Pediatricians' Attitudes and Practices on ADHD Before and After the Development of ADHD Pediatric Practice Guidelines
Pediatricians' Attitudes and Practices on ADHD Before and After the Development of ADHD Pediatric Practice Guidelines
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DOI：
10.1177/1087054709344194
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发表时间：
2010-05-01
影响因子：
3
通讯作者：
O'Connor, Karen G.
中科院分区：
文献类型：
--
作者：
Wolraich, Mark L.;Bard, David E.;O'Connor, Karen G.
目的：该研究旨在评估1999年至2005年期间AAP研究员报告的关于ADHD的态度和做法的变化，在此期间，AAP ADHD指南，培训和质量改进举措发生。方法：这项研究评估了1999年至2005年期间由美国儿科学会发起的调查，分别涉及1,000名和1,603名儿科医生的随机样本。结果如下：研究结果显示，儿科医生自我报告的对指南的遵守率显着增加，尽管增幅不大。大约81%的受访者报告常规使用正式的诊断标准（从67%上升），67%的受访者常规使用ADHD教师评级量表（1999年调查时为49%）。调查结果进一步表明，两次调查的儿科医生都广泛使用兴奋剂药物治疗;在2005年的调查中，更多的儿科医生报告说，如果第一种兴奋剂不起作用，他们会使用第二种兴奋剂，还有更多的儿科医生报告说，他们几乎总是提供父母培训，尽管估计人数仍然只有总数的四分之一左右;对这些举措的熟悉程度越高，就预示着对准则遵守情况的报告越多。结论：从业者报告的行为已经朝着更好地遵守AAP ADHD指南的方向发展，并且对为加强实践而开发的材料做出了积极的回应和更多的使用。作者推断，实践的变化可能是由于许多因素，包括AAP指南和相关的实施工作。改变医生的做法需要通过一个持续的过程，需要针对医生，其他提供者和家庭的多个，不同的，持续的努力来维持。(J.的AT。Dis. 2010; 13（6）563-572）
Purpose: The study aims to assess the changes in attitudes and practices about ADHD reported by AAP fellows between 1999 and 2005 during which AAP ADHD guidelines, training, and quality improvement initiatives occurred. Method: The study assesses AAP-initiated surveys that were conducted between 1999 and 2005 and involving a random sample of 1,000 and 1,603 pediatricians, respectively. Results: The findings reveal that significant, although modest, increases occurred in pediatric practitioners' self-reported adherence to the guidelines. About 81% of respondents reported routine use of formal diagnostic criteria (up from 67%), and 67% of the respondents routinely use ADHD teacher rating scales (compared to 49% in the 1999 survey). Findings further reveal that treatment with stimulant medications was used extensively by pediatricians from both surveys; more pediatricians in the 2005 survey reported use of a second stimulant if the first did not work, and still more reported almost always providing parent training, although the estimated number remained only about a quarter of the total; and greater familiarity with the initiatives predicted better reported adherence to the guidelines. Conclusion: The reported behaviors of practitioners have moved in the direction of greater adherence with the recommended AAP ADHD guidelines, and there was a positive response to, and a greater use of, the materials developed to enhance practice. The authors infer that practice changes may be due to many factors, including AAP guidelines and associated implementation efforts. Changing physician practices needs to be sustained through a continuing process that requires multiple, varying, sustained efforts directed at physicians, other providers, and families. (J. of Att. Dis. 2010; 13(6) 563-572)