Pediatrics in China: challenges and prospects

Liu, Yang; Yang, Lili; Xu, Siyun; Zhao, Zhiyuan

doi:10.1007/s12519-017-0117-3

Cited by 15 publications

(11 citation statements)

References 1 publication

(1 reference statement)

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“…There is currently a great opportunity to address this problem, as the Chinese government has launched a zero-mark-up policy aiming to eliminate the economic incentives for over-prescribing [40]. However, China is currently facing a pediatrician shortage [41]; pediatrics has been reported as the most crowded department in many hospitals and pediatricians were under much higher pressure from patients (i.e. children's parents) than were doctors in other departments [42].…”

Section: Discussionmentioning

confidence: 99%

Parental self-medication with antibiotics for children promotes antibiotic over-prescribing in clinical settings in China

Wang

Sun

et al. 2020

Antimicrob Resist Infect Control

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Background Self-medication with antibiotics (SMA) is one of the most dangerous inappropriate antibiotic use behaviors. This study aims to investigate the impact of parental SMA for children before a consultation on their doctor’s subsequent antibiotic prescribing behavior, including intravenous (IV) antibiotic use in the clinical setting of China. Methods A cross-sectional survey was conducted between June 2017 and April 2018 in three provinces of China. A total of 9526 parents with children aged 0–13 years were investigated. Data from 1275 parents who had self-medicated their children and then visited a doctor in the past month were extracted and analyzed. Results One-third (410) of the studied children had parental SMA before the consultation and 83.9% of them were subsequently prescribed antibiotics by doctors. Children with parental SMA were more likely to be prescribed antibiotics (aOR = 7.79, 95% CI [5.74–10.58]), including IV antibiotics (aOR = 3.05, 95% CI [2.27–4.11]), and both oral and IV antibiotics (aOR = 3.42, 95% CI [2.42–4.84]), than children without parental SMA. Parents with SMA behaviors were more likely to request antibiotics (aOR = 4.05, 95% CI [2.59–6.31]) including IV antibiotics (aOR = 2.58, 95% CI [1.40–4.76]), and be fulfilled by doctors (aOR = 3.22, 95% CI [1.20–8.63]). Conclusions Tailored health education for parents is required in both community and clinical settings to discourage parental SMA for children. The doctors should not prescribe unnecessary antibiotics to reinforce parents’ SMA behaviors. We recommend expanding the current IV antibiotics ban in outpatient settings of China to cover outpatient pediatrics.

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Section: Discussionmentioning

confidence: 99%

Parental self-medication with antibiotics for children promotes antibiotic over-prescribing in clinical settings in China

Wang

Sun

et al. 2020

Antimicrob Resist Infect Control

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“…Sixth, parents’ experiences reflect the severe shortage of medical resources in pediatric oncology in China. There is a massive disparity in pediatric medical capacities between urban and rural areas in China (Liu et al, 2018). All young children with ALL require treatment at large hospitals that have pediatric oncology expertise; however, hospital capacity to provide care is already severely strained.…”

Section: Discussionmentioning

confidence: 99%

Parents’ Experiences of Having a Young Child With Acute Lymphoblastic Leukemia in China

Liu

Petrini

Luo

et al. 2020

J Pediatr Oncol Nurs

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Background: Understanding parents’ experiences is a prerequisite to developing interventions that are sensitive to needs of children and families. In China, little is known about parental experiences of having a young child with acute lymphoblastic leukemia (ALL). This phenomenological study aimed to describe parental experiences of having a young child with ALL in China. Method: Ten parents, recruited in central China using purposive sampling, participated in face-to-face, in-depth interviews using Haase’s adaptation of Colaizzi’s phenomenological method. Results: Five theme categories were identified: (a) The Cancer Diagnosis as a Terrible Disaster—The Sky is Falling, (b) Fighting the Beast, (c) Putting on a Happy Face and Other Coping Strategies, (d) Diagnosis Disclosure: If We Tell and How to Tell, and (e) Hope-Filled Expectations: Returning to Normal Life. Conclusion: Parents put their child’s health as their top priority. They strive to manage uncertainty about prognosis and cope with enormous pressures caused by children’s suffering, financial burden, and stigma. Parents also express their resilience and hope throughout their child’s cancer journey. Support services to strengthen specific families’ protective factors (i.e., family/community support, hope, and positive coping) are needed to foster resilience and quality of life. Health care professionals should systematically assess parents’ needs, provide validated education materials, and implement tailored interventions across the cancer continuum. Public education and advocacy about cancer is also necessary to decrease cancer-related stigma, and provide financial aid and health care resources in pediatric oncology.

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“…According to a report from UNICEF (the United Nations International Children’s Emergency Fund), approximately 271 million children between 0 and 17 years were in China in 2015 4 . At the same time, there are only 118 000 registered pediatricians in China 5 . The shortage of pediatricians and specialized children’s hospitals in China is a well-known challenge 2,6 .…”

Section: Introductionmentioning

confidence: 99%

PedMap: a pediatric diseases map generated from clinical big data from Hangzhou, China

Dong

et al. 2019

Sci Rep

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Epidemiological knowledge of pediatric diseases may improve professionals’ understanding of the pathophysiology of and risk factors for diseases and is also crucial for decision making related to workforce and resource planning in pediatric departments. In this study, a pediatric disease epidemiology knowledgebase called PedMap (http://pedmap.nbscn.org) was constructed from the clinical data from 5 447 202 outpatient visits of 2 189 868 unique patients at a children’s hospital (Hangzhou, China) from 2013 to 2016. The top 100 most-reported pediatric diseases were identified and visualized. These common pediatric diseases were clustered into 4 age groups and 4 seasons. The prevalence, age distribution and co-occurrence diseases for each disease were also visualized. Furthermore, an online prediction tool based on Gaussian regression models was developed to predict pediatric disease incidence based on weather information. PedMap is the first comprehensive epidemiological resource to show the full view of age-related, seasonal, climate-related variations in and co-occurrence patterns of pediatric diseases.

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Pediatrics in China: challenges and prospects

Cited by 15 publications

References 1 publication

Parental self-medication with antibiotics for children promotes antibiotic over-prescribing in clinical settings in China

Parental self-medication with antibiotics for children promotes antibiotic over-prescribing in clinical settings in China

Parents’ Experiences of Having a Young Child With Acute Lymphoblastic Leukemia in China

PedMap: a pediatric diseases map generated from clinical big data from Hangzhou, China

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