Caracterización clínica y demográfica de la hospitalización psiquiátrica infantojuvenil en un hospital general

Duarte, Viviana; Zelaya, Lourdes

doi:10.31698/ped.46022019004

Cited by 5 publications

(9 citation statements)

References 11 publications

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“…Detailed findings of the included studies are collated in tables 1–4. Eighteen studies addressed trends and/or numbers/proportions of admissions,3 4 6–8 18–30 12 provided data about HCP views/experiences,4 31–41 two provided data about CYP views/experiences37 42 and four aimed at improving the care during admissions 6 40 43 44…”

Section: Resultsmentioning

confidence: 99%

Admissions to paediatric medical wards with a primary mental health diagnosis: a systematic review of the literature

Vázquez-Vázquez,

Smith,

Gibson

et al. 2024

Arch Dis Child

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ObjectiveTo systematically review the literature describing children and young people (CYP) admissions to paediatric general wards because of primary mental health (MH) reasons, particularly in MH crisis.DesignPubMed, Embase, PsycINFO, Web of Science and Google Scholar were searched, with no restriction on country or language. We addressed five search questions to inform: trends and/or the number of admissions, the risk factors for adverse care, the experiences of CYP, families/carers and healthcare professionals (HCPs) and the evidence of interventions aimed at improving the care during admissions.Two reviewers independently assessed the relevance of abstracts identified, extracted data and undertook quality assessment. This review was registered with PROSPERO (CRD42022350655).ResultsThirty-two studies met the inclusion criteria. Eighteen addressed trends and/or numbers/proportions of admissions, 12 provided data about the views/experiences of HCPs, two provided data about CYP’s experiences and four explored improving care. We were unable to identify studies examining risk factors for harm during admissions, but studies did report the length of stay in general paediatric/adult settings while waiting for specialised care, which could be considered a risk factor while caring for this group.ConclusionsMH admissions to children’s wards are a long-standing issue and are increasing. CYP will continue to need to be admitted in crisis, with paediatric wards a common location while waiting for assessment. For services to be delivered effectively and for CYP and their families/carers to feel supported and HCPs to feel confident, we need to facilitate more integrated physical and MH pathways of care.PROSPERO registration numberCRD42022350655.

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Section: Resultsmentioning

confidence: 99%

Admissions to paediatric medical wards with a primary mental health diagnosis: a systematic review of the literature

Vázquez-Vázquez,

Smith,

Gibson

et al. 2024

Arch Dis Child

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“…Ibeziako et al (7) reported 3799 paediatric MH admissions to the ED and inpatient units at a paediatric hospital from March 2019 – February 2021. Duarte and Zelaya (26) reported 180 admissions of patients with psychiatric diagnoses (January-August 2015); 74.4% required admission to the paediatric ward or hospital inter-consultation because of psychiatric pathology or primary psychiatric disorders. Wallis (28) reported 111 emergency admissions (83 patients) of CYP with MH needs to the paediatric ward between August 2017 and July 2017.…”

Section: Resultsmentioning

confidence: 99%

“…Detailed findings of the included studies are collated in Tables 1-4. Eighteen studies addressed trends and or numbers/proportions of admissions (3,4,(6)(7)(8)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), 12 provided data about HCPs views/experiences (4,(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41), two provided data about CYP views/experiences (37,42) and four aimed at improving the care during admissions (6,40,43,44).…”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…Insert Figure 1 Trends/number/proportions of admissions of CYP We found 18 studies reporting numbers and proportions of primary MH admissions of CYP ≤18 years to paediatric settings (Table 1). Nine used a retrospective chart review design for reporting admissions to single hospitals (7,8,18,(21)(22)(23)26,28,29). Ibeziako et al (7) reported 3799 paediatric MH admissions to the ED and inpatient units at a paediatric hospital from March 2019 -February 2021.…”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…Only one study (7%) provided clear information about the measurements undertaken to address non-response (22), and none reported clear information about concerns around non-response bias. Five studies (33%) did not provide clear methods to determine statistical significance or precision estimates (8,18,21,24,28) and 10 (67%) did not disclose if funding sources or conflicts of interest might affect authors' interpretation of the results (19)(20)(21)(22)(23)(24)26,28,32).…”

Section: Hcps' Experiencesmentioning

confidence: 99%

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‘Admissions to paediatric medical wards with a primary mental health diagnosis: a systematic review of the literature’

Vázquez-Vázquez,

Smith,

Gibson

et al. 2023

Preprint

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ObjectiveTo systematically review the literature describing children and young people (CYP) admissions to paediatric general wards because of primary mental health reasons, particularly in MH crisis.DesignPubMed, Embase, PsychINFO, Web of Science and Google Scholar were searched. We addressed five search questions to inform: trends and/or the number of admissions, the risk factors for adverse care, the experiences of CYP, families/carers and health care professionals (HCPs) and the evidence of interventions aimed at improving the care during admissions.Two reviewers independently assessed the relevance of abstracts identified, extracted data and undertook quality assessment. This review was registered with Prospero (CRD42022350655).ResultsThirty-two studies met the inclusion criteria. Eighteen addressed trends and or numbers/proportions of admissions, 12 provided data about the views/experiences of HCPs, two provided data about CYPs’ experiences and four explored improving care. We were unable to identify studies examining risk factors for harm during admissions, but studies did report the length of stay in general paediatric/adult settings while waiting for specialised care, which could be considered a risk factor while caring for this group.ConclusionsMH admissions to children’s wards are a long-standing issue and are increasing. CYP will continue to need to be admitted in crisis, with paediatric wards a common allocation whilst waiting for assessment. For services to be delivered effectively and for CYPs and their families/carers to feel supported and HCPs to feel confident, we need to facilitate more integrated physical and MH pathways of care.What is already known on this topic?-There is evidence that both the number of paediatric admissions and the severity of MH crisis in CYP have increased. Children’s wards are not designed to treat CYP with MH problems and HCPs haven’t had enough training.-There is no published systematic review on this topic.What this study adds?-This is the first systematic review on CYP admissions to paediatric wards with a primary MH indication.-Evidence suggested increased numbers of admissions to paediatric wards over time. HCPs reported concerns about skill sets to manage CYP with MH presentations and questioned the appropriateness of the acute ward for this care.-There is limited evidence on CYP experiences during admissions and on studies to improve care. We found no evidence of specific risk factors for adverse care for CYP and families/carers during admissions and no studies on families/carers’ experiences.

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Mental Health Admissions to Paediatric Wards Study (MAPS): protocol of a prospective study of mental health admissions to paediatric wards in England using surveillance and qualitative methods

Hudson,

Vázquez-Vázquez,

Gibson

et al. 2024

bmjpo

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IntroductionChildren and young people (CYP) presenting with a mental health (MH) crisis are frequently admitted to general acute paediatric wards as a place of safety. Prior to the pandemic, a survey in England showed that CYP occupied 6% of general paediatric inpatient beds due to an MH crisis, and there have been longstanding concerns about the quality of care to support these patients in this setting. MAPS aims to generate a Theory of Change (ToC) model to improve the quality of care for CYP admitted to acute paediatric services after presenting with an MH crisis. Here, we describe work packages (WPs) 2 and 3 of the study, which have been granted ethics approval.Methods and analysisWe will undertake a national (England), sequential, mixed-methods study to inform a ToC framework alongside a stakeholder group consisting of patients, families/carers and healthcare professionals (HCPs). Our study consists of four WPs undertaken over 30 months. WP2 is limited to working with stakeholders to develop a data collection instrument and then use this in a prospective study of MH admissions over 6 months in 15 purposively recruited acute paediatric wards across England. WP3 consists of gathering the views of CYP, their families/carers and HCPs during admissions using semistructured interviews.Ethics and disseminationWP2 and WP3 received ethical approval (ref: 23/LO/0349). We will publish the overall synthesis of data and the final ToC to improve care of CYP with MH crisis admitted to general acute paediatric settings. As co-producers of the ToC, we will work with our stakeholder group to ensure wide dissemination of findings. Potential impacts will be upon service development, new models of care, training and workforce planning.PROSPERO registration numberCRD42022350655.

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Caracterización clínica y demográfica de la hospitalización psiquiátrica infantojuvenil en un hospital general

Cited by 5 publications

References 11 publications

Admissions to paediatric medical wards with a primary mental health diagnosis: a systematic review of the literature

Admissions to paediatric medical wards with a primary mental health diagnosis: a systematic review of the literature

‘Admissions to paediatric medical wards with a primary mental health diagnosis: a systematic review of the literature’

Mental Health Admissions to Paediatric Wards Study (MAPS): protocol of a prospective study of mental health admissions to paediatric wards in England using surveillance and qualitative methods

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