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全科医生在注意力缺陷/多动障碍诊断与管理中的态度和实践

Attitudes and practices of general practitioners in the diagnosis and management of attention-deficit/hyperactivity disorder.

作者信息

Shaw K A, Mitchell G K, Wagner I J, Eastwood H L

机构信息

School of Population Health, University of Queensland Medical School, Herston, Queensland, Australia.

出版信息

J Paediatr Child Health. 2002 Oct;38(5):481-6. doi: 10.1046/j.1440-1754.2002.00033.x.

Abstract

OBJECTIVE

To assess understanding of, and actual and potential roles in management of attention-deficit/hyperactivity disorder (ADHD) among GPs.

METHODS

A cross-sectional questionnaire survey of Queensland GPs selected randomly from the Royal Australian College of General Practitioners directory of members was carried out. Main outcome measures were knowledge levels of ADHD, current management practices, referral patterns and self-perceived information and training needs.

RESULTS

Three hundred and ninety-nine GPs returned a completed questionnaire (response rate 76%). Roles identified by GPs were: the provisional diagnosis of ADHD and referral to specialist services for confirmation of the diagnosis and initiation of management; assistance with monitoring progress once a management plan was in place; education of the child and their family regarding the disorder; and liaison with the school where necessary. Perceived barriers to increased involvement of GPs were: time and resource constraints of general practice; concerns regarding abuse and addiction liability of prescription stimulants; complex diagnostic issues associated with childhood behavioural problems; and lack of training and education regarding ADHD.

CONCLUSIONS

General practitioners identify a role for themselves in ADHD care that is largely supportive in nature and involves close liaison with specialist services.

摘要

目的

评估全科医生对注意力缺陷多动障碍(ADHD)管理的理解以及在其中的实际和潜在作用。

方法

对从澳大利亚皇家全科医生学院成员名录中随机选取的昆士兰全科医生进行了横断面问卷调查。主要结局指标为ADHD的知识水平、当前管理实践、转诊模式以及自我感知的信息和培训需求。

结果

399名全科医生返回了完整问卷(回复率76%)。全科医生确定的作用包括:ADHD的初步诊断以及转诊至专科服务以确诊和启动管理;在管理计划实施后协助监测进展;对儿童及其家庭进行关于该疾病的教育;以及在必要时与学校联络。全科医生增加参与度的感知障碍包括:全科医疗的时间和资源限制;对处方兴奋剂滥用和成瘾责任的担忧;与儿童行为问题相关的复杂诊断问题;以及缺乏关于ADHD的培训和教育。

结论

全科医生确定了自己在ADHD护理中的作用,该作用在很大程度上具有支持性质,并且涉及与专科服务的密切联络。

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