Anand Puneet, Sachdeva Ankur, Kumar Vipin
Department of Pediatrics, ESIC Medical College and Hospital, Faridabad, Haryana, India.
Department of Psychiatry, ESIC Medical College and Hospital, Faridabad, Haryana, India.
J Family Community Med. 2018 May-Aug;25(2):114-119. doi: 10.4103/jfcm.JFCM_142_16.
Attention-deficit hyperactivity disorder (ADHD) is a common childhood neurobehavioral disorder, which may cause impairment in multiple domains. Understanding the pathway to care helps in planning effective early interventions. The study aims to provide a quantitative description of the factors affecting the help-seeking pathway.
The study was conducted at an outpatients department of a tertiary care multispecialty hospital. Fifty consecutive consenting children aged 5-15 years were screened and diagnosed for ADHD using Conners' Parent Rating Scale-Revised: Short Form, Diagnostic and Statistical Manual of Mental Disorders fourth edition text revision criteria, and Kiddie Schedule for affective disorders and schizophrenia. A semi-structured questionnaire was used to study the pathway of care, using the WHO template. The data were analyzed using appropriate parametric and nonparametric tests in SPSS software.
The average delay from the onset of the illness to first consultation with a qualified health professional was 2.32 ± 1.9 years. Children with an urban background, from a nuclear family, with literate mothers, with a family income of more than Rs. 30,000/month, having hyperactive and combined type of ADHD, and who were referred by school teachers presented significantly earlier. The main source of referrals were school teachers and general medical practitioners. The most common parental beliefs for delay were the views that the "child is naughty" and that "hyperactivity is part of normal growth."
Parents' help-seeking behavior is affected by different sociocultural beliefs. Such factors as the lack of recognition and awareness of ADHD, resulting in the delay in seeking treatment should be addressed through health promotion programs.
注意力缺陷多动障碍（ADHD）是一种常见的儿童神经行为障碍，可能在多个领域造成损害。了解就医途径有助于规划有效的早期干预措施。本研究旨在对影响寻求帮助途径的因素进行定量描述。
本研究在一家三级护理多专科医院的门诊部进行。使用康纳斯父母评定量表修订版简式、《精神疾病诊断与统计手册》第四版文本修订标准以及儿童情感障碍和精神分裂症量表，对连续50名年龄在5至15岁且同意参与的儿童进行ADHD筛查和诊断。采用世界卫生组织模板的半结构化问卷来研究就医途径。在SPSS软件中使用适当的参数和非参数检验对数据进行分析。
从疾病发作到首次咨询合格健康专业人员的平均延迟时间为2.32±1.9年。来自城市背景、核心家庭、母亲识字、家庭月收入超过30000卢比、患有多动型和混合型ADHD且由学校教师转诊的儿童就诊时间明显更早。转诊的主要来源是学校教师和普通医生。父母认为延迟的最常见信念是“孩子调皮”以及“多动是正常成长的一部分”。
父母的求助行为受到不同社会文化信念的影响。诸如对ADHD缺乏认识和了解导致寻求治疗延迟等因素，应通过健康促进项目加以解决。
