Factors associated with non‐urgent presentations in the paediatric emergency department using Andersen's behavioural model: A cross‐sectional descriptive study

Objectives To explore the rate of NUPs and associated factors in the PED of the ‘Hospital Universitario y Politécnico La Fe’ in Valencia (Spain) using Andersen's Behavioural Model. Methods We conducted a descriptive cross‐sectional study using Andersen's Behavioural Model in parents visiti...

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Veröffentlicht in:Journal of clinical nursing 2024-08, Vol.33 (8), p.3172-3187
Hauptverfasser: Montoro‐Pérez, Néstor, Montejano‐Lozoya, Raimunda, Escribano, Silvia, Richart‐Martínez, Miguel
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container_end_page 3187
container_issue 8
container_start_page 3172
container_title Journal of clinical nursing
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creator Montoro‐Pérez, Néstor
Montejano‐Lozoya, Raimunda
Escribano, Silvia
Richart‐Martínez, Miguel
description Objectives To explore the rate of NUPs and associated factors in the PED of the ‘Hospital Universitario y Politécnico La Fe’ in Valencia (Spain) using Andersen's Behavioural Model. Methods We conducted a descriptive cross‐sectional study using Andersen's Behavioural Model in parents visiting the PED with their children at the ‘Hospital Universitario y Politécnico La Fe’ in Valencia (Spain). Results The study involved a total of 530 participants, of whom 419 (79%) had made an NUP. The predisposing factors identified were: (I) paediatric patients brought in by their fathers (OR = 0.460; p = 0.005), (II) lower educational attainment (OR = 3.841; p = 0.000), (III) first‐time parenthood (OR = 2.335; p = 0.000) and (IV) higher parental stress (OR = 1.974; p = 0.023). The enabling factors included: (I) responsibility for a significant part of the childcare shared with others (OR = 0.348; p = 0.041) and (II) the perception that PEDs provide better care than primary care (PC) services (OR = 1.628; p = 0.005). The need factors were: (I) existing chronic illness in the child seeking care (OR = 0.343; p = 0.000) and (II) the perceived severity of the urgency (OR = 0.440; p = 0.031). Conclusions The NUP rates found in this study are similar to those found internationally. In accordance with Andersen's Behavioural Model, we identify predisposing, enabling and need factors to explain the multifactorial nature of NUPs in PEDs. Implications for Practice Identifying the factors associated with NUPs enables interventions to be targeted at those groups most likely to engage in NUPs, thereby optimising the functioning of the PED and improving the well‐being of children and families. These interventions should focus on improving parental health literacy, providing education on making appropriate decisions about accessing health services and recognising severe symptoms in children, as well as improving access to high‐quality PC services. Providing support to parents during the transition to parenthood would also be beneficial. Reporting Method This paper adheres to the STROBE initiative guidelines. Contribution from patients or members of the public Participants, who voluntarily agreed to take part, contributed to the study by completing a paper‐based questionnaire containing all the study variables as prepared by the research team.
doi_str_mv 10.1111/jocn.17004
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Methods We conducted a descriptive cross‐sectional study using Andersen's Behavioural Model in parents visiting the PED with their children at the ‘Hospital Universitario y Politécnico La Fe’ in Valencia (Spain). Results The study involved a total of 530 participants, of whom 419 (79%) had made an NUP. The predisposing factors identified were: (I) paediatric patients brought in by their fathers (OR = 0.460; p = 0.005), (II) lower educational attainment (OR = 3.841; p = 0.000), (III) first‐time parenthood (OR = 2.335; p = 0.000) and (IV) higher parental stress (OR = 1.974; p = 0.023). The enabling factors included: (I) responsibility for a significant part of the childcare shared with others (OR = 0.348; p = 0.041) and (II) the perception that PEDs provide better care than primary care (PC) services (OR = 1.628; p = 0.005). The need factors were: (I) existing chronic illness in the child seeking care (OR = 0.343; p = 0.000) and (II) the perceived severity of the urgency (OR = 0.440; p = 0.031). Conclusions The NUP rates found in this study are similar to those found internationally. In accordance with Andersen's Behavioural Model, we identify predisposing, enabling and need factors to explain the multifactorial nature of NUPs in PEDs. Implications for Practice Identifying the factors associated with NUPs enables interventions to be targeted at those groups most likely to engage in NUPs, thereby optimising the functioning of the PED and improving the well‐being of children and families. These interventions should focus on improving parental health literacy, providing education on making appropriate decisions about accessing health services and recognising severe symptoms in children, as well as improving access to high‐quality PC services. Providing support to parents during the transition to parenthood would also be beneficial. Reporting Method This paper adheres to the STROBE initiative guidelines. Contribution from patients or members of the public Participants, who voluntarily agreed to take part, contributed to the study by completing a paper‐based questionnaire containing all the study variables as prepared by the research team.</description><identifier>ISSN: 0962-1067</identifier><identifier>ISSN: 1365-2702</identifier><identifier>EISSN: 1365-2702</identifier><identifier>DOI: 10.1111/jocn.17004</identifier><identifier>PMID: 38258512</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Adolescent ; Adult ; Child ; Child, Preschool ; Cross-Sectional Studies ; emergency department ; Emergency medical care ; emergency overcrowding ; Emergency Service, Hospital - statistics &amp; numerical data ; Female ; Health behavior ; health service use ; Health services utilization ; Humans ; Infant ; Male ; Models, Psychological ; non‐urgent ; paediatrics ; Parents &amp; parenting ; Parents - psychology ; Pediatrics ; Spain</subject><ispartof>Journal of clinical nursing, 2024-08, Vol.33 (8), p.3172-3187</ispartof><rights>2024 John Wiley &amp; Sons Ltd.</rights><rights>Copyright © 2024 John Wiley &amp; Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3574-a2700cde32af0aa0acf74c4ab3c9426054cdd0d071acec8b3b7b89f99c36efce3</citedby><cites>FETCH-LOGICAL-c3574-a2700cde32af0aa0acf74c4ab3c9426054cdd0d071acec8b3b7b89f99c36efce3</cites><orcidid>0000-0001-6548-8025 ; 0000-0002-7943-3591 ; 0000-0002-4274-1048 ; 0000-0001-6890-3001</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjocn.17004$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjocn.17004$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38258512$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Montoro‐Pérez, Néstor</creatorcontrib><creatorcontrib>Montejano‐Lozoya, Raimunda</creatorcontrib><creatorcontrib>Escribano, Silvia</creatorcontrib><creatorcontrib>Richart‐Martínez, Miguel</creatorcontrib><title>Factors associated with non‐urgent presentations in the paediatric emergency department using Andersen's behavioural model: A cross‐sectional descriptive study</title><title>Journal of clinical nursing</title><addtitle>J Clin Nurs</addtitle><description>Objectives To explore the rate of NUPs and associated factors in the PED of the ‘Hospital Universitario y Politécnico La Fe’ in Valencia (Spain) using Andersen's Behavioural Model. Methods We conducted a descriptive cross‐sectional study using Andersen's Behavioural Model in parents visiting the PED with their children at the ‘Hospital Universitario y Politécnico La Fe’ in Valencia (Spain). Results The study involved a total of 530 participants, of whom 419 (79%) had made an NUP. The predisposing factors identified were: (I) paediatric patients brought in by their fathers (OR = 0.460; p = 0.005), (II) lower educational attainment (OR = 3.841; p = 0.000), (III) first‐time parenthood (OR = 2.335; p = 0.000) and (IV) higher parental stress (OR = 1.974; p = 0.023). The enabling factors included: (I) responsibility for a significant part of the childcare shared with others (OR = 0.348; p = 0.041) and (II) the perception that PEDs provide better care than primary care (PC) services (OR = 1.628; p = 0.005). The need factors were: (I) existing chronic illness in the child seeking care (OR = 0.343; p = 0.000) and (II) the perceived severity of the urgency (OR = 0.440; p = 0.031). Conclusions The NUP rates found in this study are similar to those found internationally. In accordance with Andersen's Behavioural Model, we identify predisposing, enabling and need factors to explain the multifactorial nature of NUPs in PEDs. Implications for Practice Identifying the factors associated with NUPs enables interventions to be targeted at those groups most likely to engage in NUPs, thereby optimising the functioning of the PED and improving the well‐being of children and families. These interventions should focus on improving parental health literacy, providing education on making appropriate decisions about accessing health services and recognising severe symptoms in children, as well as improving access to high‐quality PC services. Providing support to parents during the transition to parenthood would also be beneficial. Reporting Method This paper adheres to the STROBE initiative guidelines. 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Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical nursing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Montoro‐Pérez, Néstor</au><au>Montejano‐Lozoya, Raimunda</au><au>Escribano, Silvia</au><au>Richart‐Martínez, Miguel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors associated with non‐urgent presentations in the paediatric emergency department using Andersen's behavioural model: A cross‐sectional descriptive study</atitle><jtitle>Journal of clinical nursing</jtitle><addtitle>J Clin Nurs</addtitle><date>2024-08</date><risdate>2024</risdate><volume>33</volume><issue>8</issue><spage>3172</spage><epage>3187</epage><pages>3172-3187</pages><issn>0962-1067</issn><issn>1365-2702</issn><eissn>1365-2702</eissn><abstract>Objectives To explore the rate of NUPs and associated factors in the PED of the ‘Hospital Universitario y Politécnico La Fe’ in Valencia (Spain) using Andersen's Behavioural Model. Methods We conducted a descriptive cross‐sectional study using Andersen's Behavioural Model in parents visiting the PED with their children at the ‘Hospital Universitario y Politécnico La Fe’ in Valencia (Spain). Results The study involved a total of 530 participants, of whom 419 (79%) had made an NUP. The predisposing factors identified were: (I) paediatric patients brought in by their fathers (OR = 0.460; p = 0.005), (II) lower educational attainment (OR = 3.841; p = 0.000), (III) first‐time parenthood (OR = 2.335; p = 0.000) and (IV) higher parental stress (OR = 1.974; p = 0.023). The enabling factors included: (I) responsibility for a significant part of the childcare shared with others (OR = 0.348; p = 0.041) and (II) the perception that PEDs provide better care than primary care (PC) services (OR = 1.628; p = 0.005). The need factors were: (I) existing chronic illness in the child seeking care (OR = 0.343; p = 0.000) and (II) the perceived severity of the urgency (OR = 0.440; p = 0.031). Conclusions The NUP rates found in this study are similar to those found internationally. In accordance with Andersen's Behavioural Model, we identify predisposing, enabling and need factors to explain the multifactorial nature of NUPs in PEDs. Implications for Practice Identifying the factors associated with NUPs enables interventions to be targeted at those groups most likely to engage in NUPs, thereby optimising the functioning of the PED and improving the well‐being of children and families. These interventions should focus on improving parental health literacy, providing education on making appropriate decisions about accessing health services and recognising severe symptoms in children, as well as improving access to high‐quality PC services. Providing support to parents during the transition to parenthood would also be beneficial. Reporting Method This paper adheres to the STROBE initiative guidelines. Contribution from patients or members of the public Participants, who voluntarily agreed to take part, contributed to the study by completing a paper‐based questionnaire containing all the study variables as prepared by the research team.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38258512</pmid><doi>10.1111/jocn.17004</doi><tpages>16</tpages><orcidid>https://orcid.org/0000-0001-6548-8025</orcidid><orcidid>https://orcid.org/0000-0002-7943-3591</orcidid><orcidid>https://orcid.org/0000-0002-4274-1048</orcidid><orcidid>https://orcid.org/0000-0001-6890-3001</orcidid></addata></record>
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subjects Adolescent
Adult
Child
Child, Preschool
Cross-Sectional Studies
emergency department
Emergency medical care
emergency overcrowding
Emergency Service, Hospital - statistics & numerical data
Female
Health behavior
health service use
Health services utilization
Humans
Infant
Male
Models, Psychological
non‐urgent
paediatrics
Parents & parenting
Parents - psychology
Pediatrics
Spain
title Factors associated with non‐urgent presentations in the paediatric emergency department using Andersen's behavioural model: A cross‐sectional descriptive study
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