Program in Child Health Evaluative Sciences, Research Institute The Hospital for Sick Children, Toronto, Canada.
BMC Psychiatry. 2014 Apr 12;14:110. doi: 10.1186/1471-244X-14-110.
Young adolescents' and their parents' experiences with Attention-Deficit/Hyperactivity Disorder (ADHD) and its treatment were explored to investigate beliefs and attitudes regarding use of stimulant medication, and their influence on treatment decisions.
Using in-depth qualitative interviews, 12 adolescents with ADHD aged 12 - 15 years, and their parents described their experiences of ADHD and its treatment. Twenty four interviews, 12 with adolescents and 12 with their parents elicited detailed descriptions of beliefs about ADHD, attitudes about stimulant use and the circumstances surrounding treatment decisions. Verbatim transcripts were iteratively analyzed by a team of researchers following an interpretive interactionist framework.
Young people offered three themes describing ADHD: 1) personality trait, 2) physical condition or disorder, and 3) minor issue or concern. Regarding medication use, youth described 1) benefits, 2) changes in sense of self, 3) adverse effects, and 4) desire to discontinue use. Parents' beliefs were more homogeneous than youth beliefs, describing ADHD as a disorder requiring treatment. Most parents noted benefits from stimulant use. Themes were 1) medication as a last resort, 2) allowing the child to reach his or her potential; and 3) concerns about adverse and long-term effects. Families described how responsibility for treatment decisions is transferred from parent to adolescent over time.
Young adolescents can have different beliefs about ADHD and attitudes about medication use from their parents. These beliefs and attitudes influence treatment adherence. Incorporating input from young adolescents when making clinical decisions could potentially improve continuity of treatment for youth with ADHD.
本研究旨在探索青少年及其父母对注意缺陷多动障碍（ADHD）及其治疗的体验，以调查他们对兴奋剂药物使用的信念和态度，及其对治疗决策的影响。
本研究采用深入的定性访谈方法，对 12 名 12-15 岁的 ADHD 青少年及其父母进行了访谈，以描述他们对 ADHD 及其治疗的体验。24 次访谈中，有 12 次访谈是针对青少年的，12 次访谈是针对其父母的，这些访谈详细描述了他们对 ADHD 的信念、对兴奋剂使用的态度以及围绕治疗决策的情况。研究团队采用解释性互动主义框架，对逐字记录的转录内容进行了迭代分析。
青少年提供了三个描述 ADHD 的主题：1）个性特征；2）身体状况或障碍；3）轻微问题或担忧。关于药物使用，青少年描述了 1）益处；2）自我感觉的变化；3）不良反应；4）停药意愿。与青少年相比，父母的信念更加一致，他们将 ADHD 描述为一种需要治疗的疾病。大多数父母注意到兴奋剂使用的益处。父母的主题包括 1）药物是最后的治疗手段；2）让孩子发挥潜力；3）对不良反应和长期影响的担忧。家庭描述了随着时间的推移，治疗决策的责任是如何从父母转移到青少年身上的。
青少年可能对 ADHD 有不同的信念，对药物使用有不同的态度，这些信念和态度影响着治疗的依从性。在做出临床决策时，纳入青少年的意见可能会潜在地改善 ADHD 青少年的治疗连续性。
