Effect Of Early Intervention Model On High-risk Infants Based On Family-community-hospital Tripartite Interaction

BackgroundNeonatal brain damage is one of important factors leading to severe mental retardation and even death of newborns,high-risk infants increase by hundreds of thousands every year with severely situation in China.0-3 years old is the fastest stage of brain development in infants and young children,missing early diagnosis and early intervention opportunities will cause dysfunction or brain injury sequelae that are difficult to treat.Therefore,effective early intervention for high-risk children and the establishment of a comprehensive early-stage intervention system for high-risk children are essential for the health management of newborns.Although there are many studies on high-risk children intervention in China,however,the scale and scope of these researches are small,and the research direction is relatively scattered,many high-risk children are intervened after discharge based on the management of children's health care department and neonatology.However,some high-risk children who are not hospitalized are often overlooked and miss the best opportunity for intervention,The existing intervention model in China lacks unified and reasonable intervention methods,intervention time and intervention intensity.Pure rehabilitation training is expensive,causing great mental stress and financial burden on infants and their families.Studies have shown that early intervention in science has a significant effect on the repair of nerve function,enabling the potential of high-risk newborns to prevent and alleviate the occurrence of disability,and intelligence will gradually catch up with normal children.At present,the early intervention mode of high-risk children is mainly based on the combination of family and hospital.The community health service center,as the "gatekeeper" of the health care network,also has an vital role in infants health management.But the early intervention study of high-risk children of community-family-hospital linkage is in a blank period,and the effect of early intervention of high-risk children with tripartite linkage needs to be further tested.Children's Hospital of Jinan is the only children's specialist hospital in Shandong Province and the technical guidance institution of community hospitals in Jinan,so it is based on this institution to carry out the research on the three-way linkage model of early intervention of high-risk children.ObjectiveThis study dynamically monitored the development of high-risk children's brain,evaluated the current situation of high-risk children and the effect of family-c ommunity-family "three-link" early intervention model in multiple dimensions,aiming to discover and explore the pros and cons of this intervention model,f urthermore,we also for the purpose of exploring suitable intervention mechanis m and effective management model for high-risk children,in order to provide a basis for establishing a comprehensive and effective high-risk monitoring inter vention network system and achieve early detection,early intervention,reductio n or avoidance of disability in high-risk children.MethodsBased on the data of monitoring and management of high-risk infants in Jinan from 2009 to 2012,the study used random cluster sampling method to select 4 urban community hospitals in Jinan as research areas.The children born from 1.1-12.30 in the year 2009 were 7926,of which 1998 were high-risk children.Finally,339 high-risk infants who met the inclusion criteria were selected as sample participants and longitudinally monitoring to 2 years old.The screening and monitoring procedures for high-risk infants are composed of screening,monitoring,referral,evaluation,and intervention.Community doctors are responsible for screening and monitoring high-risk children using the Denver Developmental Screening(DDST)and cerebral palsy tests.Gesell and 52 children's developmental scales were used to evaluate their neuromotor development and developmental quotient on a regular basis,and then a combination of medical intervention and family training was implemented based on the assessment results.The analysis method used t test or ?2 test according to the characteristics of the data,analysing thedifference of physical,intelligent development,neuromotor development and system intervention effects of the high-risk infants between intervention group and the control group.Results1.The body weight,head circumference and body length of the intervention group were higher than those of the non-intervention group(P<0.05).2.The developmental quotient of each energy region in the system intervention group and the non-system intervention group increased gradually with age,and the developmental quotient in the system intervention group was significantly higher than that in the non-system intervention group(P<0.05).3.At 24 months,the developmental quotient of the system intervention group caughtup with the normal control group(P>0.05).The incidence of central developmental disorders and motor backwardness in the intervention group was significantly lower than that in the non system intervention group.4.Case-based interventions have also further improved their effectiveness.ConclusionsMonitoring and intervention High-risk infants in Community provides the management model of most high-risk children in the community,through early screening and regular detection,timely detection of abnormal development or suspected children,timely and appropriate intervention to reduce the incidence of cerebral palsy and intellectual disability.