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识别自闭症友善医疗保健的组成部分:使用改良 Delphi 法的探索性研究。

Identifying Components of Autism Friendly Health Care: An Exploratory Study Using a Modified Delphi Method.

机构信息

Boston Medical Center, Boston, MA.

Indiana University, Bloomington, IN.

出版信息

J Dev Behav Pediatr. 2023 Jan 1;44(1):e12-e18. doi: 10.1097/DBP.0000000000001139. Epub 2022 Nov 11.

Abstract

OBJECTIVES

Autistic individuals report lower health care satisfaction. However, there is currently no set of "best practice" standards about caring for autistic individuals. In this exploratory study, we aim to identify features of Autism Friendly practice according to a sample consisting of mainly professionals whose interests include autism using a modified 3-round Delphi-a method that identifies a consensus view across subject participants.

METHODS

Statements about components of an Autism Friendly health care practice were compiled in consultation with the steering committee of an Autism Friendly Initiative at a single, urban academic safety-net hospital. Participants were recruited through our national network of professionals and patients/families mailing list. Examples of invited professionals included researchers, health care workers, and educators. In the first 2 rounds, we distributed electronic surveys to participants, who scored statements from 1 to 9 regarding importance. In round 2, statements that were scored low by all stakeholder groups were eliminated. Seventy-eight participants responded to the first-round survey, and 51 participants responded to the second-round survey. In the third round, 38 participants ranked 16 statements from most to least important. Statements are summarized and presented in the Results section.

RESULTS

Topics that emerged from highly ranked statements include environmental/operational modifications (e.g., longer appointment times) and staff training to support autistic patients.

CONCLUSION

Highly ranked statements represented previously reported barriers, including the need for staff training and inclusive engagement with the autistic community. The findings can help inform health care organizations to determine priorities when building an Autism Friendly health care practice.

摘要

目的

自闭症个体报告的医疗保健满意度较低。然而,目前还没有一套针对自闭症患者护理的“最佳实践”标准。在这项探索性研究中,我们旨在根据主要由对自闭症感兴趣的专业人员组成的样本,使用经过修改的 3 轮 Delphi 法确定自闭症友好实践的特征 - 一种在主题参与者中确定共识观点的方法。

方法

在单一的城市学术保障医院的自闭症友好倡议指导委员会的协商下,编制了关于自闭症友好医疗保健实践组成部分的陈述。参与者通过我们的专业人员和患者/家属邮件列表的全国网络招募。受邀专业人员的示例包括研究人员、医疗保健工作者和教育工作者。在第 1 轮和第 2 轮中,我们向参与者分发了电子调查,参与者根据重要性对陈述进行了 1 到 9 的评分。在第 2 轮中,所有利益相关者群体评分较低的陈述被删除。78 名参与者对第一轮调查做出了回应,51 名参与者对第二轮调查做出了回应。在第 3 轮中,38 名参与者对 16 个陈述进行了从最重要到最不重要的排名。陈述在结果部分进行了总结和呈现。

结果

排名较高的陈述中出现的主题包括环境/运营修改(例如,延长预约时间)和支持自闭症患者的员工培训。

结论

排名较高的陈述代表了先前报告的障碍,包括员工培训和与自闭症社区的包容性参与的需求。这些发现可以帮助医疗保健组织确定在建立自闭症友好医疗保健实践时的优先事项。

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