School of Pharmacy, Royal College of Surgeons in Ireland, Dublin, Ireland.
School of Pharmacy, Royal College of Surgeons in Ireland, Dublin, Ireland.
Res Social Adm Pharm. 2019 Sep;15(9):1095-1101. doi: 10.1016/j.sapharm.2018.11.004. Epub 2018 Nov 10.
Reported prevalence of ADHD in children varies greatly from country to country. There is a similar disparity between rates of medication prescriptions for ADHD, with significant variation existing between rates in USA and Europe. North American studies report that parents have concerns about starting and continuing ADHD medication in children, though little is known about experiences in other geographies and healthcare systems. These studies may inform supports required, and help understand if these concerns may result in different treatment patterns, in other geographies.
To explore experiences of parents of children who used ADHD medication in Ireland.
A qualitative methodology was employed. Data were gathered through in-depth semi-structured interviews with ten parents who had a child with ADHD and had commenced medication. Analysis was performed using a phenomenographic approach.
Four descriptive categories relating to parents' experiences of decision-making emerged. Symptom severity prior to diagnosis, duration of ADHD symptoms and parental struggle to make an informed risk/benefit decision influenced decision-making. The child's immediate response to medication was identified as an important factor facilitating persistence and adherence. Over time, parents sought to regain some control over and gain confidence in medication management and decision-making.
The decision to use medication in ADHD is difficult and dynamic for parents in Ireland. It is driven by a sense of urgency and powerlessness, mobilizing feelings of doubt, anxiety and guilt before concluding with a sense of autonomy and increased confidence. Lack of awareness of ADHD and treatments, alongside access to care issues, add to parental anxiety in Ireland. This is in contrast to previous North American studies. Current provisions of support and information at the time of ADHD diagnosis are insufficient. Initial reaction to medication options should be explored by clinicians and support continued over time.
儿童注意缺陷多动障碍（ADHD）的报告患病率在各国之间差异很大。ADHD 药物治疗的处方率也存在类似的差异，美国和欧洲之间存在显著差异。北美研究报告称，父母对开始和继续为儿童使用 ADHD 药物存在担忧，尽管人们对其他地区和医疗保健系统的经验知之甚少。这些研究可以为所需的支持提供信息，并帮助了解这些担忧是否会导致其他地区的治疗模式不同。
探讨爱尔兰 ADHD 儿童用药父母的经验。
采用定性方法。通过对 10 名有 ADHD 儿童并开始用药的父母进行深入的半结构化访谈收集数据。使用现象学方法进行分析。
出现了四个与父母决策经验相关的描述类别。诊断前的症状严重程度、ADHD 症状持续时间以及父母努力做出知情的风险/收益决策，都影响了决策。孩子对药物的即时反应被认为是促进坚持和依从性的重要因素。随着时间的推移，父母试图重新获得对药物管理和决策的一些控制和信心。
在爱尔兰，父母决定是否使用 ADHD 药物是困难和动态的。这是由紧迫感和无力感驱动的，在得出自主和信心增强的结论之前，会引起怀疑、焦虑和内疚的感觉。对 ADHD 和治疗方法的认识不足，以及获得医疗保健的机会问题，增加了爱尔兰父母的焦虑。这与之前的北美研究不同。目前 ADHD 诊断时提供的支持和信息不足。临床医生应探讨对药物选择的初始反应，并持续提供支持。
