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注意力缺陷多动障碍(ADHD)过渡期:儿童服务临床医生对 ADHD 青少年医疗过渡期信息作用的看法。

In transition with attention deficit hyperactivity disorder (ADHD): children's services clinicians' perspectives on the role of information in healthcare transitions for young people with ADHD.

机构信息

University of Exeter, St Luke's Campus, Exeter, EX1 2LU, UK.

Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, DK-5000, Odense C, Denmark.

出版信息

BMC Psychiatry. 2022 Apr 9;22(1):251. doi: 10.1186/s12888-022-03813-6.

Abstract

BACKGROUND

National clinical guidelines emphasise the need for good communication of information by clinicians to young people and their parent/carers about what to expect during transition into adult services. Recent research indicates that of young people in need of transition for attention deficit hyperactivity disorder (ADHD), only a minority experience continuity of care into adulthood, with additional concerns about quality of transition. This qualitative analysis explored the role that information plays in the transition from child to adult mental health services for young people with ADHD, from the perspectives of clinicians working in children's services.

METHODS

Participants were recruited from National Health Service (NHS) Trusts located across the United Kingdom (UK), with varying service configurations. Twenty-two qualitative interviews were conducted with 15 paediatricians and seven psychiatrists working in child services and supporting young people with ADHD. The Framework Method was used to complete a thematic analysis of data related to the role of information in transitional care.

RESULTS

Two themes were identified in relation to the role of information in supporting transition and promoting continuity of care. Information for clinicians; about adult mental health services, the young person and their ADHD, and exchanged between services. Sharing information with young people; about transition processes, self-management, to support service engagement, and tailored to be accessible to young people with ADHD. Clinicians in children's services reported variable access to information. Clear protocols and being able to communicate about ADHD as a long-term condition, were described as having a positive impact on the transition process.

CONCLUSIONS

These findings illustrate that clear information on the transition process, and communication of evidence based and up-to-date information on ADHD as a long-term condition are essential components for clinicians supporting transition into adult services. Information exchange can be supported through transition discussions with young people, and joint meetings between services Discussions should be accompanied by accessible resources for young people and parents/carers such as leaflets and websites. Further efforts should be focussed on enabling clinicians to provide timely and appropriate information to young people with ADHD to support transition.

摘要

背景

国家临床指南强调,临床医生需要向年轻人及其父母/照顾者传达有关在过渡到成人服务期间的预期信息。最近的研究表明,在需要过渡到注意力缺陷多动障碍(ADHD)的年轻人中,只有少数人能够顺利过渡到成年,并且对过渡质量存在额外的担忧。这项定性分析从在儿童服务中工作的临床医生的角度探讨了信息在 ADHD 年轻人从儿童到成人心理健康服务过渡中的作用。

方法

参与者是从英国各地的国家卫生服务(NHS)信托机构招募的,这些机构的服务配置各不相同。对 15 名儿科医生和 7 名从事儿童服务并支持 ADHD 年轻人的精神科医生进行了 22 次定性访谈。采用框架方法对与过渡护理中信息作用相关的数据进行主题分析。

结果

与支持过渡和促进连续护理的信息作用相关,确定了两个主题。为临床医生提供信息;关于成人心理健康服务、年轻人及其 ADHD,以及在服务之间交换信息。与年轻人分享信息;关于过渡过程、自我管理,以支持服务参与,并针对 ADHD 年轻人的需求进行调整,使其易于理解。儿童服务中的临床医生报告说,信息的获取情况各不相同。清晰的协议和能够就 ADHD 作为一种长期疾病进行沟通,被描述为对过渡过程产生积极影响。

结论

这些发现表明,明确的过渡过程信息,以及就 ADHD 作为一种长期疾病的循证和最新信息进行沟通,是支持年轻人过渡到成人服务的临床医生的重要组成部分。信息交流可以通过与年轻人进行过渡讨论以及服务之间的联席会议来支持。讨论应伴随针对年轻人和父母/照顾者的易访问资源,例如传单和网站。应进一步努力使临床医生能够及时向 ADHD 年轻人提供适当的信息,以支持过渡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a53/8994234/ecc783f390d3/12888_2022_3813_Fig1_HTML.jpg

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