Kotowycz Natalie, Crampton Susan, Steele Margaret
Faculty of Medicine, University of Western Ontario, London, Ont.
Can J Rural Med. 2005 Summer;10(3):149-54.
To examine the current practice of rural family physicians in managing children with attention-deficit hyperactivity disorder (ADHD).
Chart review of children and adolescents with a recorded diagnosis of ADHD. The data collected include the patient's age at diagnosis, the diagnosing physician, the number and type of presenting symptoms, whether the Diagnostic Statistical Manual, 4th ed (DSM-IV) criteria were met, pertinent treatment regimens, family history and comorbid conditions. Participating physicians were asked to complete a questionnaire.
Elgin County, Ontario.
Thirty-six family physicians were contacted and 11 agreed to participate. Thirty-nine charts were reviewed. The average number of presenting symptoms was 2.9 for ADHD-inattentive subtype and 2.1 for ADHD-hyperactivity subtype. A diagnostic protocol was included in 20.5% of the charts. Of the 39 charts reviewed, 25.6% had sufficient information for the patients to meet the ADHD criteria. Family physicians diagnosed 5.1% of the cases, and the duration of time between referral to specialist and appointment was 47.2 weeks.
Together the lack of symptom recording, the long duration between referrals, and the low percentage of family physicians diagnosing ADHD all suggest the need for developing diagnostic protocols for family physicians and increasing their knowledge of diagnosing and managing ADHD.
研究农村家庭医生对注意力缺陷多动障碍（ADHD）患儿的当前诊疗实践。
对已记录诊断为ADHD的儿童和青少年病历进行回顾。收集的数据包括诊断时患者的年龄、诊断医生、出现症状的数量和类型、是否符合《精神疾病诊断与统计手册》第4版（DSM-IV）标准、相关治疗方案、家族史和共病情况。参与的医生被要求填写一份问卷。
安大略省埃尔金县。
联系了36位家庭医生，11位同意参与。审查了39份病历。注意力不集中型ADHD的平均症状数量为2.9个，多动型ADHD为2.1个。20.5%的病历包含诊断方案。在审查的39份病历中，25.6%有足够信息表明患者符合ADHD标准。家庭医生诊断出5.1%的病例，从转诊到专科医生处就诊的间隔时间为47.2周。
症状记录缺失、转诊间隔时间长以及家庭医生诊断ADHD的比例低，这些都表明需要为家庭医生制定诊断方案，并增加他们对ADHD诊断和管理的知识。
