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关于儿童自闭症的知识以及尼日利亚医护人员对照顾儿童自闭症及其他发育障碍儿童需求和权利的设施及法律可及性的看法。

Knowledge about childhood autism and opinion among healthcare workers on availability of facilities and law caring for the needs and rights of children with childhood autism and other developmental disorders in Nigeria.

作者信息

Bakare Muideen O, Ebigbo Peter O, Agomoh Ahamefule O, Eaton Julian, Onyeama Gabriel M, Okonkwo Kevin O, Onwukwe Jojo U, Igwe Monday N, Orovwigho Andrew O, Aguocha Chinyere M

机构信息

Child and Adolescent Unit, Federal Neuro-Psychiatric Hospital, New Haven, Enugu, Enugu State, Nigeria.

出版信息

BMC Pediatr. 2009 Feb 12;9:12. doi: 10.1186/1471-2431-9-12.

DOI:10.1186/1471-2431-9-12
PMID:19216754
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2650693/
Abstract

BACKGROUND

In designing programs to raise the community level of awareness about childhood autism in sub-Saharan Africa, it is logical to use the primary healthcare workers as contact point for education of the general public. Tertiary healthcare workers could play the role of trainers on childhood autism at primary healthcare level. Assessing their baseline knowledge about childhood autism to detect areas of knowledge gap is an essential ingredient in starting off such programs that would be aimed at early diagnosis and interventions. Knowledge of the healthcare workers on availability of facilities and law that would promote the required interventions is also important. This study assessed the baseline knowledge about childhood autism and opinion among Nigerian healthcare workers on availability of facilities and law caring for the needs and rights of children with childhood autism and other developmental disorders.

METHOD

A total of one hundred and thirty four (134) consented healthcare workers working in tertiary healthcare facilities located in south east and south-south regions of Nigeria were interviewed with Socio-demographic, Knowledge about Childhood Autism among Health Workers (KCAHW) and Opinion on availability of Facilities and Law caring for the needs and rights of children with Childhood Autism and other developmental disorders (OFLCA) questionnaires.

RESULTS

The total mean score of participated healthcare workers on KCAHW questionnaire was 12.35 +/- 4.40 out of a total score of 19 possible. Knowledge gap was found to be higher in domain 3 (symptoms of obsessive and repetitive pattern of behavior), followed by domains 1 (symptoms of impairments in social interaction), 4 (type of disorder autism is and associated co-morbidity) and 2 (symptoms of communication impairments) of KCAHW respectively among the healthcare workers. Knowledge about childhood autism (KCA) as measured by scores on KCAHW questionnaire was significantly associated with age group distribution of the healthcare workers, with those age group of fourth decades and above more likely to have higher mean score (p = 0.004) and previous experience of managing children with autism spectrum disorders (ASD) (p = 0.000). KCA showed near significant association with area of specialty, with those healthcare workers in psychiatry compared to pediatrics having higher mean score (p = 0.071) and also with years of working experience of the healthcare workers (p = 0.056). More than half of the healthcare workers subscribed to the opinion that facilities and law caring for the needs and rights of children with childhood autism and other developmental disorders are lacking in Nigeria.

CONCLUSION

The correlates of KCA may help in selection of those tertiary healthcare workers that would best fit the role of trainers. It is important to update the knowledge gaps of those healthcare workers who scored low in different domains of KCAHW questionnaire. It is imperative for policy makers in Nigeria to advocate and implement multidisciplinary healthcare service system that would ensure early diagnosis and interventions. Nationally representative baseline epidemiological data that would guide policy and planning are also desirable.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b769/2650693/f4f33f04e4f6/1471-2431-9-12-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b769/2650693/f4f33f04e4f6/1471-2431-9-12-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b769/2650693/f4f33f04e4f6/1471-2431-9-12-1.jpg
摘要

背景

在设计提高撒哈拉以南非洲地区社区对儿童自闭症认识水平的项目时,将初级卫生保健工作者作为向公众进行教育的联系点是合乎逻辑的。三级卫生保健工作者可以在初级卫生保健层面发挥儿童自闭症培训师的作用。评估他们关于儿童自闭症的基线知识以发现知识差距领域,是启动此类旨在早期诊断和干预的项目的重要因素。卫生保健工作者对有助于进行所需干预的设施和法律的了解也很重要。本研究评估了尼日利亚卫生保健工作者关于儿童自闭症的基线知识,以及他们对照顾儿童自闭症和其他发育障碍儿童的需求及权利的设施和法律的看法。

方法

对总共134名同意参与的在尼日利亚东南部和西南部地区三级医疗设施工作的卫生保健工作者进行了访谈,使用了社会人口统计学、卫生工作者关于儿童自闭症的知识(KCAHW)以及关于照顾儿童自闭症和其他发育障碍儿童的需求及权利的设施和法律的看法(OFLCA)问卷。

结果

参与的卫生保健工作者在KCAHW问卷上的总平均得分是12.35 +/- 4.40(满分19分)。发现知识差距在第3领域(强迫性和重复行为模式的症状)中更高,其次是KCAHW的第1领域(社交互动障碍的症状)、第4领域(自闭症类型及相关共病)和第2领域(沟通障碍的症状)。通过KCAHW问卷得分衡量的关于儿童自闭症的知识(KCA)与卫生保健工作者的年龄组分布显著相关,40岁及以上年龄组的人更有可能获得更高的平均得分(p = 0.004)以及之前管理自闭症谱系障碍(ASD)儿童的经验(p = 0.000)。KCA与专业领域接近显著相关(p = 0.071),与儿科相比,精神科的卫生保健工作者平均得分更高,并且也与卫生保健工作者的工作年限相关(p = 0.056)。超过一半的卫生保健工作者赞同这样的观点,即尼日利亚缺乏照顾儿童自闭症和其他发育障碍儿童的需求及权利的设施和法律。

结论

KCA的相关因素可能有助于挑选最适合培训师角色的三级卫生保健工作者。更新那些在KCAHW问卷不同领域得分较低的卫生保健工作者的知识差距很重要。尼日利亚的政策制定者必须倡导并实施多学科医疗服务体系,以确保早期诊断和干预。同样需要全国代表性的基线流行病学数据来指导政策和规划。

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