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知情同意与兴奋剂药物:青少年及家长对治疗注意力缺陷/多动障碍的兴奋剂药物的益处和风险信息的理解能力。

Informed consent and stimulant medication: adolescents' and parents' ability to understand information about benefits and risks of stimulant medication for the treatment of attention-deficit/hyperactivity disorder.

作者信息

Schachter Debbie, Tharmalingam Sukirtha, Kleinman Irwin

机构信息

Centre for Addiction and Mental Health, Child, Youth and Family Program, Toronto, Canada.

出版信息

J Child Adolesc Psychopharmacol. 2011 Apr;21(2):139-48. doi: 10.1089/cap.2010.0037.

Abstract

BACKGROUND

This study of informed consent examines understanding of information needed to consent to stimulant treatment for attention-deficit/hyperactivity disorder (ADHD). The understanding of adolescents with ADHD, their parents, control adolescents, and their parents is compared.

METHOD

Fifty-eight ADHD and 64 control adolescents between the ages of 12 and 16 and their parents were studied. Baseline understanding of information was determined. Subjects received information relevant to informed consent for stimulation medication and afterward were evaluated on their recall understanding and their final understanding.

RESULTS

Knowledge was increased after the information session for all subjects. There was no significant difference between unadjusted baseline, recall, and final knowledge of control adolescents and parents. Although unadjusted baseline, recall, and final knowledge of ADHD adolescents is significantly less than that of parents, 78% of ADHD adolescents had final understanding scores within 2 standard deviations of parents' scores. After controlling for baseline understanding and cognitive variables, there was no significant difference between understanding of ADHD adolescents and ADHD parents, whereas control adolescents understanding scores were higher than that of their parents. Understanding was highly associated with mathematics achievement in all groups.

CONCLUSION

The majority of adolescents with ADHD, both with and without a history of stimulant medication treatment, have understanding that is similar to their parents and their inclusion in the informed consent process should be encouraged. Extra care should be afforded to those adolescents with low numeracy or literacy to ensure their understanding.

摘要

背景

本关于知情同意的研究考察了对注意力缺陷多动障碍(ADHD)兴奋剂治疗同意所需信息的理解情况。比较了患有ADHD的青少年及其父母、对照青少年及其父母的理解情况。

方法

对58名12至16岁患有ADHD的青少年及其父母以及64名对照青少年及其父母进行了研究。确定了对信息的基线理解情况。受试者接受了与兴奋剂药物知情同意相关的信息,之后对他们的回忆理解和最终理解进行了评估。

结果

所有受试者在信息介绍会后知识都有所增加。对照青少年及其父母未经调整的基线、回忆和最终知识之间没有显著差异。虽然患有ADHD的青少年未经调整的基线、回忆和最终知识明显低于其父母,但78%的患有ADHD的青少年最终理解得分在父母得分的2个标准差范围内。在控制了基线理解和认知变量后,患有ADHD的青少年与其父母的理解之间没有显著差异,而对照青少年的理解得分高于其父母。在所有组中,理解与数学成绩高度相关。

结论

大多数患有ADHD的青少年,无论有无兴奋剂药物治疗史,其理解与父母相似,应鼓励他们参与知情同意过程。对于那些算术或读写能力较低的青少年应格外关注,以确保他们的理解。

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