Division of Developmental and Behavioral Pediatrics, Boston Medical Center, Boston MA; and.
San Diego Department of Psychiatry, University of California, Child and Adolescent Research Center, La Jolla, CA.
J Dev Behav Pediatr. 2024 Jan 1;45(1):e39-e45. doi: 10.1097/DBP.0000000000001228. Epub 2023 Oct 23.
Autistic individuals have higher rates of co-occurring medical conditions and service use. However, autistic individuals and their families also reported lower satisfaction with health care service delivery. Previous studies described health care experiences of autistic adults, but less is known about those of autistic adolescents and young adults. This study aimed to qualitatively describe the health care experiences of autistic youth.
Four longitudinal/serial focus groups were conducted with 8 autistic adolescents and young adults. Participants were members of an autistic patient advisory board, which is part of a broader initiative at a large, urban, safety-net hospital to improve the health care experiences of autistic patients. Focus groups were conducted virtually and were audio-recorded. Audio recordings were transcribed and verified for accuracy. Transcripts were consensus-coded with an inductive approach using tenets of grounded theory.
Findings included 4 recurring themes: accessibility and accommodations, barriers of health service use, patient involvement in health care decisions, and facilitators of patient-clinician relationship. Participants noted that visit preparation, sensory items, and repeated positive interactions with clinician were helpful to build a positive health care experience.
Our findings support previous research that suggest the need to individualize care, ensure availability of accommodations, apply flexibility in practice whenever possible, and increase health care professional knowledge about this unique patient population.
自闭症个体有更高的共病率和医疗服务利用率。然而,自闭症个体及其家庭对医疗保健服务的满意度也较低。先前的研究描述了自闭症成年人的医疗保健体验,但对自闭症青少年和年轻人的了解较少。本研究旨在定性描述自闭症青年的医疗保健体验。
对 8 名自闭症青少年和年轻人进行了 4 次纵向/系列焦点小组。参与者是一个自闭症患者顾问委员会的成员,该委员会是一家大型城市医疗保健系统改善自闭症患者医疗保健体验的更广泛倡议的一部分。焦点小组通过虚拟方式进行,并进行音频记录。音频记录被转录并进行准确性验证。使用扎根理论的原则,对转录本进行共识编码和归纳方法。
研究结果包括 4 个反复出现的主题:可及性和适应性、医疗服务使用障碍、患者参与医疗保健决策以及促进医患关系。参与者指出,就诊准备、感官项目和与临床医生的反复积极互动有助于建立积极的医疗保健体验。
我们的研究结果支持了先前的研究,表明需要个性化护理,确保适应性的可用性,在可能的情况下灵活运用实践,并增加医疗保健专业人员对这一独特患者群体的了解。