Reid Natasha, Kent Nykola, Hewlett Nicole, Bagley Kerryn, Tsang Tracey W, Goldsbury Sarah, Williams Robyn, Akison Lisa, Holland Lorelle, Vanderpeet Chelsea, Doyle Michael, Boaden Nirosha, Hayes Nicole
Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia.
School of Biomedical Sciences, The University of Queensland, St Lucia, Queensland, Australia.
Alcohol Clin Exp Res (Hoboken). 2023 Nov;47(11):2007-2021. doi: 10.1111/acer.15191. Epub 2023 Sep 21.
We undertook a scoping review to identify the factors outside of current fetal alcohol spectrum disorder (FASD) diagnostic criteria to be considered as part of a holistic assessment process. This included physical, social, cultural, mental health and wellbeing factors to inform targeted recommendations and supports to improve outcomes for individuals with FASD. Evidence from this review will be used to inform the revision of the Australian Guide to the Diagnosis of FASD. Six electronic databases were searched. Studies were eligible if they included factors outside of the diagnostic criteria that cover dysmorphology, growth restriction, neurodevelopmental impairments. Data charting and content analysis were performed to synthesize the results. One hundred twenty-one studies were included that spanned 12 key areas These included physical health, sleep, adverse postnatal experiences, substance use/other risk-taking behaviors, contact with the criminal justice system, mental health, First Nations cultural considerations, transition to adult roles, involvement with the out-of-home care system, feeding and eating, strengths/interests/external resources and incontinence. Areas to be considered as part of a holistic assessment and diagnostic process spanned individual, family, and system level factors. Results provide guidance for clinicians on the wide range of factors that could influence long-term health, development, and wellbeing for individuals with prenatal alcohol exposure and FASD. In practice, this guidance can be used to inform an individualized assessment process to facilitate tailored recommendations and supports to best meet the complex needs of individuals living with FASD and their families.
我们进行了一项范围综述，以确定当前胎儿酒精谱系障碍（FASD）诊断标准之外的因素，这些因素应作为整体评估过程的一部分加以考虑。这包括身体、社会、文化、心理健康和幸福等因素，以便为针对性的建议和支持提供依据，从而改善FASD患者的预后。本次综述的证据将用于为《澳大利亚FASD诊断指南》的修订提供参考。我们检索了六个电子数据库。如果研究包括诊断标准之外涵盖畸形、生长受限、神经发育障碍的因素，则这些研究符合纳入标准。我们进行了数据图表绘制和内容分析以综合研究结果。共纳入121项研究，涉及12个关键领域，包括身体健康、睡眠、产后不良经历、物质使用/其他冒险行为、与刑事司法系统的接触、心理健康、原住民文化考量、向成人角色的转变、与家庭外照料系统的接触、喂养与饮食、优势/兴趣/外部资源以及大小便失禁。作为整体评估和诊断过程一部分应考虑的领域涵盖个人、家庭和系统层面的因素。研究结果为临床医生提供了指导，使其了解可能影响产前酒精暴露和FASD患者长期健康、发育和幸福的广泛因素。在实践中，该指导可用于为个性化评估过程提供参考，以便促成量身定制的建议和支持，从而最好地满足FASD患者及其家庭的复杂需求。
