Broder-Fingert Sarabeth, Shui Amy, Ferrone Christine, Iannuzzi Dorothea, Cheng Erika R, Giauque Ann, Connors Susan, McDougle Christopher J, Donelan Karen, Neumeyer Ann, Kuhlthau Karen
Boston Medical Center, Division of General Pediatrics, Boston University School of Medicine, Boston, Massachusetts; Division of General Academic Pediatrics, MassGeneral Hospital for Children, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Lurie Center for Autism, MassGeneral Hospital, Harvard Medical School, Lexington, Massachusetts; and
Biostatistics Center, and.
Pediatrics. 2016 Feb;137 Suppl 2:S196-204. doi: 10.1542/peds.2015-2851R.
Hospital admissions can be difficult for patients with autism spectrum disorder (ASD). We created an autism-specific care plan (ACP) to help improve the hospital experience for patients with ASD, and we tested feasibility and acceptability and compared the experience of care for children with and without an ACP.
We performed a nonrandomized, retrospective chart review of all patients with ASD and a hospital admission from January 2013 to December 2013 (n = 142) to determine feasibility of the intervention. We then mailed surveys to all 142 families to measure experience with the ACP and to compare experience of care in those who did and did not have an ACP. Using multivariable linear regression we assessed the association of experience of care with ACP use while adjusting for covariates.
The ACP was well tolerated by parents and used frequently by staff. Compared with parents who did not use the ACP, parents who used the ACP reported a better experience relating to their general hospital experience (B = 1.48, P < .001) and staff attention to their child's ASD-specific needs (B = 3.07, P < .001).
According to this pilot study, care plans are feasible and hold promise to improve the experience of care for children with ASD and their families in the hospital setting.
自闭症谱系障碍（ASD）患者住院可能会面临困难。我们制定了一项针对自闭症的护理计划（ACP），以帮助改善ASD患者的住院体验，并测试其可行性和可接受性，同时比较有和没有ACP的儿童的护理体验。
我们对2013年1月至2013年12月期间所有患有ASD且住院的患者（n = 142）进行了非随机回顾性病历审查，以确定干预措施的可行性。然后，我们向所有142个家庭邮寄了调查问卷，以衡量他们对ACP的体验，并比较有和没有ACP的家庭的护理体验。我们使用多变量线性回归评估了在调整协变量的情况下护理体验与使用ACP之间的关联。
家长对ACP耐受性良好，工作人员也经常使用。与未使用ACP的家长相比，使用ACP的家长报告称，他们在总体住院体验方面（B = 1.48，P < .001）以及工作人员对其孩子ASD特定需求的关注方面（B = 3.07，P < .001）有更好的体验。
根据这项初步研究，护理计划是可行的，有望改善ASD儿童及其家庭在医院环境中的护理体验。
