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全科医生对儿童发育和行为障碍的了解。

General practitioners' knowledge on childhood developmental and behavioural disorders.

作者信息

Lian W B, Ho S K Y, Yeo C L, Ho L Y

机构信息

Department of Neonatology, Singapore General Hospital, Outram Road, Singapore 169608.

出版信息

Singapore Med J. 2003 Aug;44(8):397-403.

Abstract

INTRODUCTION

Childhood developmental and behavioural disorders are increasingly being recognised, with high demands for earlier diagnosis and intervention. In Singapore, referrals to the Child Development Unit, KK Women's and Children's Hospital, originate mainly from primary health care practitioners, who therefore should have adequate baseline knowledge of normal development as well as common developmental and behavioural disorders.

METHODOLOGY

A pilot study, using a questionnaire survey, was conducted, with the aim of assessing existing knowledge in childhood developmental and behavioural paediatrics amongst a cohort of general practitioners (GPs) in Singapore. True/False questions on normal development as well as developmental disorders such as autistic spectrum disorder (ASD), attention deficit/hyperactivity disorder (ADHD) and learning disability, were structured. These disorders were selected because of their relatively higher prevalence.

RESULTS

A total of 48 GPs were surveyed, representing 2% of non-specialists practising in the private sector. The median total score (T-score) was 9 (range 6 to 13) of a possible 14. Only just over a-third of the group achieved the pass rate (defined arbitrarily as 75%) for T-score, with two-thirds replying correctly to all questions on normal development. Scores for factual ASD/ADHD questions were also not ideal, with some myths being believed as truths.

CONCLUSION

The scores reflect knowledge and educational deficits in developmental paediatric medicine amongst the study cohort. Expected to provide holistic care and counselling, these GPs are currently insufficiently equipped with the necessary knowledge and skills to support families of special-needs children. Education and training programmes in this aspect of paediatric medicine are clearly needed, through the organisation of CME lectures and incorporation of various developmental topics into the training curriculum. This will enable early identification and diagnosis of childhood developmental and behavioural disorders, which will in turn allow greater optimisation of potential and functionality in these special-needs children.

摘要

引言

儿童发育和行为障碍日益受到关注,对早期诊断和干预的需求很高。在新加坡,转介至新加坡妇幼医院儿童发育科的病例主要来自基层医疗从业者,因此他们应具备正常发育以及常见发育和行为障碍的足够基础知识。

方法

开展了一项试点研究,采用问卷调查的方式,旨在评估新加坡一组全科医生(GP)对儿童发育和行为儿科学的现有知识。设计了关于正常发育以及发育障碍(如自闭症谱系障碍(ASD)、注意力缺陷多动障碍(ADHD)和学习障碍)的是非题。选择这些障碍是因为它们的患病率相对较高。

结果

共调查了48名全科医生,占私营部门非专科医生的2%。在满分14分的情况下,总得分中位数(T分)为9分(范围为6至13分)。该组中只有略超过三分之一的人达到了T分的及格率(任意定义为75%),三分之二的人正确回答了所有关于正常发育的问题。关于ASD/ADHD事实性问题的得分也不理想,一些误解被当作事实。

结论

这些分数反映了研究队列中发育儿科学方面的知识和教育缺陷。这些全科医生本应提供全面的护理和咨询,但目前他们缺乏支持特殊需求儿童家庭所需的必要知识和技能。显然需要通过组织继续医学教育讲座以及将各种发育主题纳入培训课程,开展儿科学这方面 的教育和培训项目。这将有助于早期识别和诊断儿童发育和行为障碍,进而更大程度地优化这些特殊需求儿童的潜能和功能。

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