Effatpanah Mohammad, Shariatpanahi Ghazal, Sharifi Amirsina, Ramaghi Rozita, Tavakolizadeh Reza
Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Child Neurol. 2019 Spring;13(2):29-35.
Autism spectrum disease (ASD) is not a common diagnosis for children presenting with neurodevelopmental delay before 36 months in Iran. Although recent years have witnessed improvements in diagnosis of pediatrics psychological disorders the role of referral system starting with health care workers (HCW) is not clear. Therefore, we aimed to investigate the common concepts about ASD among pediatricians and HCW.
MATERIALS & METHODS: Pediatricians were randomly selected from four teaching hospital of Tehran University of Medical Sciences, Tehran, Iran in 2012-13. HCW were randomly selected from 3 urban health care centers in Tehran, Iran. DSM-IV TR criteria for ASD was used to assess knowledge. Participants were asked to rate sixteen statements on beliefs about autism to assess attitude.
Overall, 122 pediatricians and 90 HCWs with mean ± SD age of 36±4.7 yr and 76.4% being female recruited. Pediatricians had significantly higher encounter with autistic patients (18% vs. 10%, value=0.06) and parents of autistic child (17% vs. 12%, -value=0.07). But generally, 209 participants (98.6%) declared that they were familiar with autism. There was no statistically significant difference between study groups in rating DSM-IV TR criteria for ASD as "necessary for diagnosis". Age, gender and working experience, did not differ between pediatricians or HCW answers (all -values >0.05). Among HCW participants, higher educational level was associated with higher disagreement about "autistic children is schizophrenic" (=0.01). Moreover, HCW with higher working experience had higher agreement rate with "autistic children needs special education" statement (= 0.04).
There are still misconceptions about ASD regarding developmental, cognitive and emotional features in both HCW and pediatricians needed to be educated through national program.
在伊朗，自闭症谱系障碍（ASD）并非36个月前出现神经发育迟缓儿童的常见诊断。尽管近年来儿科心理障碍的诊断有所改善，但从医护人员开始的转诊系统的作用尚不清楚。因此，我们旨在调查儿科医生和医护人员对ASD的常见认知。
2012 - 13年从伊朗德黑兰医科大学的四家教学医院中随机选取儿科医生。从伊朗德黑兰的3个城市医疗中心随机选取医护人员。采用美国精神疾病诊断与统计手册第四版修订版（DSM - IV TR）中ASD的标准来评估知识水平。要求参与者对关于自闭症的16条信念陈述进行评分以评估态度。
总体而言，招募了122名儿科医生和90名医护人员，平均年龄±标准差分别为36±4.7岁，女性占76.4%。儿科医生接触自闭症患者（18%对10%，P值 = 0.06）和自闭症儿童家长（17%对12%，P值 = 0.07）的比例显著更高。但总体上，209名参与者（98.6%）表示他们熟悉自闭症。在将DSM - IV TR中ASD标准评为“诊断必需”方面，研究组之间无统计学显著差异。儿科医生或医护人员的回答在年龄、性别和工作经验方面无差异（所有P值>0.05）。在医护人员参与者中，较高的教育水平与对“自闭症儿童是精神分裂症患者”的更高分歧相关（P = 0.01）。此外，工作经验更丰富的医护人员对“自闭症儿童需要特殊教育”陈述的认同率更高（P = 0.04）。
医护人员和儿科医生在ASD的发育、认知和情感特征方面仍存在误解，需要通过国家项目进行教育。
