Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK.
BMJ Open. 2021 Mar 18;11(3):e043336. doi: 10.1136/bmjopen-2020-043336.
To investigate autistic people's views on the importance and availability of adjustments to mental and physical healthcare provision. To explore whether specific categories of adjustments can be identified and to identify any differences in their importance and availability between mental and physical healthcare.
Data from two studies, both employing a cross-sectional survey design.
UK-based autistic adults registered with the Adult Autism Spectrum Cohort-UK were contacted by post or online. In both studies, recruitment was staged over a 12-month period. Non-responders were sent a single reminder letter 2 weeks after initial contact.
537 autistic adults completed a survey about mental health services (51% response rate), 407 completed the physical health survey (49% response rate). Within these samples, 221 participants completed both surveys.
Each study developed a bespoke survey to explore participants' views on mental and physical health services, respectively. Both included an identical list of adjustments that participants rated based on importance and availability.
Three factors of important adjustments were identified: sensory environment, clinical and service context, and clinician knowledge and communication. Adjustments across healthcare settings were widely rated as being important yet rarely available. One significant difference between the importance of adjustments available through mental and physical health services was identified. Participants reported that having access to a clinician who is willing to adapt their approach to suit the person's preferences was significantly more important for participants attending mental health settings (p=0.001).
Autistic people reported the limited availability of important adjustments in current healthcare provision. To address unmet need and tackle the health inequalities faced by autistic people attending physical and mental healthcare settings, healthcare providers should offer adjustments relating to the three identified factors. Future research should focus on identifying and addressing service provider barriers to implementation.
调查自闭症患者对精神和身体健康护理服务调整的重要性和可及性的看法。探讨是否可以确定特定类别的调整，并确定精神和身体健康护理之间它们的重要性和可及性的差异。
来自两项研究的数据，均采用横断面调查设计。
通过邮寄或在线联系英国注册的成人自闭症谱系队列-英国的成年自闭症患者。在两项研究中，招募分 12 个月进行。对未回复者，在初次联系后 2 周内发送了一封单一的提醒信。
537 名成年自闭症患者完成了一项关于精神卫生服务的调查（响应率为 51%），407 名完成了一项关于身体健康的调查（响应率为 49%）。在这些样本中，221 名参与者完成了两项调查。
两项研究分别开发了专门的调查来探索参与者对精神和身体健康服务的看法，均包含参与者根据重要性和可及性进行评分的相同调整列表。
确定了三个重要调整因素：感官环境、临床和服务环境以及临床医生的知识和沟通。调整在医疗保健环境中广泛被认为是重要的，但很少有可用的。在通过精神和身体健康服务获得的调整的重要性方面发现了一个显著差异。参与者报告说，在精神卫生服务机构中，有一位愿意调整其方法以适应患者偏好的临床医生，对参与者来说非常重要（p=0.001）。
自闭症患者报告称，目前医疗服务提供的重要调整措施有限。为了解决未满足的需求并解决自闭症患者在身体和心理健康保健机构中面临的健康不平等问题，医疗保健提供者应提供与三个确定因素相关的调整。未来的研究应重点关注确定和解决服务提供者实施的障碍。
