Awareness of ADHD in primary care: stakeholder perspectives
Awareness of ADHD in primary care: stakeholder perspectives
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DOI：
10.1186/s12875-020-01112-1
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发表时间：
2020-02-28
影响因子：
2.9
通讯作者：
Daley, D.
中科院分区：
文献类型：
--
作者：
French, B.;Perez Vallejos, E.;Daley, D.
背景 在许多欧洲国家，注意力缺陷多动障碍 (ADHD) 的诊断不足，获得护理和诊断的过程复杂且多变。在许多国家，全科医生 (GP) 指的是二级护理，个人在二级护理中接受评估，并在适当的情况下接受诊断和获得护理。因此，全科医生必须清楚地了解这种疾病及其护理途径。虽然之前的研究强调了全科医生 ADHD 意识的潜在障碍，但这项定性研究旨在进一步探索个体利益相关者的经验。方法 半结构化访谈探讨了多个利益相关者的观点，包括全科医生 (n = 5)、医疗保健专家 (n = 5)、患者（ADHD 成人 n = 5）和家长 (n = 5)，他们在初级保健中具有 ADHD 的表现和管理经验。使用主题分析和遵循扎根理论的原则对这些访谈进行了分析。结果 利益相关者将 ADHD 评估、诊断和治疗描述为一个复杂的过程。许多因素影响了这一过程，例如复杂的途径、缺乏服务、有限的全科医生认可和知识以及多个利益相关者之间和内部的沟通困难。结论 这项分析强调了接受（或不接受）诊断可能产生的重大影响，并进一步探讨了混乱的 ADHD 护理途径，强调了全科医生识别和成人服务短缺的关键问题。讨论了对实践和未来研究的影响，表明强烈需要更多委托途径和全科医生特定教育计划。
Background Attention Deficit Hyperactivity Disorder (ADHD) is underdiagnosed in many European countries and the process of accessing care and diagnosis is complex and variable. In many countries, general practitioners (GPs) refer on to secondary care where individuals receive an assessment and, if appropriate, a diagnosis and access to care. It is therefore essential that GPs have a clear understanding of the disorder and its care pathways. While previous studies have highlighted potential barriers in GPs' ADHD awareness, this qualitative study aims to further explore individual stakeholders' experiences. Methods Semi-structured interviews explored the views of multiple stakeholders- GPs (n = 5), healthcare specialists (n = 5), patients (adults with ADHD n = 5) and parents (n = 5) with experience of the presentation and management of ADHD in primary care. These interviews were analysed using thematic analyses and following principles of grounded theory. Results Stakeholders described ADHD assessment, diagnosis and treatment as an intricate process. Many factors affected this process such as complex pathways, lack of services, limited GP recognition and knowledge, and communicative difficulties between and within multiple stakeholders. Conclusion This analysis underlines the significant impact that receiving (or not) a diagnosis can have, and further explores muddled ADHD care pathways, highlighting key issues around GP identification and the shortage of adult services. Implications for practice and future research are discussed, suggesting a strong need for more commissioned pathways and GP specific educational programs.