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“看在上帝的份上,快给我转诊吧”:一项关于抽动秽语综合征和抽动障碍患者在英国获得医疗服务经历的联合定性研究。

'For the love of God, just refer me': a co-produced qualitative study of the experiences of people with Tourette Syndrome and tic disorders accessing healthcare services in the UK.

作者信息

Babbage Camilla May, Davies E Bethan, Jones Daniel P, Stevenson Paul, Salvage Jennifer, Anderson Seonaid, McNally Emma, Groom Madeleine J

机构信息

NIHR MindTech Medtech Co-operative, Institute of Mental Health, University of Nottingham, Nottingham, UK

School of Medicine, Academic Unit of Mental Health & Clinical Neurosciences, University of Nottingham, Nottingham, UK.

出版信息

BMJ Open. 2025 Sep 5;15(9):e098306. doi: 10.1136/bmjopen-2024-098306.

Abstract

OBJECTIVES

Chronic tic disorders (CTDs)-such as Tourette Syndrome (TS)-are neurodevelopmental disorders affecting at least 1% of the population, causing repetitive involuntary movements and vocalisations known as tics. This study aimed to explore the lived experiences of accessing healthcare for people with CTD or TS and their families in the United Kingdom (UK), as part of a larger programme of work to inform change to healthcare services for this population.

DESIGN

Informed and designed with extensive patient and public involvement, the design utilised qualitative research using focus groups. Reflexive thematic analysis was used to analyse the data.

SETTING

Participants were recruited via online support groups, social media and research registers.

PARTICIPANTS

Seven focus groups were held separately with young people with tics (n=2), adults with tics (n=10) and parents/guardians of children with tics (n=11), led by a lived experience expert (coauthor PS) and facilitated by researchers. Discussion focused on three areas: the impact of living with tics, experience accessing healthcare for tics and management of tics.

RESULTS

Five themes were developed highlighting challenges across the healthcare pathway, including gaining a diagnosis, and receiving treatment, resulting in the use of self-support methods to reduce tic expression or the impact of tics. Themes also illustrated perceptions that healthcare provider's knowledge impacted initial interactions with the healthcare system, and how healthcare systems were not felt to be prioritising CTDs.

CONCLUSIONS

The findings highlight a lack of prioritisation for tic disorders compounded by a healthcare structure which does not support a complex condition that requires a multidisciplinary approach. This research calls for improvements to UK healthcare services for CTD.

摘要

目标

慢性抽动障碍(CTD),如妥瑞氏症(TS),是一种神经发育障碍,影响着至少1%的人口,会导致重复性的不自主运动和发声,即抽动。本研究旨在探索英国患有CTD或TS的患者及其家人在获取医疗服务方面的生活经历,这是一项更大规模工作项目的一部分,该项目旨在为改善这一人群的医疗服务提供依据。

设计

在患者和公众的广泛参与下进行设计,采用焦点小组的定性研究方法。运用反思性主题分析对数据进行分析。

地点

通过在线支持小组、社交媒体和研究登记册招募参与者。

参与者

分别与患有抽动的年轻人(n = 2)、患有抽动的成年人(n = 10)以及患有抽动的儿童的父母/监护人(n = 11)进行了7次焦点小组讨论,由一位有亲身经历的专家(共同作者PS)主持,研究人员协助。讨论集中在三个方面:抽动对生活的影响、抽动症的医疗服务获取经历以及抽动的管理。

结果

形成了五个主题,突出了整个医疗过程中的挑战,包括获得诊断和接受治疗,导致使用自我支持方法来减少抽动表现或抽动的影响。这些主题还说明了人们认为医疗服务提供者的知识会影响与医疗系统的最初互动,以及感觉医疗系统没有将CTD作为优先事项。

结论

研究结果凸显了抽动障碍未得到优先重视,再加上医疗结构不支持这种需要多学科方法的复杂病症。这项研究呼吁改善英国针对CTD的医疗服务。

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