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asibiti yara (CH) [1] asibiti ne wanda ke ba da hidima na musamman ga jarirai, yara, matasa, da matasa daga haihuwa har zuwa shekaru 18, kuma ta hanyar shekaru 21 da sama a Amurka.[2] A wasu lokuta na musamman, suna iya kula da manya.[3][4] Adadin asibitocin yara sun karu a cikin karni na 20, yayin da likitancin yara da ƙwarewar tiyata suka rabu da likitan ciki da ƙwarewa na tiyata na manya.

Haɗin kai

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Asibitocin yara suna da hankali sosai ga tallafin yara da iyalansu. Wasu yara da matasa dole ne su ciyar da lokaci mai tsawo a asibiti, don haka samun damar yin wasa da ma'aikatan koyarwa na iya zama muhimmin ɓangare na kulawar su.[5] Tare da haɗin gwiwar gida, wannan na iya haɗawa da tafiye-tafiye zuwa lambunan botanical na gida, zoos, da ɗakin karatu na jama'a misali.[6] Zane-zane don sabon asibitin yara na Cambridge, wanda aka amince da shi a 2022, yana shirin haɗa cikakkiyar kiwon lafiya na hankali da na jiki ga yara da matasa, yana tattara ayyukan abokan tarayya uku: Asibitocin Jami'ar Cambridge NHS Foundation Trust, Cambridgeshire da Peterborough NHS Foundation Trust. Jami'ar Cambridgeschire da Jami'ar Кембридж tare da ayyukan kiwon lafiya da na jiki da na hankali da ke kusa da aikin bincike.[7]

Ma'aikata

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Baya ga tallafin zamantakewar al'umma, asibitoci yara suna da ƙarin fa'idar kasancewa da ƙwararrun da aka horar da su wajen kula da yara. Likitan likita wanda ke gudanar da horo na sana'a a cikin ilimin yara dole ne a karbe shi don zama memba ta kwalejin kwararru kafin su iya yin aikin ilimin yara. Wadannan sun hada da Royal Australasian College of Physicians (RACP), Royal College of Paediatrics and Child Health (RCPCH), da kuma Hukumar Kula da Yara ta Amurka. A New Zealand, RACP tana ba da horo na sana'a a cikin ilimin yara. Da zarar an kammala horo na RACP an ba likita kyautar Fellowship of the RACP (FRACP) a cikin ilimin yara.[8] Duk da yake asibitoci da yawa na yau da kullun na iya kula da yara yadda ya kamata, ƙwararrun likitocin yara na iya zama mafi kyawun zaɓi idan ya zo ga magance cututtukan da ba a saba gani ba waɗanda zasu iya zama masu kisa ko masu lahani ga yara ƙanana, a wasu lokuta kafin haihuwa. Har ila yau, asibitocin yara da yawa za su ci gaba da ganin yara da ke da cututtukan da ba a saba gani ba har zuwa balaga, suna ba da damar ci gaba da kulawa.

Tarihi

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Kulawa da son rai na farko

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Kafin sauye-sauyen asibiti na karni na 19, ana tunanin jin daɗin yaro yana hannun mahaifiyar; sabili da haka, akwai ɗan tattaunawa game da maganin yara, kuma a sakamakon haka babu cibiyoyin da suka fi mayar da hankali kan warkar da yara.

Asibitoci da asibitoci sune farkon siffofin abin da daga baya zai zama asibitocin yara. Asibitin Florence na Innocent (Ospedale degli Innocenti) asalinsa gidan marayu ne wanda aka buɗe a cikin 1445; manufarsa ita ce kula da marasa lafiya da jarirai da aka watsar da su. Asibitoci irin su Asibitin Foundling wanda Thomas Coram ya kafa a cikin 1741 an kirkiresu ne don karɓar jarirai da aka watsar, kula da su zuwa lafiya, koya musu kasuwanci ko ƙwarewa, da kuma haɗa su cikin al'umma.

Cibiyoyin da aka ba da gudummawa sun ba da magani da kulawa ta likita ga waɗanda ba za su iya biyan kulawa mai zaman kanta ba. Likitan yara na Scotland George Armstrong, wanda ya kafa asibitin farko na Burtaniya, a cikin 1769, ya yi adawa da kulawar marasa lafiya ga yara marasa lafiya. Armstrong ya ce:

Amma karamin tunani zai tabbatar da duk wani mai tunani cewa irin wannan Shirin kamar wannan ba za a iya aiwatar da shi ba. Idan ka ɗauki yaro mara lafiya ga Iyayensa ko Nurse, nan da nan ka karya zuciyarsa.[9]

Rashin yarda da shigarwa wani lokacin ya dogara ne akan dalilai masu amfani, misali rage barazanar kamuwa da cuta daga yara masu cututtuka kamar typhus, diphtheria da kyanda, wadanda suka kasance babban dalilin mutuwar jarirai. Yanayin son rai na asibitoci yana nufin cewa irin wannan barkewar cutar tana da tsada sosai.

Misalai na ƙarni na 19

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A tsakiyar karni na 19 na yammacin duniya, mata masu matsakaicin matsayi da likitoci sun ƙara damuwa game da jin daɗin yara a cikin yanayin rayuwa mara kyau. Kodayake mutuwar jarirai ta fara raguwa, har yanzu ya kasance sanannen batun. Masu gyara zamantakewa sun zargi fitowar masana'antu da iyaye matalauta saboda rashin kula da yaransu yadda ya kamata. A cikin shekarun 1870, ra'ayi mai yawa tsakanin likitoci da ma'aikatan jinya shine cewa yara sun fi dacewa ta hanyar kai su asibiti, nesa da sau da yawa matalauta, yanayin rashin tsabta a gida.[10] A mayar da martani, masu gyarawa da likitoci sun kafa asibitocin yara.[11]

A farkon karni na 19, asibitocin yara sun buɗe a manyan birane a duk faɗin Turai. Asibitin farko da aka amince da shi shi ne Hôpital des Enfants Malades a Paris, wanda aka buɗe a cikin 1802. An kafa Babban Asibitin Ormond Street a Landan a 1852, kuma shine asibitin yara na farko na Burtaniya.[12] An kirkiro Asibitin Yara na Philadelphia a Pennsylvania a 1855. [13] Asibitin Royal don Yara Marasa Lafiya, Edinburgh shine asibitin yara na farko a Scotland kuma an buɗe shi a cikin 1860. [14] Asibitin Yara Marasa Lafiya a Toronto, Ontario shine asibitin yara na farko na Kanada kuma an buɗe shi a shekara ta 1875. [15] A ƙarshen karni na 19, kuma a cikin shekaru ashirin na farko na karni na 20, yawan asibitocin yara ya ninka sau uku a Kanada da Amurka.[11] Daga shekarun 1850 zuwa kusan 1910, yawancin birane a Burtaniya sun gina asibitocin yara, wanda ya haɗa da manyan asibitoci kamar Royal Hospital for Sick Children, Glasgow, Babban Asibitin Ormond Street da Royal Manchester Children's Hospital.[10]

Asibitocin yara na yammacin farko cibiyoyi ne masu zaman kansu waɗanda aka ba da gudummawa ta son rai, da kuma bincike. Sau da yawa, ana iya shigar da yara ne kawai idan an tallafa musu da wasika ta shawarwari daga wani asibiti. An tura "matalauta marasa cancanta" zuwa asibitocin asibitoci, yayin da ake kula da yara na tsakiya, kuma ana aiki da su, a gida. Asibitoci sun kafa nasu dokoki kuma suna da nasu hanyar aiki, gami da tsara shigarwa. Sau da yawa suna ware yara a ƙarƙashin shekaru biyu a kan dalilai na jin kai da na zahiri kuma galibi suna jinkirin shigar da yara waɗanda ke buƙatar kulawa ta dogon lokaci saboda tsoron cewa waɗannan rayuka za su ɓace ko kuma cewa kulawa ta dogon zango za ta toshe gadaje ga waɗanda ke cikin buƙata. [16] [10]

Asibitocin yara na farko sun fi mayar da hankali kan kulawa ta gajeren lokaci da kuma kula da cututtuka masu sauƙi maimakon kulawa mai tsanani na dogon lokaci. Magani da cututtuka masu tsanani da cututtuttuka a asibitocin yara na farko na iya haifar da yaduwar cutar a duk asibitin wanda zai zubar da albarkatun da suka riga sun iyakance. Cutar da ta fi tsanani a asibitin yara za ta haifar da mutuwar da yawa fiye da rayuka da aka ceto kuma saboda haka za ta karfafa ra'ayin da ya gabata cewa mutane galibi suna mutuwa yayin da suke asibiti.[11]

Kwarewar Asibitocin Yara

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A cikin karni na 19, an sami canjin zamantakewa a yadda ake kallon yara. Wannan canjin ya cire wasu daga cikin ikon iyaye kuma ya sanya shi a hannun masu sana'a. A farkon karni na 20, lafiyar yaro ta kara da alaƙa da likitoci da asibitoci. Wannan ya kasance sakamakon ayyukan lasisi, kafa ƙungiyoyin kiwon lafiya, da kuma sababbin fannoni na kiwon lafiya da aka gabatar a duk faɗin ƙasashe.[17] Sabbin fannoni na kiwon lafiya sun ba likitoci damar gina ayyukansu ta hanyar "suna kula da bukatun kiwon lafiya na marasa lafiya masu zaman kansu, kula da gwada sabbin hanyoyin warkewa ga matalauta marasa lafiya, da kuma koyar da ɗaliban likita. " Don kara girman matsayinsu, likitoci sun fara shirya asibitocin yara; ta hanyar yin hakan, ya kuma kawo hankali da muhimmancin ƙwarewarsu a cikin tsarin kiwon lafiya ya dace. [17][11]

Sau da yawa ana maye gurbin kulawar mata ta son rai ko ta addini ta hanyar kulawa da ma'aikatan jinya da aka horar da su.

Masu sukar kula da asibiti na yara

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A tarihi, asibitocin yara da yawa sun iyakance ikon yara da iyaye don hulɗa, kamar ta hanyar iyakance lokutan ziyara. An soki wannan hanyar shekaru da yawa kafin sauye-sauye a aikace ya faru.

Likita James Henderson Nicholl na asibitin Glasgow na yara marasa lafiya, wanda ya fara aikin tiyata na rana kamar Hernia da cleft palate, ya bayyana a cikin 1909 cewa: '[Ni] yara a ƙarƙashin shekaru 2, akwai wasu ayyukan tiyata da gaske waɗanda ba za a iya aiwatar da su da kyau a cikin sassan marasa lafiya kamar yadda yake a cikin unguwanni.' Nicholl ya yi imanin cewa asibiti ba lallai ba ne, kuma iyayensu sun fi kula da yara daga gidansu da kuma ma'aikatan jinya da ke ziyara da ke ziungaka yau da kullun. Nicholl ya yi jayayya cewa "rabuwa da uwa sau da yawa yana da lahani".[18]

A lokacin yakin basasa, wanda ya kai ga yakin duniya na biyu, likitocin kwakwalwa sun nuna damuwa game da yara da ke nesa da iyaye, kamar a lokacin asibiti. Harry Edelston, wani Likitan kwakwalwa a Leeds, ya ba da cikakken bayani cewa yara sun lalace ta hanyar kasancewa a asibiti.

A zamanin bayan yakin, masu sukar sun zama masu yawa kuma an gudanar da bincike don bincika yiwuwar cutar. René Spitz, wani masanin ilimin halayyar dan adam na Austrian-Amurka, ya wallafa wata kasida a 1945 inda ya lura da mummunar tasirin asibiti, bisa ga bincikensa tare da yara masu zaman kansu.[19]

LA Perry ya rubuta wani labarin Lancet na 1947 wanda ya nuna rashin amincewa da ƙuntatawa na ziyarar iyaye a kan yara da ke asibiti. Koyaya, Edelston ya rubuta a cikin 1948, cewa yawancin waɗannan abokan aiki har yanzu sun ki yarda da raunin asibiti Bowlby ya yi nazarin ɓarayi 44 kuma ya gano cewa adadi mai yawa ya sami rabuwa da mahaifiyarsu da wuri. A shekara ta 1949, ya yi amfani da bayanan don rubuta rahoto ga Hukumar Lafiya ta Duniya game da lafiyar kwakwalwa ta yara marasa gida a bayan yakin Turai.[20]

Tare da gabatar da penicillin a cikin mafi yawan al'ummar kiwon lafiya a cikin shekarun 1940, an cire babban ƙin yarda da likitoci da ma'aikatan jinya, cewa ziyarar iyaye a cikin unguwanni na asibiti da aka gabatar da cututtukan giciye. Wani babban bita a cikin 1949, a cikin watanni 11, ya nuna cewa yara da aka shigar da su a cikin unguwanni 26 a asibitoci 14 ba su nuna alaƙa tsakanin ziyara da kamuwa da cuta daga iyaye zuwa yara ba. A wannan lokacin, ayyukan aiki na likitoci da ma'aikatan jinya, har yanzu suna ba da babbar ƙiyayya ga ziyara.[21] AD Hunt ya ba da rahoton cewa:

Yaron da ke asibiti an dauke shi a matsayin na'urar halitta, mafi kyau ba tare da iyayensa ba waɗanda, a cikin sa'o'i na ziyarar mako-mako ko na mako-mayoyi, suna da guba sosai a tasirin su, suna haifar da hayaniya, yawanci halayyar rikici, da kuma ƙin ma'aikatan asibiti.[22]

Masanin ilimin halayyar dan adam na Burtaniya John Bowlby, wanda a baya ya soki tsarin kwashewa yakin duniya na biyu da ke raba iyaye da yara, da mataimakinsa na bincike a Asibitin Tavistock, James Robertson, ma'aikacin zamantakewa na Scotland kuma masanin ilimin halayen halayyar mutum, ya yi bincike game da rabuwa da yara daga iyayensu yayin zaman asibiti kuma ya soki mummunan tasirin da ke tattare da manufofin iyakantaccen ziyara. [23][24]

A cikin shekarun 1950, 'yan siyasa na Burtaniya sun damu sosai game da tasirin manufofin asibitin yara don ƙirƙirar kwamiti don bincika jin daɗin yara marasa lafiya a asibiti. Wannan kwamitin ya samar da Rahoton Platt na 1959, yana ba da shawarar cewa yara ya kamata su sami damar zuwa ga iyayensu yayin da suke rashin lafiya. Rahoton yana da tasiri ga kula da yara a asibiti a Burtaniya da New Zealand, Australia, Kanada da Amurka.

Yin amfani da bayanan fitar da asibiti daga 2003 zuwa 2011, Hukumar Kula da Lafiya da Inganci (AHRQ) ta yi nazarin abubuwan da ke faruwa a cikin jimlar farashin asibiti, matsakaicin farashin asibiti. Hukumar ta gano cewa ga yara masu shekaru 0-17, jimlar farashin ya karu da sauri don asibitin tiyata kuma ya ragu saboda rauni a asibiti. Bugu da ƙari, matsakaicin farashin asibiti, ko farashin kowane fitarwa, ya karu da akalla 2% ga duk asibitoci kuma ana sa ran ya karu da aƙalla 4% har zuwa 2013. Baya ga wannan shine asibitin lafiyar kwakwalwa, wanda ya ga karuwar kashi 1.2%, kuma an tsara shi don karuwa kawai 0.9% ta hanyar 2013. Duk da hauhawar farashin da farashi a kowane fitarwa, asibiti (sai dai asibiti na lafiyar kwakwalwa) ga yara masu shekaru 0-17 sun ragu a lokaci guda, kuma an tsara su don ci gaba da raguwa.[25]

A cikin 2006-2011, yawan amfani da sashen gaggawa (ED) a Amurka ya kasance mafi girma ga marasa lafiya da ba su kai shekara ɗaya ba, amma mafi ƙasƙanci ga marasa lafiya masu shekaru 1-17. Yawan amfani da ED ga marasa lafiya da ba su kai shekara guda ba ya ragu a lokaci guda; wannan shine kawai rukunin shekaru da ya ga raguwa.[26]

Tsakanin shekara ta 2008 da 2012, ci gaban matsakaicin farashin asibiti a kowane zama a Amurka ya kasance mafi girma ga marasa lafiya masu shekaru 17 da ƙanana.[27] A cikin 2012 akwai kusan asibiti miliyan 5.9 ga yara a Amurka, daga cikinsu miliyan 3.9 ne ne da aka haifa kuma 104,700 ne da aka yi wa matasa masu juna biyu.[28]

Manazarta

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  1. ↑ Steiner MJ, Hall M, Sutton AG, Stephens JR, Leyenaar JK, Chase L, McDaniel CE (October 30, 2023). "Pediatric Hospitalization Trends at Children's and General Hospitals, 2000-2019". JAMA. 330 (19): 1906–1908. doi:10.1001/jama.2023.19268. PMC 10616761 Check |pmc= value (help). PMID 37902774 Check |pmid= value (help).
  2. ↑ Samfuri:Multiref2
  3. ↑ "Adult Cystic Fibrosis Program". Nationwide Children's Hospital.
  4. ↑ "Adult Congenital Heart Disease Program". Texas Children's Hospital. Archived from the original on 2020-10-06. Retrieved 2020-05-21.
  5. ↑ "Where special treatment is just what the doctor ordered | News". 2016-08-21. Archived from the original on 2016-08-21. Retrieved 2018-10-19.
  6. ↑ "The 50 Most Amazing Children's Hospitals in the World – Healthcare Administration Degree Programs". www.healthcare-administration-degree.net. Archived from the original on 19 December 2017. Retrieved 12 April 2018.
  7. ↑ "Special report: Designing a new model for children's hospitals". Building Better Healthcare. 21 July 2022. Archived from the original on 28 September 2022. Retrieved 28 September 2022.
  8. ↑ "Paediatrics". www.mcnz.org.nz. Archived from the original on 13 April 2018. Retrieved 12 April 2018.
  9. ↑ H. Beukers; John Michael Henderson Moll (1989). Clinical Teaching, Past and Present. Rodopi. p. 27. ISBN 978-90-5183-082-8. Retrieved 21 May 2018.
  10. 1 2 3 Davies, Ruth (5 January 2010). "Marking the 50th anniversary of the Platt Report: from exclusion, to toleration and parental participation in the care of the hospitalized child". Journal of Child Health Care. 14 (1): 6–23. doi:10.1177/1367493509347058. PMID 20051502. S2CID 206719396.
  11. 1 2 3 4 Sloane, David (October 2005). "Not Designed Merely to Heal: Women Reformers and the Emergence of Children's Hospitals". The Journal of the Gilded Age and Progressive Era. 4 (4): 331–354. doi:10.1017/S1537781400002747. S2CID 162917903.
  12. ↑ "Great Osmond Street Hospital Charity". Archived from the original on 2016-03-23. Retrieved 2016-04-08.
  13. ↑ "About the Children's Hospital of Philadelphia". The Children's Hospital of Philadelphia. Archived from the original on 2010-06-29. Retrieved 2016-04-08.
  14. ↑ Young, D.G. (August 1999). "The Mason Brown Lecture: Scots and paediatric surgery". Journal of the Royal College of Surgeons Edinburgh. 44: 211–15. PMID 10453141. Archived from the original on 2014-07-14.
  15. ↑ "History and milestones". Archived from the original on 2009-03-01. Retrieved 2016-04-08.
  16. ↑ Cite error: Invalid <ref> tag; no text was provided for refs named ":1".
  17. 1 2 Cite error: Invalid <ref> tag; no text was provided for refs named ":4".
  18. ↑ Nicoll, James H. (18 September 1909). "The Surgery of Infancy" (PDF). British Medical Journal: 753–754. Archived from the original (PDF) on 3 March 2016. Retrieved 21 May 2018.
  19. ↑ Spitz, Rene A. (13 February 2017). "Hospitalism An Inquiry into the Genesis of Psychiatric Conditions in Early Childhood". The Psychoanalytic Study of the Child. 1 (1): 53–74. doi:10.1080/00797308.1945.11823126. PMID 21004303.
  20. ↑ Cite error: Invalid <ref> tag; no text was provided for refs named "Karen19942".
  21. ↑ Watkins, A. G.; Lewis-Faning, E. (17 September 1949). "Incidence of Cross-infection in Children's Wards". BMJ. 2 (4628): 616–619. doi:10.1136/bmj.2.4628.616. PMC 2051037. PMID 18140555.
  22. ↑ Hunt, A.D. (November 1974). "On the Hospitalisation of Children: An Historical Approach". Pediatrics. 54 (5): 542–546. doi:10.1542/peds.54.5.542. PMID 4616215. S2CID 39091723.
  23. ↑ Alsop-Shields, Linda; Mohay, Heather (20 December 2001). "John Bowlby and James Robertson: theorists, scientists and crusaders for improvements in the care of children in hospital". Journal of Advanced Nursing. 35 (1): 50–58. doi:10.1046/j.1365-2648.2001.01821.x. PMID 11442682.
  24. ↑ Robertson, James (10 December 1958). "Going to Hospital with Mother". Proceedings of the Royal Society of Medicine. 52 (381): 381–3, discussion 383–4. doi:10.1177/003591575905200518. PMC 1869195. PMID 13658166.
  25. ↑ Weiss AJ, Barrett ML, Andrews RM (July 2014). "Trends and Projections of U.S. Hospital Costs by Payer, 2003-2013" (176). Rockville, MD: Agency for Healthcare Research and Quality. Archived from the original on 2022-03-11. Retrieved 2014-08-15. Cite journal requires |journal= (help)
  26. ↑ Skiner HG, Blanchard J, Elixhauser A (September 2014). "Trends in Emergency Department Visits, 2006-2011" (179). Rockville, MD: Agency for Healthcare Research and Quality. Archived from the original on 2014-12-24. Retrieved 2014-10-20. Cite journal requires |journal= (help)
  27. ↑ Moore B, Levit K, Elixhauser A (October 2014). "Costs for Hospital Stays in the United States, 2012" (181). Rockville, MD: Agency for Healthcare Research and Quality. Archived from the original on 2014-11-29. Retrieved 2014-11-26. Cite journal requires |journal= (help)
  28. ↑ Witt WP, Wiess AJ, Elixhauser A (December 2014). "Overview of Hospital Stays for Children in the United States, 2012". HCUP Statistical Brief. Rockville, MD: Agency for Healthcare Research and Quality (186). PMID 25695124. Archived from the original on 2018-09-24. Retrieved 2015-04-06.
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