Concannon P E, Tang Y P
Child and Family Health Service, Royal North Shore and Ryde Health Sector, Sydney, New South Wales, Australia.
J Paediatr Child Health. 2005 Dec;41(12):625-30. doi: 10.1111/j.1440-1754.2005.00771.x.
There are few studies exploring parental perceptions of the diagnosis and overall treatment of their children with attention deficit hyperactivity disorder (ADHD). This community-based study was conducted to consider this important aspect of care.
A total of 7 226 (65%) parents responded to a community survey of 11 184 children aged 10-12 years living in northern Sydney in 2000, out of which 278 children with ADHD were identified. Their parents completed an anonymous questionnaire covering their perceptions relating to diagnosis, treatment and overall management.
Only 66% of parents recalled the use of questionnaires or rating scales. There were 82% of children who had trialed medication and 66% of these were still taking it. Behavioural intervention had occurred in 42% of the children. Non-conventional treatments, most commonly elimination diet and/or fatty acid supplementation, had been used in 71% of the children. These were considered helpful in one-third of cases. A total of 55% of parents reported being either satisfied or very satisfied with their child's care. Parents were more likely to report satisfaction when their children were on medication and when reviews were held at least 6 monthly. Lack of educational support and teachers' understanding of ADHD were identified as ongoing issues.
Parental responses suggested that adherence to recommended diagnostic guidelines was inadequate. Behavioural intervention was underutilized despite its documented positive role. Non-conventional therapies were widely used and considered helpful in one-third of the children who used them. Use of stimulant medication and frequent reviews were more likely to be associated with overall management satisfaction.
很少有研究探讨父母对其患有注意力缺陷多动障碍(ADHD)的孩子的诊断及整体治疗的看法。本社区研究旨在考量这一重要的护理方面。
2000年,对居住在悉尼北部的11184名10至12岁儿童进行了社区调查,共有7226名(65%)家长做出回应,其中识别出278名患有ADHD的儿童。他们的父母填写了一份匿名问卷,内容涵盖他们对诊断、治疗及整体管理的看法。
只有66%的家长记得使用过问卷或评定量表。82%的儿童试用过药物治疗,其中66%仍在服药。42%的儿童接受过行为干预。71%的儿童使用过非传统治疗方法,最常见的是排除饮食和/或补充脂肪酸,三分之一的案例认为这些方法有帮助。共有55%的家长表示对孩子的护理感到满意或非常满意。当孩子服药且至少每6个月进行一次评估时,家长更有可能表示满意。教育支持的缺乏以及教师对ADHD的理解不足被视为持续存在的问题。
家长的反馈表明,对推荐诊断指南的遵循不够充分。尽管行为干预已被证明有积极作用,但利用不足。非传统疗法被广泛使用,三分之一使用这些疗法的儿童认为有帮助。使用兴奋剂药物和频繁评估更有可能与整体管理满意度相关。