Gimbler Berglund Ingalill, Huus Karina, Enskär Karin, Faresjö Maria, Björkman Berit
*Department of Nursing and §Department of Natural Science and Biomedicine, CHILD research group, School of Health and Welfare, Jönköping University, Jönköping, Sweden; †Department of Natural Science and Biomedicine, School of Health and Welfare, The Biomedical Platform, Jönköping University, Jönköping, Sweden; ‡Division of Medical Diagnostics, Region Jönköping County, Jönköping, Sweden.
J Dev Behav Pediatr. 2016 Jul-Aug;37(6):457-64. doi: 10.1097/DBP.0000000000000289.
The overall aim of this study was to describe the current set of guidelines for the preparation and care for children with autism spectrum disorder (ASD) in the perioperative setting across Sweden and explore the content of these guidelines in detail.
An online questionnaire was distributed to the chairpersons of all anesthesia departments (n = 68) and pediatric departments (n = 38) throughout Sweden. Follow-up phone calls were made to those departments that did not return the questionnaire. The presence of guidelines was analyzed through descriptive statistics. These guidelines and comments on routines used in these departments were analyzed inspired by conventional content analysis.
Seven of the 68 anesthesia departments and none of the 38 pediatric departments across Sweden have guidelines for preparing and/or administering care to children with ASD within the perioperative setting. From the guidelines and routines used, 3 categories emerge: "lacking the necessary conditions," "no extra considerations needed," and "care with specific consideration for children with ASD." These 3 categories span a continuum in the care. In the first category, the anesthesia induction could result in the child with ASD being physically restrained. In the last category, the entire encounter with the health care service would be adapted to the specific needs of the child.
There is a lack of evidence-based guidelines specifically designed to meet the needs of children with ASD in the preoperative period in Sweden. Further research is needed to understand if children with ASD would benefit from evidence-based guidelines.
本研究的总体目标是描述瑞典围手术期自闭症谱系障碍（ASD）患儿的当前准备和护理指南，并详细探讨这些指南的内容。
向瑞典所有麻醉科（n = 68）和儿科（n = 38）的主任发放了在线问卷。对未回复问卷的科室进行了跟进电话调查。通过描述性统计分析指南的存在情况。受传统内容分析法启发，对这些科室使用的指南和常规做法的评论进行了分析。
瑞典68个麻醉科中有7个科室以及38个儿科科室中没有一个科室制定了围手术期为ASD患儿准备和/或提供护理的指南。从所使用的指南和常规做法中，出现了3类：“缺乏必要条件”、“无需额外考虑”以及“对ASD患儿进行特殊护理”。这3类涵盖了护理中的一个连续统一体。在第一类中，麻醉诱导可能导致ASD患儿受到身体约束。在最后一类中，与医疗服务的整个接触过程将根据患儿的特殊需求进行调整。
瑞典缺乏专门为满足ASD患儿术前需求而设计的循证指南。需要进一步研究以了解ASD患儿是否会从循证指南中受益。
