英国初级保健中患者获取抽动支持的体验:一项在线混合方法调查。

Patients' experience of accessing support for tics from primary care in the UK: an online mixed-methods survey.

机构信息

School of Medicine, Leicester Medical School, College of Life Sciences, University of Leicester, Leicester, UK.

Mental Health & Clinical Neurosciences, NIHR Nottingham Biomedical Research Centre, School of Medicine, NIHR MindTech Medtech Co-operative, University of Nottingham, Nottingham, UK.

出版信息

BMC Health Serv Res. 2023 Jul 24;23(1):788. doi: 10.1186/s12913-023-09753-5.

Abstract

BACKGROUND

Tics are common in children and young people and may persist into adulthood. Tics can cause challenges with social, occupational, physical, and academic functioning. The current study explores the perceptions of adults with tics and parents/carers of young people with tics regarding their experience of accessing support from professionals in primary care in the UK.

METHODS

Two online cross-sectional surveys were completed by 33 adults with tics and 94 parents/carers of children with tics. Participants were recruited across three online tic support groups. Tic specialist psychologists, academic researchers, and people with lived experience of tics provided feedback on the surveys before they were made available online. Mixed-method analyses were conducted on the surveys. Qualitative data from the free-text responses were analysed using thematic analysis and triangulated with quantitative findings where appropriate.

RESULTS

While some participants felt supported by general practitioners (GPs), many felt dismissed. The impact of tics was not always explored, nor information on tics provided, during the consultation. Although 78.7% of participants were referred to secondary care for their tics, some struggled to get the referral. Within secondary care, most adult respondents were assessed by neurologists whilst young people were typically assessed by paediatricians or psychiatrists. Most of these secondary care clinicians did not specialise in tic disorders, with only 27.9% of participants being assessed by tic specialists. Mode waitlist time was 3-6 months for young people and longer for adult respondents. Some participants were referred to multiple secondary care services, spanning neurology, paediatrics, and psychiatry, with each stating that they do not provide support for tics. 21% of participants mentioned being discharged from secondary care with no ongoing support. Almost one-third of respondents accessed support within private healthcare.

CONCLUSIONS

Generally, more negative than positive experiences were reported. Possible contributing factors included a lack of clear tic referral pathways, long waitlists, a lack of information about tics provided in primary care appointments and a lack of support offered following diagnosis by secondary care services, together with poor access to tic specialist clinicians. This study highlights areas where improvements to UK services for tics can be made.

摘要

背景

抽动症在儿童和青少年中很常见,并且可能持续到成年。抽动症会导致社交、职业、身体和学业功能方面的挑战。本研究探讨了英国初级保健专业人员对抽动症患者及其年轻患者家属/照顾者的看法,了解他们对支持的需求。

方法

通过三个在线抽动症支持小组招募了 33 名抽动症患者和 94 名儿童抽动症患者的家长/照顾者,他们完成了两项在线横断面调查。在在线调查之前,抽动症专科心理学家、学术研究人员和有抽动症生活经历的人对其进行了反馈。对调查数据进行了混合方法分析。对自由文本回复的定性数据进行了主题分析,并与适当的定量发现进行了三角剖分。

结果

虽然一些参与者认为全科医生(GP)对他们有所支持,但许多人感到被忽视。在就诊期间,抽动症的影响并未得到充分探讨,也未提供有关抽动症的信息。尽管 78.7%的参与者因抽动症被转诊至二级保健机构,但有些人难以获得转诊。在二级保健机构中,大多数成年受访者由神经科医生评估,而年轻人则由儿科医生或精神科医生评估。这些二级保健临床医生大多没有专门治疗抽动障碍,只有 27.9%的参与者由抽动症专家评估。年轻人的平均候补名单时间为 3-6 个月,成年受访者的时间更长。一些参与者被转诊到多个二级保健服务机构,包括神经科、儿科和精神科,他们表示这些服务机构均不提供抽动症的支持。21%的参与者提到从二级保健机构出院后没有持续的支持。近三分之一的受访者在私人医疗保健机构获得了支持。

结论

总体而言,报告的体验更多是负面的。可能的促成因素包括缺乏明确的抽动症转诊途径、候补名单时间长、初级保健预约中缺乏有关抽动症的信息以及二级保健服务机构诊断后提供的支持不足,以及获得抽动症专科医生的机会有限。这项研究强调了英国抽动症服务可以改进的领域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b82/10367334/11a1d20aed34/12913_2023_9753_Fig1_HTML.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索