21st century well-child care

Escobar, Ana Maria de Ulhôa; Grisi, Sandra

doi:10.1590/1806-9282.62.06.479

Cited by 3 publications

(4 citation statements)

References 13 publications

(11 reference statements)

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“…This result was important to physicians due to great advances in scientific knowledge in clinical practice in newborn, children and adolescent patients, particularly in those with complex chronic diseases. 2 , 3 , 4 , 12 , 27 One-quarter of pediatricians reported publishing research papers in medical literature. There has been an increase of this practice in our Medical School and Pediatric Department in the last years, reinforcing the relevance of additional gains in writing a manuscript, 28 such as professional education, financial, social benefits and intellectual pleasure.…”

Section: Discussionmentioning

confidence: 99%

“…General and pediatric residency programs have been modified worldwide with new curriculums, including a modern approach to teaching, patient care with ethical and humanistic attitudes, and research training. 1 , 2 , 3 , 4 , 5 , 6 Increasing technological innovation with new medical procedures, radiology and laboratory exams, translational medicine with drugs development and specific therapeutic targets for each disease are a reality in daily pediatric practice. 2 , 5 , 7 , 8 , 9 , 10 , 11 , 12 , 13 …”

Section: Introductionmentioning

confidence: 99%

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Pediatricians After Residency: A Survey of Personal/Professional Data and Issues

Silva

Trindade

Abel

et al. 2021

Rev. paul. pediatr.

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Objective: To assess personal, professional, medical, and scientific educational characteristics and issues reported by pediatricians. Methods: Cross-sectional study based on an online survey including 614 pediatricians who graduated in the last 15 years at a University Pediatric Department in Brazil. Results: The response rate was 331/614(54%). The majority were females (82%), the median age was 33 years (27-40) and median years of pediatric practice was 5 (1-13). High workload (>60 hours/week) occurred in 25% and 47% earned ≥15 minimum wages/month. The most work-related issues reported were long working hours, poor social life and a sedentary lifestyle (>50%). Pediatricians were further divided into two groups, according to years of pediatric clinical practice: group 1 (≤5 years) and group 2 (>5 years). The median of overall satisfaction with pediatric residency [8(0-10) vs. 9 (4-10); p=0.002] was significantly reduced in group 1. The frequencies of workload >60 hours, work on pediatric ward and pediatric intensive care were significantly higher in the first group (p<0.05). Regarding main issues related to clinical practice in the last year, long working hours (73 vs. 53%; p<0.001), poor social life (75 vs. 62%; p=0.018) and harassment (23 vs. 4%; p=0.003) were significantly higher in the first group. Conclusions: Very early career pediatricians (≤5 years) reported higher workload, lower income, work-related issues and different location of pediatric practice compared to early career pediatricians (>5 years). The overall satisfaction with pediatric residency was good, however, reduced in very early career pediatricians.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pediatricians After Residency: A Survey of Personal/Professional Data and Issues

Silva

Trindade

Abel

et al. 2021

Rev. paul. pediatr.

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“…The majority of participants reported attending professional conferences regularly. In fact, this population has a notable interest in scientific knowledge (1).…”

Section: ' Discussionmentioning

confidence: 99%

Profile of health professionals who completed a master's, doctoral, or post-doctoral degree in one Brazilian pediatric program

Silva

Trindade

Cruz

et al. 2020

Clinics

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OBJECTIVE: This study aimed to determine the personal and professional characteristics, and the physical, psychiatric/psychological, and professional issues that exist among master's-, doctoral-, and post-doctoral-level health professionals. METHODS: A cross-sectional, online, self-reported survey of 452 postgraduates who completed master's, doctoral, or post-doctoral degrees in one graduate program in pediatrics in Sã o Paulo, Brazil, was conducted. RESULTS: The response rate was 47% (211/453). The majority of participants were women (78%) and physicians (74%), and the median age was 47 years (28-71). Master's, doctoral, and post-doctoral degrees were reported by 73%, 53%, and 3%, respectively. High workload (440 hours/week) occurred in 59%, and 45% earned X15 minimum wages/month. At least one participation in scientific meeting in the past year was reported by 91%, and 79% had published their research. Thirty-nine percent served as a member of a faculty of an institution of higher learning. The data were analyzed by two age groups: participants aged p48 years (group 1) and participants aged 448 years (group 2). The median rating of overall satisfaction with the profession in the past year [8 (0-10) vs. 9 (1-10), p=0.0113]; workload 440 hours/week (53% vs. 68%, p=0.034); and X15 minimum wages/month (37% vs. 56%, p=0.0083) were significantly lower in group 1. Further analysis by gender revealed that the median rating of overall satisfaction with the profession in the past year [8 (0-10) vs. 9 (3-10), p=0.0015], workload 440 hours/week (53% vs. 83%, p=0.0002), and X15 minimum wages/month (37% vs. 74%, p=0.0001) were significantly lower in women compared with men. The median rating of overall satisfaction with the mentorship supervision provided was significantly higher among the women 10 (5-10) vs. 10 (2-10), p=0.0324]. CONCLUSIONS: The majority of master's-, doctoral-, and post-doctoral-level health professionals were women and physicians, and had published their thesis. Younger postgraduates and women reported low salaries, less likelihood of working 440 hours/week, and less overall satisfaction with their profession. Further longitudinal and qualitative studies are warranted to assess career trajectories after graduation.

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“…This fact is due to the advancements in medical diagnosis, with new technologies and specific treatments for different illnesses and comorbidities. [1][2][3][4][5][6][7][8][9][10][11] Of note, child and adolescent populations with chronic health disabilities requiring highly complex medical care have been increasingly followed-up in tertiary centers. A French study with individuals younger than 14 years old showed that 3.3% of patients had long-term conditions, and 1.4% had complex chronic diseases.…”

Section: Introductionmentioning

confidence: 99%

Complexity of Pediatric Chronic Disease: Cross-Sectional Study With 16,237 Patients Followed by Multiple Medical Specialties

Passone

Grisi

Farhat

et al. 2020

Rev. paul. pediatr.

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Objective: To assess demographic data and characteristics of children and adolescents with pediatric chronic diseases (PCD), according to the number of specialties/patient. Methods: We performed a cross-sectional study with 16,237 PCD patients at outpatient clinics in one year. Data were analyzed by an electronic data system, according to the number of physician appointments for PCD. This study assessed: demographic data, follow-up characteristics, types of medical specialty, diagnosis (International Statistical Classification of Diseases and Related Health Problems - ICD-10), number of day hospital clinic visits, and acute complications. Results: Patients followed by ≥3 specialties simultaneously showed a significantly higher duration of follow-up compared to those followed by ≤2 specialties [2.1 (0.4-16.4) vs. 1.4 (0.1-16.2) years; p<0.001] and a higher number of appointments in all specialties. The most prevalent medical areas in patients followed by ≥3 specialties were: Psychiatry (Odds Ratio - OR=8.0; confidence interval of 95% - 95%CI 6-10.7; p<0.001), Palliative/Pain Care (OR=7.4; 95%CI 5.7-9.7; p<0.001), Infectious Disease (OR=7.0; 95%CI 6.4-7.8; p<0.001) and Nutrology (OR=6.9; 95%CI 5.6-8.4; p<0.001). Logistic regressions demonstrated that PCD patients followed by ≥3 specialties were associated with high risk for: number of appointments/patient (OR=9.2; 95%CI 8.0-10.5; p<0.001), day hospital clinic visits (OR=4.8; 95%CI 3.8-5.9; p<0.001), emergency department visits (OR=3.2; 95%CI 2.9-3.5; p<0.001), hospitalizations (OR=3.0; 95%CI 2.7-3.3; p<0.001), intensive care admissions (OR=2.5; 95%CI 2.1-3.0; p<0.001), and deaths (OR=2.8; 95%CI 1.9-4.0; p<0.001). The diagnosis of asthma, obesity, chronic pain, and transplant was significantly higher in patients followed by ≥3 specialties. Conclusions: The present study showed that PCD patients who required simultaneous care from multiple medical specialties had complex and severe diseases, with specific diagnoses.

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21st century well-child care

Cited by 3 publications

References 13 publications

Pediatricians After Residency: A Survey of Personal/Professional Data and Issues

Pediatricians After Residency: A Survey of Personal/Professional Data and Issues

Profile of health professionals who completed a master's, doctoral, or post-doctoral degree in one Brazilian pediatric program

Complexity of Pediatric Chronic Disease: Cross-Sectional Study With 16,237 Patients Followed by Multiple Medical Specialties

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