Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Cohen Children's Medical Center of New York, New Hyde Park, NY.
Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.
J Dev Behav Pediatr. 2018 Jun;39(5):365-375. doi: 10.1097/DBP.0000000000000573.
The purpose of this study was to identify factors that predict parent satisfaction (PS) with their child with autism spectrum disorder (ASD)'s visit to a hospital emergency department (ED) or urgent care (UC) center.
Parents recruited through a national database whose child (3-21 years; N = 378) with ASD had been treated in an ED/UC center within the previous 3 years completed an anonymous on-line questionnaire. They answered questions about whether they were satisfied overall with the visit and the care provided, their demographics, patient characteristics, their expectations and preparation for the visit, and the ED/UC center experience itself, including their observations of staff interpersonal and communication skills (ICSs) and behaviors, and whether the patient was disruptive (D). Multiple correspondence analysis (MCA) was used to demonstrate the relative effects of individual variables on PS.
Among the 10 most important determinants of PS with the visit were the 9 assessed staff ICS behaviors. These were followed by shorter than expected waiting time and the patient not being disruptive (ND) during the visit. PS was not associated with any of the 3 measures of patient disability severity (ASD subtype, communicative competence, or restrictiveness of educational placement), whether the patient is hyperreactive to sensory stimuli, reason for the visit, or parent's education.
PS with an ED/UC center visit when the patient has autism depends mostly on the quality of staff interactions with the patient and family. It is important for ED/UC center administrators to ensure that staff understand how to interact and communicate effectively with patients with ASD and their families.
本研究旨在确定哪些因素可预测自闭症谱系障碍（ASD）患儿家长对其前往医院急诊科（ED）或急诊所（UC）的满意度（PS）。
通过国家数据库招募了患儿（3-21 岁；N=378）在过去 3 年内曾在 ED/UC 中心接受过治疗的家长，让他们完成一份匿名在线问卷。他们回答了一些问题，包括他们对就诊整体是否满意、对所提供的护理是否满意、他们的人口统计学特征、患者特征、他们对就诊的期望和准备情况，以及 ED/UC 中心的就诊体验本身，包括他们对工作人员人际和沟通技巧（ICS）和行为的观察，以及患者是否有干扰行为（D）。多元对应分析（MCA）用于显示个体变量对 PS 的相对影响。
在对 PS 有重要影响的 10 个因素中，有 9 个是评估的工作人员 ICS 行为。其次是等待时间短于预期，以及就诊过程中患者不干扰（ND）。PS 与患者残疾严重程度的 3 个测量指标（ASD 亚型、沟通能力或教育安置的限制）、患者是否对感官刺激过度反应、就诊原因或家长的教育程度均无相关性。
当患者患有自闭症时，ED/UC 中心就诊的 PS 主要取决于工作人员与患者及其家属互动的质量。ED/UC 中心管理人员应确保工作人员了解如何与 ASD 患者及其家属进行有效互动和沟通。
