- 期刊
Psychiatric Consultations in Pediatric Inpatients
兒科住院病童之精神科會診
摘要
疾病與住院對病童常產生情緒問題或加重原先的心理疾患。過去研究也發現住院病童有高比率的心理、情緒問題。這些問題能及早發現處理能改善住院的過程。本文回顧過去三年在某醫學中必兒科病房的精神科會診資料，研究會診的原因、精神科的診斷與處理。同時將結果與國外報告及本院非兒科病房的精神科會診作比較。 結果發現三年中兒科病房的精神科會診有40次，佔兒科入院的0.35%，全部精神科會診的1.0%。此會診略低於國外報告且遠少於非兒科病房的會診率。在精神科的診斷中較常見的適應疾患，焦慮或體化症疾患，診斷未定及無精神科診斷。與非兒科病房比較，適應性疾患診斷率相近，但在其它病房最常見的器質精神症卻只有4個個案(10%)。精神科的處理以藥物調整及使用精神科藥物最常使用，但心理與家庭的治療也常見。 本研究發現兒科病房的精神科會診不同於一般病房，需要更深入的研究與專家的參與。另外在病童中有高比率的情緒問題但精神科的會診率卻很低，有幾個可能因素將在內文討論。如何增進兒科醫師精神科會診醫師的合作以增進病童的醫療照顧，是值得努力的方向。
並列摘要
Emotional problems are not uncommon in hospitalized children. The authors reviewed psychiatric consultations on a pediatric ward in a medical center and compared the findings with a non-pediatric group and the Western reports. Forty consultations were requested in a three-year period which represented 0.35% of all admissions to pediatric ward and 1.0% of all psychiatric consultations in that period. The consultation rate of the pediatric ward is significantly lower than that of the non-pediatric wards. The most common reason for the referrals was for the evaluation of possible psychopatho geneses from unexplained physical symptoms. A wide range of psychiatric diagnoses were found. Among them, adjustment disorders, anxiety or somatoform disorders, diagnosis deferred and no psychiatric diagnosis were the most commonly made. Pediatric patients had a similar percentage diagnosis of adjustment disorders compared with the non-pediatric group but far less organic mental disorders. Besides medication, psychological and family intervention were frequently recommended by the psychiatrists. These findings suggest that there were unique psychological characteristics in the hospitalized children which required specialists and further studies. It is hoped that increasing the collaboration between pediatricians and psychiatrists can improve the medical care of these sick children.
延伸閱讀
- 陳長益（1986）。過動與不專心兒童的診療。中華民國特殊教育學會年刊，()，311-339。https://www.airitilibrary.com/Article/Detail?DocID=a0000110-N202301110028-00018
- 蔡世仁、陳展航、沈楚文（1996）。一所公立醫學中心精神科住院病患之分析。慈濟醫學雜誌，8(1)，55-59。https://doi.org/10.6440/TZUCMJ.199603.0055
- 陳心怡、童伊迪、唐宜楨（2014）。精神疾患家庭之未成子女的預防介入策略初探。身心障礙研究季刊，12(2)，106-119。https://www.airitilibrary.com/Article/Detail?DocID=17292832-201406-201412080001-201412080001-106-119
- 劉瑋馨（2022）。急性精神科住院之青少年病患醫療利用及護理照護之相關性探討〔碩士論文，國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342/NTU202201672
- 徐澄清（1961）。小兒科與兒童精神科之關系。Acta Paediatrica Sinica，2(1)，52-57。https://www.airitilibrary.com/Article/Detail?DocID=00016578-196103-2-1-52-57-a