delay (6.4%) was higher than that in other fields. Conclusions: The proportion of GDD children with developmental delay in 4-5 domains was 54.5%. The most frequent domain of delay was fine motor. The frequencies of developmental delays in fine motor skills, adaptability, language, and social self-care in boys were higher than in girls. Most of the developmental delays in GDD children were marginal and mild. The rate of severe developmental delay in language was higher than in other domains.

PMID:40518401 | DOI:10.3760/cma.j.cn112338-20240914-00577

Zhonghua Liu Xing Bing Xue Za Zhi. 2025 Jun 10;46(6):1043-1050. doi: 10.3760/cma.j.cn112338-20241211-00788.

ABSTRACT

Objective: To analyze the epidemiological and clinical characteristics of pertussis cases identified through active surveillance. Methods: Active surveillance for pertussis was conducted in three sentinel hospitals in Yiwu, Zhejiang Province, and Yongcheng, Henan Province. The study population included cases that met the surveillance case definition and sought medical care at outpatient/emergency departments or were hospitalized between June 1, 2021, and May 31, 2022. Samples were collected for bacterial culture and PCR detection. Case information and clinical data were collected. Differences in rates were assessed using the chi-square test or Fisher’s exact probability test, and the differences in cough time were compared using the Mann-Whitney U test. Results: Among 1 423 cases of pertussis surveillance, the positive rate of pertussis was 28.11% (400/1 423), with a median age of 5 years (interquartile range: 2, 8). The positive rate in Yongcheng, Henan Province, and Yiwu, Zhejiang Province were 39.27% (216/550) and 21.08% (184/873), respectively; the positive rate of pertussis was highest in July 2021, and the highest positive rate of pertussis was among those aged 10-14. The positive rate of pertussis in hospitalized cases was higher than in outpatient/emergency cases (26.68%) (χ²=4.16, P=0.041). Among the 400 laboratory test-positive cases, the highest proportion of atypical symptom cases was in adults aged 20-59 (43.33%, 13/30). The specificity rates of apnea and worsening nocturnal cough in monitored cases under 3 months of age were 100.00% and 73.81%, respectively. Among monitored cases aged 3 months to 9 years, the proportions of symptoms including worsening nighttime cough (63.00%) and night sweats (4.59%) in test-positive cases were significantly higher than those in the test-negative group (47.77% and 0.56%, respectively), with statistically significant differences (both P<0.05). The specificity rates of worsened nighttime coughing and night sweats were 52.23% and 99.44%, respectively. Conclusions: The active surveillance results for pertussis showed that the 10-14 age group exhibited the highest positivity rate. Active surveillance enhanced the detection rate of pertussis. Among laboratory-confirmed cases, the proportion of atypical symptoms was the highest in adults, suggesting that laboratory testing should be combined to diagnose programs of pertussis. For infants under 3 months, worsening nighttime cough and apnea increase the diagnostic specificity, while for individuals aged 3 to 9 years old, worsening nighttime cough and night sweats increase the diagnostic specificity.

PMID:40518400 | DOI:10.3760/cma.j.cn112338-20241211-00788

Enferm Intensiva (Engl Ed). 2025 Jun 14;36(3):500544. doi: 10.1016/j.enfie.2025.500544. Online ahead of print.

ABSTRACT

INTRODUCTION: Acute kidney injury (AKI) is a frequent complication in Intensive Care Unit (ICU) patients with high morbidity and mortality.

OBJECTIVE: To analyze the incidence of mechanical and metabolic adverse events associated with continuous renal replacement therapy using sodium citrate as a regional anticoagulant.

MATERIAL AND METHODS: Observational, descriptive and prospective study performed in a polyvalent ICU during three years. Patients with AKI treated with renal replacement therapy and sodium citrate (Prismocitrate 18/0 mmol/L [0.5%]) were included. Patients with liver failure, active bleeding, severe thrombocytopenia, ICU stay of less than 24 h or treated with other anticoagulants were excluded. Demographic variables, severity index (APACHE II), vasoactive drug use, adverse events, and catheter characteristics were recorded. Anticoagulation efficacy was assessed with filter duration. Statistical analysis was performed with SPSS v.28.0, with P < .05 as the significance level. The study was approved by the ethics committee and informed consent was obtained from the patients or their relatives.

RESULTS: We studied 100 patients, 62% men, with a mean age of 63 ± 14.5 years. The main causes of AKI were septic shock, hemorrhagic shock and Covid-19. The median ICU stay was 16 days (RIC 8-43), with intra-ICU mortality of 48%. Therapy lasted a median of 60.5 h (RIC 38-107). Only one patient presented bleeding, and in 26% the filter coagulated. There were no cases of citrate toxicity. Electrolyte complications included hypocalcemia (45%), hypokalemia (41%), hyponatremia (36%) and metabolic acidosis (30%).

CONCLUSIONS: Mechanical and metabolic complications are common in continuous renal replacement therapies with sodium citrate. It is essential for ICU staff to be aware of their high prevalence in order to optimize clinical management.

PMID:40517456 | DOI:10.1016/j.enfie.2025.500544

Eur J Public Health. 2025 Jun 15:ckaf040. doi: 10.1093/eurpub/ckaf040. Online ahead of print.

ABSTRACT

Healthcare claims data are increasingly used to derive chronic condition (CC) surveillance indicators, although comparative evidence with self-reported data remains scarce. We explored the agreement and comparative validity (concurrent and predictive) of 20 CC prevalence indicators independently constructed using the French National Health Data System (SNDS) and Health, Health Care, and Insurance Survey (ESPS 2010-2014). Individual data from 5039 ESPS participants aged ≥25 years, representative of the 2010 French general population, were linked to the SNDS. Follow-up data included a 2014 health self-assessment and 5-year mortality. We considered 20 CCs with corresponding SNDS case-identifying algorithms and self-reported information from ESPS, including most cardiovascular diseases and frequent cancers. Kappa statistics assessed agreement between CC indicators across databases. Polytomous and dichotomous logistic regression assessed determinants of disagreement between sources and associations of indicators with health outcomes (concurrent and predictive validity). Prevalence values were much higher with survey data except for hypertension, diabetes, thyroid disorders, epilepsy, and most cancers for which they were closer (±20%) to claims data. Agreement between CC indicators varied from the strongest (hypertension, diabetes, thyroid disorders, most cancers) to the weakest (cardiac rhythm disorders, peptic ulcer, chronic liver diseases). Sex, age, and multimorbidity strongly influenced agreement. Most claims database indicators were more strongly associated with health outcomes. Health interview surveys and healthcare claims-derived indicators are not interchangeable given their specific determinants. Since no general rule applies to all CCs, the advantages and disadvantages of each data source should be closely considered in case-to-case analysis.

PMID:40517434 | DOI:10.1093/eurpub/ckaf040

Orv Hetil. 2025 Jun 15;166(24):930-941. doi: 10.1556/650.2025.33324. Print 2025 Jun 15.

ABSTRACT

Bevezetés: Az egészségügyi dolgozók elleni erőszak a kórházak minőségbiztosítása miatt gyakran kutatott terület. A gyermekkórházakra vonatozó kutatások száma azonban kevesebb. A munkahelyi erőszak hatása csökkenti a kórházi szolgáltatás hatékonyságát. Az agresszió észlelése szociálpszichológiai folyamat, különösen érdekes akkor, ha az interakcióban beteg gyermek is jelen van. A hozzátartozók és a betegek erőszakos magatartásmintáin kívül az agresszió egyébként is jelen van az egészségügyi dolgozók munkahelyen töltött mindennapjaiban bullyng formájában. Célkitűzés: A részletes leíró statisztikán túl, kutatásunkban megvizsgáltuk a dolgozók demográfiai adatai és az észlelt munkahelyi erőszak közötti kapcsolatot. Emellett kitértünk a dolgozói helyzetértékelésre, valamint a sürgősségi ellátás jellegzetességeire. Módszer: Exploratív keresztmetszeti kutatásunkba 266 egészségügyi dolgozót vontunk be (81,2% nő, átlagéletkor 42 év). A kutatócsoportunk által összeállított online kérdőívbe a demográfiai és a munkavégzéssel kapcsolatos kérdéseken túl beépítettük a Magyarországon is már többször felhasznált Nyílt Agresszió Skála elemeit is, amelyeket a vizsgálat helyszínéül szolgáló, központi elhelyezkedésű gyermekkórház sajátosságaihoz igazítottunk. A mérőeszközbe beépítettük egy korábban a kórházban végzett, a munkahelyi erőszakra irányuló kutatás eredményeit is. A kérdőíves felmérést orientációs beszélgetések előzték meg a kórház összesen 32 szervezeti egységében. Eredmények: A nemzetközi kutatási eredményekkel összhangban azt tapasztaltuk, hogy a kórházban a leggyakrabban észlelt erőszaktípus egyéves prevalenciája a betegek részéről 60,1%, a hozzátartozók felől 78,7%, valamint a kollégák irányából 53,8%. Mind a három kategóriában a verbális megnyilvánulások voltak a leggyakoribbak. A négy leginkább észlelt magatartásminta mindhárom tanúsítói csoport vonatkozásában a kiabálás, a sértegetés, a káromkodás és a becsmérlő fenyegetés volt. A legnagyobb kockázati profilú dolgozók ápolói végzettséggel rendelkező, beosztott szakdolgozók voltak, akik állandó nappalos vagy nappali és éjszakai váltakozó beosztásban látják el feladatukat, főleg fekvőbetegekkel foglalkoznak, másodállást vállalnak, és anyanyelvükön kívül beszélik az angol nyelvet is. A helyzetértékelést tekintve a válaszolók (n = 149) 23%-a romló, 70%-a stagnáló, míg 7%-a javuló tendenciát tapasztalt a megkérdezés előtti fél évben. A sürgősségi ellátásban dolgozók 100%-a tapasztalt valamilyen verbális agressziót a hozzátartozók irányából, és ez nagyobb mértékűnek mutatkozott, mint a máshol dolgozók esetében (82%). Megbeszélés: A Heim Pál Országos Gyermekgyógyászati Intézetben is körülírható volt az egészségügyi dolgozók elleni erőszak észlelése és a demográfiai változók kapcsolata. Ennek tekintetében azonban külön ügyelni kell a gyermek-hozzátartozó-ellátó kommunikáció sajátosságainak értelmezésére. Következtetés: Általánosságban elmondható, hogy az alacsonyabb beosztású egészségügyi dolgozók érintkeznek gyakrabban a betegekkel és a hozzátartozókkal olyan élethelyzetben, amikor megnyilvánulhat a munkahelyi erőszak. Az interakció észlelésére különböző előjelű hatással bír a stressz, a munka megszervezése, az építészeti környezet, az agresszív magatartások jelentésének lehetősége, az esemény utáni ’debriefing’ (a tapasztalatok megbeszélése), az ’anti-bullying’ (bántalmazás elleni) protokoll megléte és a deeszkalációs technikák ismerete. Orv Hetil. 2025; 166(24): 930–941.

PMID:40517377 | DOI:10.1556/650.2025.33324