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开发并实地测试一种决策辅助工具,以促进新诊断为注意力缺陷多动障碍的成年人进行共同决策。

Development and field testing of a decision aid to facilitate shared decision making for adults newly diagnosed with attention-deficit hyperactivity disorder.

机构信息

Graduate School of Nursing, St. Luke's International University, Chuo-ku, Tokyo, Japan.

Department of Neuropsychiatry, School of Medicine, Kyorin University, Mitaka-shi, Tokyo, Japan.

出版信息

Health Expect. 2022 Feb;25(1):366-373. doi: 10.1111/hex.13393. Epub 2021 Dec 2.

Abstract

BACKGROUND

The number of individuals who are diagnosed with attention-deficit hyperactivity disorder (ADHD) during adulthood has increased in recent years. However, there is still no decision aid (DA) to help adults newly diagnosed with ADHD make decisions regarding further treatments.

OBJECTIVE

This study aimed to describe the development process of a DA for adults newly diagnosed with ADHD and its field testing during the shared decision-making (SDM) process in a clinical setting.

METHODS

The development process involved the creation of a DA prototype using the International Patient Decision Aid Standards criteria and revision of the prototype through the stakeholders' reviews. The field testing of the DA compared scores before and after the SDM process on the service users' knowledge scale, decisional conflict scale and the Conners Adult ADHD Rating Scales.

RESULTS

The developed DA contained options of watchful waiting with own coping skills and pharmacological treatment, which consisted of several kinds of drug options. Fifteen adults newly diagnosed with ADHD participated in the field testing. The participant decision-making quality outcomes such as their knowledge and decisional conflict improved after the SDM process. ADHD severity did not change.

CONCLUSION

A DA for adults with ADHD was systematically developed following the international criteria. Field testing indicated that the DA could serve as a tool to facilitate the SDM process. Further research on this DA is necessary before its routine implementation.

PATIENT OR PUBLIC CONTRIBUTION

During the development process of the DA, the service users who had already been diagnosed with ADHD reviewed the DA prototype and provided feedback, which improved the final version of the DA.

摘要

背景

近年来,成年后被诊断为注意力缺陷多动障碍(ADHD)的人数有所增加。然而,目前仍没有决策辅助工具(DA)来帮助新诊断为 ADHD 的成年人做出进一步治疗的决策。

目的

本研究旨在描述为新诊断为 ADHD 的成年人开发决策辅助工具的过程及其在临床环境中共享决策(SDM)过程中的现场测试。

方法

使用国际患者决策辅助工具标准准则创建决策辅助工具原型,并通过利益相关者的审查对原型进行修订。通过服务使用者的知识量表、决策冲突量表和 Conners 成人 ADHD 评定量表,比较 SDM 过程前后的决策辅助工具现场测试得分。

结果

开发的决策辅助工具包含观察等待与自身应对技能和药物治疗的选择,其中包括几种药物选择。15 名新诊断为 ADHD 的成年人参加了现场测试。SDM 过程后,参与者的决策质量结果(如知识和决策冲突)得到了改善。ADHD 严重程度没有变化。

结论

根据国际标准系统地开发了 ADHD 成人的决策辅助工具。现场测试表明,该决策辅助工具可作为促进 SDM 过程的工具。在常规实施之前,有必要对该决策辅助工具进行进一步研究。

患者或公众贡献

在决策辅助工具的开发过程中,已经被诊断为 ADHD 的服务使用者审查了决策辅助工具原型并提供了反馈,这改进了最终版本的决策辅助工具。

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