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低收入家庭中非裔 ADHD 儿童药物治疗决策的混合方法研究。

Medication Decision Making in Low-Income Families of Black Children With ADHD: A Mixed Methods Study.

机构信息

University of Nevada Las Vegas, Voorhees, NJ, USA.

University of Nevada Las Vegas, Las Vegas, NV, USA.

出版信息

J Atten Disord. 2023 Jun;27(8):847-858. doi: 10.1177/10870547231158382. Epub 2023 Mar 6.

Abstract

OBJECTIVES

The purpose of this study was to explore how and why some low-income Black caregivers seek medication treatment for their children with ADHD.

METHODS

Using a sequential exploratory mixed method design, Phase 1 comprised an indepth case study design of seven low-income Black caregivers of children receiving medication for ADHD. Based on findings from Phase 1, the second phase involved a secondary analysis of data on Black uninsured or publicly insured children age 6 to 17 with ADHD ( = 450).

RESULTS

Factors influencing medication decision-making included child safety and volatility, caregiver mental health, caregiver aggravation, family centered care (FCC), shared decision making (SDM), sole caregiver status, and school involvement. After adjusting for ADHD severity, previous receipt of special education services and experiences of FCC and SDM were independently associated with receipt of a medication for ADHD.

CONCLUSIONS

Clinicians and school personnel can intervene to decrease disparities in the treatment of ADHD.

摘要

目的

本研究旨在探讨一些低收入的黑人照顾者如何以及为何会为其患有 ADHD 的孩子寻求药物治疗。

方法

采用序贯探索性混合方法设计,第 1 阶段包括对 7 名接受 ADHD 药物治疗的低收入黑人儿童照顾者进行深入的个案研究。基于第 1 阶段的研究结果,第 2 阶段对年龄在 6 至 17 岁的、未投保或公共保险的黑人 ADHD 儿童(n=450)的数据进行了二次分析。

结果

影响药物决策的因素包括儿童安全和波动性、照顾者的心理健康、照顾者的烦恼、以家庭为中心的护理(FCC)、共同决策(SDM)、唯一照顾者的身份以及学校的参与度。在调整 ADHD 严重程度后,先前接受特殊教育服务以及 FCC 和 SDM 的经历与 ADHD 药物治疗的接受情况独立相关。

结论

临床医生和学校人员可以进行干预,以减少 ADHD 治疗中的差异。

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