Nosratmirshekarlou Elaheh, Andrade Brendan F, Jette Nathalie, Lawson Margaret L, Pringsheim Tamara
Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Calgary, Alberta.
Department of Psychiatry, University of Toronto, Toronto, Ontario.
J Can Acad Child Adolesc Psychiatry. 2019 Apr;28(1):30-41. Epub 2019 Mar 1.
The aim of this qualitative study was to explore the decisional needs of parents of children with ADHD and disruptive and aggressive behaviour to inform the creation of a patient decision aid.
A one-day meeting of researchers, community advocacy partners, and 11 parents of children (age range eight to 21) with aggressive and disruptive behaviour associated with a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder or Conduct Disorder was held. This meeting consisted of a two-hour educational session on the assessment and management of aggressive and disruptive behaviour in children and patient decision aids, followed by two concurrent focus groups to determine the decisional needs of parents. NVivo11 software was used for the organization of the data.
The results outline the broad themes and subthemes that emerged from the thematic analysis. These themes and subthemes include (a) decisional needs - treatment options and where to begin, availability, effectiveness of different treatment options, side effects, time, depth of information provided; (b) decision aid formats, and (c) accessibility - language, involvement of children, and dissemination.
The themes generated from the focus groups suggest that a patient decision aid for parents with children with ADHD and disruptive and aggressive behaviour should follow the general recommendations for best practices for the creation of patient decision aids. Specific information on the regional availability of non-medical treatments will be especially helpful for parents to navigate services and service providers. Consideration should be given as to how the concept of values clarification is introduced to families.
本定性研究旨在探讨患有注意力缺陷多动障碍（ADHD）且有破坏性行为和攻击性行为的儿童家长的决策需求，为创建患者决策辅助工具提供信息。
研究人员、社区宣传合作伙伴以及11位患有与注意力缺陷多动障碍（ADHD）、对立违抗障碍或品行障碍相关的攻击性行为和破坏性行为的儿童（年龄在8至21岁之间）的家长召开了为期一天的会议。此次会议包括一场关于儿童攻击性行为和破坏性行为的评估与管理以及患者决策辅助工具的两小时教育课程，随后进行了两个并行的焦点小组讨论，以确定家长的决策需求。使用NVivo11软件对数据进行整理。
结果概述了主题分析中出现的广泛主题和子主题。这些主题和子主题包括：（a）决策需求——治疗选择及从何处入手、可获得性、不同治疗选择的有效性、副作用、时间、提供信息的深度；（b）决策辅助工具的形式；（c）可及性——语言、儿童的参与以及传播。
焦点小组讨论得出的主题表明，为患有ADHD且有破坏性行为和攻击性行为的儿童的家长提供的患者决策辅助工具应遵循创建患者决策辅助工具最佳实践的一般建议。关于非医疗治疗在当地的可获得性的具体信息对家长了解服务和服务提供者尤其有帮助。应考虑如何向家庭引入价值观澄清的概念。
