VIETHAM MEDICAL JOURNAL H''2 - APRIL - 2016 Mat phan xa gan - xu'dng la trieu chu'ng rat
quan tn?ng va rat thu'dng gap d benh nhan mac hpi chii'ng Guillain - Barre. bay la mdt dau hieu quan tnDng giup ngu'di thay thudc lam sang hu'dng d§n ehan doan hdi chu'ng Guillain - Barre [4]. Trang nghien ciru eiia ehung tdi, phan xa gan - xu'dng giam hoac mat d 77,5% nhu'ng van edn bao tdn d 22,5% tru'dng hdp. Oieu nay khien cho viec chan doan xae djnh tren lam sang gap khd khan d ^A so benh nhan.
Rdi loan cam giac chii quan gap d 77,5% sd benh nhan, thu'dng gap nhat la te bi (62,5%).
Liet eac day than ktnh sp cung la trieu chu'ng thu'dng du'dc ghi nhan d nhiitig benh nhan mac benh viem nhieu re va day than kinh cap tinh.
Trong nghien cirtj nay, liet day than ktnh VII ngoai vi la hay gap nhat, cliiem t^ le 27,5%.
Xet nghiem djch nao - tiiy la xet nghiem ddng vai trd rat quan trpng trong chan doan benh nhiit la khi phu'dng phap chan doan dien - than kinh ehu^ du'dc ap dung rdng rai [5].Trong nghien ciTu eiia chimg tdi, 100% benh nhan du'dc xet nghiem dich nao - tiiy, vdi 65% benh nhan cd phan iy protein - te bao, cd 35% benh nhan chu^ cd bien dot bat thu'dng trong xet nghiem djch nao - tity trong tuan dau ciia benh.
V. KET LUJ^N
Hot ehutig Guillain - Barre vdi trieu ehiTng lam sang noi bat la yeu cd cae ehi kieu ngoai vi, giam hoae mat phan xa gan - xu'dng, phan ly protetn- te bao trong djeli nao - tuy va thu'dng cd cac bieu hien rot loan cam giac chii quan. Tuy nhien trong giai doan sdm cua benh, gan 30% benh nhan ed trieu ehirng lam sang ed the khdng day du va dien hinh.Oieu nay gay khd khan trong chan doan xac dinh va dieu tri sdm cho benh nhan neu ehi di/a vao trieu ehirng lam sang va xet nghiem dich nao - tiiy.
TAI LIEU T H A M KHAO
1. Asbury A.K (2000), New concepts of Guillain - Barre syndrome, J Child Neurol, 15(3), 183-191.
^. McGrogan A., Madle G. C , Seaman H. E,et al (2009). The epidemiology of Guillain-Barre syndrome worldwide. A systematic literature review. Neuroepldemiology, 32(2), 150-163.
3. Chroni E, Papapetropoulos S, Gioldasis G, et al (2004), Guillain - Barre syndrome In Greece;
seasonality and other clinico -epidemiological features, Eur J Neurol, 11(6), 383-388.
4. Nguyen Tuan Lu'dng (2011), Nghien cuU d$c diem lim sang vp dien smh ly than kinh cua binh nhin viim da re vi diy than kmh cip tmh, Liian van Thac si Y hoc, Dai hpc Y Ha Noi.
5. Fokke C, van den Berg B, Drenthen J, et al (2014), Diagnosis of Guillain - Ban^ syndrome and validation of Bnghton cntena, asm, 137(Pt 1), 33-43.
DANH GIA KIEN THITC, THAI DO CUA CHA/ME HOAC NGirai CHAM SOC CHINH VE PHAT HIEN SffM KHUYET TAT
tf TRE EM TAI HUYEN QUYNH PHU T I N H T H A I BINH Pham Thi Tinh*, Pham Thi Dung*, Pham Bich Phirong*
T O M TAT
Muc tieu: Tim hieu kien thCfc, thai do ciia cha me/ngu'di hoac ngu'di cham sdc chfnh ve phat hien sdm khuyet tat ii tre em tai huyen Quynh Phu, tiiih Thai Binh, tir do xay di/ng ke hoach trang bj cac kien tiiirc, ky nang ve phat hien sdm khuyet tat d tre em cho cac doi tuong nay. Phddngj/hip: Nghien culi mo ta cat ngang 182 bo/me (hoac ng^Udi cham sdc chinh) trong cac gia dinh cd tre 0 - 6 tuoi bi khuyet tat trong toan huyen. Ket qui nghien cdu: Ty le doi tu'dng nghien ciJU co kien thirc diing ve khuyet tat diiem 51,6%j^ Kien thu'c diing ve phat hien sdm khuyet tat chiem 47,8%. 60,4% ddi tu'dng nghien eiru
*Trudng Dal hoc YDudc Thii Binh Chiu traeh nhiem chinh: Pham Thi Tinh Email: [email protected] Ngay nhan bai: 6.2.2018 Ngay phan bien khoa hoc; 28.3.2018 Ngay duyet bai: 10.4.2018
chon diing do tuoi de phat hien sdm khuyet t|it 6 tre em. 51,6% doi tu'dng nghien ciru cho rang phat hien sdm khuyet tat de can thiep sdm. Nhan li/c ttiam gia phat hien sdni khuyet tat du'dc \iia chon nhiieu nhat la can bo yte (97,8%).
Td khoa: Tre khuyet tat, phat hien sdm khuyet tat.
SUMMARY
AN EVALUATION ON KNOWLEDGE, ATTITUDES OF PARENTS OR PRIMARY CARETAKERS ON EARLY DETECTION OF DISABIUTY I N CHILDREN I N QUYNH PHU
DISTRICT, T H A I B I N H PROVINCE Objectives: To study the knowledge and attitudes of parents or caretakers on early detection of childhood disability in Quynh Phu district. Thai Binh province, and to develop a plan to equip these subjects with knowledge and skills on early detecting disability in children. Methods: A cross-sectional study was carried out onl82 parents (or primary
18
TAP CHt Y HQC VI|T HAM TAP 465 - THANG 4 - SO 2 - 2018 caretakers) in families with 0-6 year-old children with
disabilities in the whole district. Results: The proportion of subjects with right knowledge about disability was 51.6%; Those with proper leiowledge about early detection of disability accounted for 47.8%. 60.4% of respondents selected the right age for early detection of disability in children. 51.6% of respondents considered and agreed that early detection of disability is necessary to have an early intervention. The most selected personnel for early disability detection was health workers with 97.8%.
Keywords: Children with disabilities, early detection
I. OiCkT VAN OE
Khuyet tat (KT) la van de mang tinh toan cau.
Trong the gidi eiia ngu'di khuyet tat ndi chung thi tre khuyet tat cung ludn tdn tai kliaeh quan va la ddi tu'dng thiet thdi nhat trong xa hpi. Ty le khuyet tat d tre em tren pham vi toan eau qua Khao sat ganh nang benh tSt toan cau (2004) chiem 5 , 1 % d nhdm 0 - 1 4 tuoi. Trong do ehau Au 4,2%; Chau My 4,5%; Khu vi/c Trung Bdng la 5,2%; Tay Thai Binh Du'dng 5,3% va Chau Phi la 6,4%. Tai Viet Nam, theo Bao cao ciia Quy dan sd Lien Hdp Qudc ve ngu'di khuyet tat d Viet Nam (2011) tdng hdp eac so lieu tir Tong dieu tra Dan sdva Nha d nam 2009 cho thay ca nu'dc cd 6,1 trieu ngu'di (chiem 7,8%) ttr 5 tudi trd ten bj khuyet tat. Trong sd dd, cd 3,6% la tre em trong dp tuot tir 5 den du'di 16 tudi va 4,7% la tre em va vj thanh nien trong dp tudi tir 5 den du'di 18 tuoi.
Theo To chuTc Y te The gidi, phat hien sdm - can thiep sdm cd the phdng ngira khoang 70%
cae khuyet tat d tre gay ra bdi benh tat, suy dinh du9ng hoac cac nguyen nhan khae. Vi vay, phat hien sdm - can thiep sdm tre khuyet tat dang la muc tieu chung ciia nhieu quoe gia tren the gidi nham khac phuc hau qua eiia khuyet tat, anh hu'dng sau sac den chat lu'dng dan so. Trong chu'dng trinh phat hien sdm - can thiep sdm cho tre khuyet tat thi cha me hoac ngu'di cham sdc chinh giu' vat trd vd ciing quan trpng. Tuy nhien, sir thieu hut ve kien thu'c va ky nang kien hp gap kiiong it khd khan ve van de nay. Tu" nhiJng ly do tren chiing tdi chpn de tai vdi muc tteu: Danh gta kien thiTc ciia cha/me hoac ngu'di cham sde chinh ve phat hien sdm - can thiep sdm khuyet tat d tre 0 - 6 tuoi huyen Quynh Phu - Thai Binh nam 2016.
II. OOI TLTQWG VA PHU'ONG PHAP NGHIEN CUU 2 . 1 . Ooi tu'dng, dja diem va thdi gian nghien cii'u: Odi tu'dng nghien ciTu (OTNC) la 182 bo/me hoac ngu'di cham sdc ehinh trong cae
gia dinh cd tre tir 0 - 6 tudi bi khuyet tat tai 36 xa, thj tran thudc huyen Quynh Phu, tinh Thai Binh. Nghien ciTu du'dc tten hanli tir thang 10/2016 den thang 3/2017.
2.2. PhUdng phap nghien cuU^
2 . 2 . 1 . Thiet ke nghien CU\J: Ap dung phd- dng phap nghien cdu djch te hoc md ti qua dieu tra cat ngang.
2.2.2. C9 mau. Tir 1 nghien cu'u khac, trong tdng so 15.685 tre 0 - 6 tudi tai dia ban nghien ciru, ehiing tdt phat hien du'dc 182 tre khuyet tat. Vi vay, trong nghien cu'u nay ehung tdi chpn mau thuan tien la 182cha/me hoac ngu'di cham sdc chinh eiia cac tre khuyet tat ndi tren.
2.3. Ngi dung va cac bien so sd dung trong nghien cdu
- Thdng tin chung ve ddi tu'dng nghien eiru:
Hp ten, tudi, gidi...
- Kien thirc ciia ddi tu'dng nghien ciiu ve:
- Tre khuyet tat.
- Phat hien sdm khuyet tat d tre em.
- Thdi diem phat hien sdm khuyet tat.
- Mue dieh eiia phat hien sdm khuyet tat.
- Nlian lire tham gia phat hien sdm khuyet tat.
- Thai dp eua ddi tu'dng nghien eiru ve:
- Sd can thiet ciia phat hien sdm khuyet tat d tre em.
- Hieu qua eiia phat hien sdm khuyet l i t d tre em.
2.4. Cdng cu thu thap sdlieu: Bp cau hdi phdng van.
2.5. Phddng phap xd ly SO lieu: So Weu xd ly bang chu'dng trinh SPSS tai Pliong Quan ly khoa hpc, Tru'dng Dai hgc Y Du^de That Binh.
III. KET QUA NGHIEN CLTU
Bang 1: Thdng tin chung ve ddi tddng nghien cdu
Noi dung Nhom
tuoi Trinh 46 hgc van
Nghe nghiep
< 3 0
>30 Khong biet chiJ
Tieu hoc THCS THPT Trung cap/CD
Dal hoc Tren dai hoc
Nong dan Con^ nhan - Vien chijc
Noi trd Kinh doanh
Khac
Tan so ( n = 1 8 2 ) 118
64 2 11 41 6 4 41 21 3 58 29 21 51 23
T y l e 64,8 35,2 1,1 6,0 22,5 3 5 , 2 22,0 11,5 1,6 31,9
15,9 11,5 28 12,6 Trong 182 ddi tu'dng nghien cu'u:
VIETHAM MEDICAL JOURNAL N°2 - APRIL - 2018 Ve dd tudi: Nhdm tudi < 30 ehiem ty le
64,8%;
Ve trinh dd hoe van: Nhdm THPT chiem ty le 35,2%.
Ve nghe nghiep: Ndng dan chiem 31,9%.
ong/ba- ^^^_
tdt nhai dephat hien sdm khuyet tat
6,6% 37.4»/n
Bieu do 1: Mdi quan he ciia ddi tddng nghien cdd vdi ire
Trong 182 DTNC ed 56% la me ciia tre, 37,4% la cha eiia tre va 6,6% la dng/ba eiia tre.
Kien thu'c cua doi tu'dng nghien cu'u ve phat hien sdm khuyet tat
Bang 2: Kien thdc ciia DTNC ve khuyet i$i va phai hien sdm
Noi dung Kien thire ve khuyet tat Kien thii'c ve
phat hien sdm khuyet
tat
Dung Dung, chu^
day dii Khong biet
Pung Dung, chu'a
day dii Khong biet
Tan sd I Ty le ( n = 1 8 2 ) o/o
17,1 23,6
Oo tuoi PHS khuyet t a t
Khae/ Khdng biet T a n ;
( n = 1 8 2 ) Ty le o/o 60,4
5,5 7,1 Ty le OTNC cho rang dp tuoi tdt nhat de phat hien sdm khuyet tat d tre ia tir 0-6tu6i ehiem 60,4%
Bang 4: Kien thdc cua DTNC vS muc dich cua phai hien sdm khuyet tai
0 6 tuoi PHS khuyet t a t | j ^ " | | j " ^ ^ ^
£)e sdm ed bien phap can thiep Giup tre cd dieu kien tham
gia cac hoat dpng trong qia dinh va cpng dong Giup tre hoi phue, phat trien tdi da eae kha nang
cdn lai eiia minh 127
51,6
69,7 Khac/Khdng biet j 11 j 6,1 51,6% DTNC cho rang phat hien sdm khijyt tat de can thiep sdm.
69^7% DTl^C cho rang phat hien sdm khuyet tat de giiip tre phue hoi.
6 , 1 % DTNC khdng biet muc dieh ciia phat hien sdm.
Bang 5: Kien thdc cua DTNC ve nhan lUc tham gia phai Men sdm khuyet tat
Ty le DTNC ed kien thUc dung ve khuyet tat chiem 51,6%; Kien thirc dung nhu'ng chu'a day dii chiem 31,3%; Cdn 17,1% DTNC chu:a ed kien thirc ve khuyet tat d tre em.
Ve phat hien sdm khuyet tat: Co 47,8% DTNC cd kien thu'c diing. Cdn 28,6% chu'a cd kien thdc ve phat hien sdm khuyet tat.
Bang 3: Kien thdc ciia DTNC ve do iudi
Nhan lire Ngu'di than trong gia
dinh Giao vien mam non
Can bo y te Can bo LBTBXH Can bo doan the Khong biet
Tan so ( n = l 8 2 ) 136 50 178
35 19 16
Tyle 'lc 74,7 27,5 97,8 19,2 10,4
-IA.
Nhan li/c tham gta phat hien sdm khuyet ta:
du'dc lu'a chpn nhieu nhat ia can bd y te (97,8%), tiep den la ngu'di ttian, cha me, ngirdi cham sdc (74,7%).
Bang 6: Thai dd cua
Noi dung Can thiet Khonq can thiet
Khonq biet
DTNC ve sdi^n thiet cua phat hien
< 30 tuoi ( n = 1 1 8 ) n 99 6 13
83,9
%
5,1 11,0
> 3 0 tuoi ( n = 6 4 ) n 45 6 13
»/o 70,3
9,4 20,3
sdm khuyet tat Tong ( n = 1 8 2 ) n 144
12 26
o/o 79,1
6,6 14,3
P
>0,05 Co 83,9% DTNC d nh6m < 30 tuoi clio rang rang phat hiSn sdm khuyet tat la can t h i a , la khong can thiet. Ty le nay d nhom >30 tuoi ia 70,3% va 9,4%. Su' khac biet nay khong thong ke vdi p>0,05.
5 , 1 % cho CO y nghla
TAP CHi Y HOC VIET NAM TAP 465 - THANG 4 SO2-2013 Bang 7: Thai dd cua DTNC ve hieu qua cua phat hien sdm khuyet tat
Ngi dung Co hieu qua Khong hieu qua
Khonq biet
< 3 0 t u 6 l ( n = 1 1 8 ) n 101
2 15
«/o 85,6
1,7 12,7
> 3 0 t u 6 l ( n = 6 4 ) n 43 7 14
»/o 67,2 10,9 21,9
T 6 n g ( n = 1 8 2 ) n 144
9 29
%
79,1 4,9 16,0
P
<0,05 Co 85,6% DTNC d nhdm < 30 tuoi cho rang rang phat hien sdm khuyet tat co hieu qua tot. 1,7%
cho ia khong hieu qua. Ty le nay d nhdm >30 tuoi ia 67,2% va 10,9%. SU lihac biet nay cd y nghla thong ke vdi p<b,05
Bang 8: Thai dd cua DTNC ve kha nang phat trien cua tre khuyet tat
Noi dung Cd the phat trien binh thiTdng Khong the phat trien binh thi/dng
Khonq biet
< 30 tuoi ( n = 1 1 8 ) n 93 11 14
»/o 78,8
9,3 11,9
> 3 0 tuoi { n = 6 4 ) n 49 8 7
76,6
%
12,5 10,9
Tong Cn=182) n 142
19 21
»/o 78,1 10,4 11,5
P
>0,05 78,8% DTNC d nhdm < 30 tuoi cho rang rang tre khuyet tat van cd the hpc tapva phat trien nhu' binh thu'dng. Ty le nay d nhdm >30 tudi la 76,6%. Su" khac biet khdng cd y nghTa thdng ke vdi p>0,05.
phat hien sdm khuyet tat d tre chiem 47,8%.
Hieu dung nhu'ng chu'a day dii ehiem 23,6%. Sd dot tu'dng edn lai 28,6% chu'a cd kien thu'c ve phat hien sdm ktiuyet tat.
Ve thdi diem phat hien sdm khuyet tat, tir ket qua bang 3 eho thay: Cd 60,4% DTNC neu dung thdi diem phat hien sdm khuyet tat d tre em la tir 0 - 6 tudi.
Trong qua trinh phat trien eua tre em thi 0 - 6 tudi la giat doan ma su" phat trien cua tre dat tdc dp nhanh nhat ve mpi m a t Day eung la thdi gian hinh thanh nen tang eho eudc sdng tu'dng lai ciia tre. Viec phat hien sdm, xac dinh diing va ed nhu'ng can thiep sdm phii hdp vdi nhu'ng dau hieu eham phat trien d tre se giiip eho tre cd cd hdi phat trien het kha nang ciia minh.
Ve muc dich phat hien sdm: 51,6% DTNC nhan thufe du'dc muc dieli cua phat hien sdm la de can thiep sdm. Ngoai ra, eac muc dich khac nhu': Giiip tre phat trien tdt da cae kha nang cdn lai cua mirih; Giiip tre hda nhap gia dinh, cpng ddng cung la nhu'ng y kien du'dc lu'a chpn nhteu.
Cd 6 , 1 % DTNC chu'a cd kien thirc ve mue dieh eiia chu'dng trinh phat hien sdm (bang 4).
Ve nhan li/e tham gia chu'dng trinh phat hien sdm khuyet tat thi hau het eae BTNC deu clio rang nguon nhan lu'c chinh tham gia vao chu'dng trinh la CBYT chiem 97,8%. Cd 74,7% chpn nhan \dc cho chu'dng trinh la bd me tre hoac ngu'di than trong gia dinh. Chi cd 27,5% DTNC ehpn giao vien mam non (bang 5).
Chiing ta deu biet rang, de chu'dng trinh phat hien sdm khuyet tat d tre em du'dc thiTc hien cd hieu qua, ngoai can bd y te thi gia dinh (cha/me Bieu dd 2: Thai dp ciia DTNC ve viec san
sang tham gta chu'dng trinh phat hien sdm.
Cd 95,2% BTNC chpn s i n sang tham gia chu'dng trinh phat hien sdm khuyet tat.
IV. BAN LUAN
Trong tong sd DTNC, nhdm < 30 tudi chiem 64,8%. Nhdm >30 tuoi ehiem 35,2%. Ve trinh dp hpe van chii yeu la bac PTTH (35,2%). Ve nghe nghiep: Nghe ndng chiem 31,9%.
Ngu'di Cham sdc chinh cua tre chii yeu la bd/me. Cd 6,6% ngu'di cham sde ehi'nh la dng/ba do trong mpt so gia dinh do bo/me tre di lam xa hoac lam cdng nhan trong nha may, xi nghiep nen ngu'di eham sdc chi'nh la dng/ba tre (bang 1, bieu ^ 1)
Kien thdc cua doi tUdng nghien cdu ve phai bien sdm khuyet tat
Ket qua nghien ciru bang 2 cho thay: Ty le OTNC CO kien thu'c dung ve khuyet tat chiem 51,6%; Cd 31,3% OTMC hieu nhutig chu^ day dii ve khai niem khuyet tat. Sd DTNC chu^ cd kien thire ve ktiuyet tat chtem 1 7 , 1 %
Tu'dng tu": Ty le OTNC cd kien thii'e diing ve
VIETNAM MEDICAL JOURNAL N°2 - APRIL - 2018 tre hoac ngu'di cham sde chinh) va dpi ngQ giao
vien mam non la nguon nhan lu'c vd cimg quan trpng. Mac dii can bd y te la ngu'di chju trach nhiem trong eham sdc sire khde cho mpi ngu'di trong dd ed tre khuyet tat nhu'ng ho dong thdi phai giai quyet rat nhieu eac chu'dng trinh khac tai cpng ddng. Neu chi cd dpi ngu nhan vien y te thi viec trien khai chu'dng trinh se gap nhieu khd khan ve nhan lu'c. Mat khae, nhti'ng ngu'di than trong gia dinh khdng ehi la ngu'di thu'dng yeu tre nhat ma hp cdn hieu du'dc nhu'ng van de khoa khan ma tre gap phai trong cuoc sdng do hau qua eua khuyet tat. Thdng qua lioat ddng cham sde, vui chdi vdi tre hang ngay, cha me cd the quan sat, cam nhan, phat hien dau liieu bat thu'dng trong sir phat trien ve the ehat, nhan thirc, ngdn ngu", tam ly ... so vdi sir phat trien binh thu'dng cira tre ciing \iia tuoi. Vi the trong chu'dng trinh phat hien sdm khuyet tat d tre khong the khong ndi den sii phdi hdp eiia gia dinh.
Thai dp cua doi tUdng nghien cdu ve phathi$n sdm khuyet tai
De danh gia thai dd ve phat hien sdm khuyet tat, Chung tdi chia DTNC theo 2 nhdm tudi;
Nhdm < 30 tudi va nhdm > 30 tudi.
Danh gia thai dp ciia OTNC ve sir can thiet ciia phat hien sdm khuyet tat, ket qua bang 6 eho thay: Nhdm < 30 tudi cd 83,9% ehon phat hien sdm khuyet tat la can thiet. Ty le nay d nhdm >30 tudi la 70,3%. Sir khac biet nay khdng cd y nghTa thong ke vdi p> 0,05.
Oanh gia thai dp eiia OTNC ve hieu qua cua chu'dng trinh phat liien sdm khuyet t i t , ket qua bang 7 eho thay: Nhdm < 30 tuoi cd 85,6% eho rang khuyet tat d tre neu cang du'dc phat hien sdm thi hieu qiia phue hoi cang cao. Ty le nay d nhdm > 30 tudi la 67,2%. Sy khac biet n^y cd y nghTa thdng ke vdi p<0,05.
Oanh gia thai dp ciia DTNC ve kha nang phat trien eiia tre khuyet tat, ket qua bang 8 eho thay: Nhdm < 30 tuoi cd 78,8% cho rang tre khuyet tSt neu du'dc can thiep sdm van cd kha nang phat trien nhir tre binh thu'dng. Ty le nay d nhdm > 30 tudi la 76,6%. Sy" khae biet nay khdng ed y nghia thdng ke vdt p>0,05.
Qua cac ket qua nghien ciru ehiing tdt nhan thay rang: Sd OTNC cd kien thirc va thai dd dung ve khuyet tat va phat hien sdm khuyet tat d tre em ehiem ty Ie kha cao.
Tuy nhien, viec danh gta kien thu'c that dd ciia eha me va ngu'di cham sdc chinh trong nghien cu'u eiia chung tdt mdt ehi thdc hien qua phdng van nen mdt so tru'dng hdp thi ngu'di tra
ldi thu'dng chpn theo xu the ma hp thay xa hpi de chap nhan hdn. Day eung chi'nh la han che cua NC khi khdng ket hdp djnh tinh de tim hieu rd hdn ve that dp ciia ddi tu'dng.
Trong sd OTI^C chu'a cd kien thirc ve khuyet tat eung nhu' phat hien sdm khuyet tat d tre em till chil yeu la dng/ba ciia tre. Viec thieu hieu biet da dan den hau qua la: Nhieu tre ed khuyet tat nhu'ng khong du'dc xae djnh eho den tan khi bat dau di hpe mau giao hoac mudn hdn. Do do, khi du'dc xae dinh bi khuyet tat thi tinh trang eiia tre khdng cdn d giai doan de cd nhu'ng can thiep kip thdi va tdt nhat. Tham chi trong nhieu tru'dng hdp, khi khuyet tat d tre du'dc phat hien thi nhij'ng cd hpi de cat thien tinh trang da hoan toan bi bd id. Chinh vi vay, truyen thdng giao due su'c khde ve phat hien sdm khuyet tat d tre em la mpt trong nhthng nhiem vu quan trpng, can du'dc thu'c hien thu'dng xuyen khdng ehi v(5i can bd y te ma vdi ea cha/me tre va dpi ngu giao vien mam non de han ehe cac hau qua cua khuyet tat.
V. KET L U ^ N
Viee danh gia the \iic, sdc khde va sii phat trien tam van ddng d tre em la vd cimg quan trpng trong cdng tac cham sdc va nudi day tre.
Ket qua eua danh gia giiip phat hien sdm - can thiep sdm cac tru'dng hdp cham phat trien hoac khuyet tat, tao cd hpi de tre phat trien binh thu'dng. Ngoai dpi ngu can bd y te thi cac thanh vien trong gia dinh (dae biet cha/me tre) la thanh phan tat yeu gop phan vao sir thanh eong CLia chu'dng trinh.
TAt UEU T H A M KHAO
1. Ban dfeu phoi cac hoat dong ho trd ngirdi khuyet tat Viet Nam (2014), Bio cao liim 2013 ve hoat dgng trd giup ngu'di khuyet tit Viet Naif,
Bo LD-TB&XH, Ha Noi l i.. Bo Lao dong - ThUOng bmh va Xa hoi (2004j|
Phin tich tinh hinh de em khuyet tit d Viet Nam. s 3. Bo Y te ( 2 0 H ) , Hudng dan Phii hien sdm - Cd
thiep sdm tre em khuyet tat, Nha xuat ban Y hoc, I 4. Tran Thj Thu Ha, Tran t r o n g Hai (2005), Phat hien sdm - can thiep sdm mot so dang tan tat 6 tre em Viet Nam, Nha xuat ban Y hoc.' >
5. Dang Thj Hu'dng (2014), Kien thii'c - Thai do - ThUc hanh ve phat hien sdm khuyet tat d tre duSi 6 tuoi ciia giao vien m^m non tai huyen Hoai Dift Ha Npi nam 2014, Luan vSn Thac sy Y te cong cpn^, Dai hpc Y te cdng cpng.
6. Quoc hoi nu'dc Cong hoa xa hoi chu nghTa Viet Nam (2010). Luat ngUdi khuyet ^ t 7. Quy Dan sd Lien Hdp quoc tai V i | t Nam
(UNFPA - 2011), Ngddi khuyet tat d Viit Nam:
Mot so kit gui chu yeu tu" Tong dieu tra Dan sov^
Nhi d Viet Nam 2009, Ha Noi.