不同人群对孤独症谱系障碍的认知情况及诊疗态度分析
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摘要
目的了解不同人群对孤独症谱系障碍(ASD)的认知情况及诊疗态度,为ASD的早发现、早诊断、早干预提供科学依据。方法采用多阶段分层整群随机抽样法抽取包头市区的3组与儿童接触密切人群(儿童亲属、社区医务工作者、儿童教育工作者)中的879人作为调查对象,以自评调查问卷开展调查对象对ASD认知情况及诊疗态度的调查。结果 31.4%的调查对象能够识别ASD患儿的症状,23.7%的调查对象能够正确辨别ASD的疾病性质为发育障碍。不同人群对ASD患儿症状的识别情况比较,差异有统计学意义(P<0.05),不同人群对ASD疾病性质的正确辨别情况比较,差异也有统计学意义(P<0.05)。在"发现儿童存在行为问题时是否就诊"的问题上,85.4%的调查对象选择马上就诊;在"ASD的早期治疗和干预是否可促进患儿病情改善"的问题上,76.5%的调查对象认为ASD的早期治疗和干预可以促进患儿病情的改善。不同人群对儿童存在行为问题时的就诊态度比较,差异有统计学意义(P<0.05),不同人群对ASD早期治疗和干预作用的态度比较,差异也有统计学意义(P<0.05)。此外,儿童亲属对ASD的认知较差,且诊疗态度最为消极。结论包头市区与儿童接触密切人群对ASD的总体认知水平较低,但社区医务工作者和儿童教育工作者对ASD的认知水平均优于儿童亲属。故提高3组人群,尤其是儿童亲属对ASD的认知水平,对ASD的早发现、早诊断、早干预非常必要。
Objective To investigate the awareness and management attitude towards autism spectrum disorders(ASD)among different populations,so as to provide scientific evidence for early recognition,early diagnosis and early intervention of ASD.Methods Based on the method of multi-stage stratified cluster random sampling,a total of 879 subjects from three populations in Baotou urban area who were in close contact with children(family members,community medical workers,and childhood educators) participated in this survey.A self-administered questionnaire was used to investigate the awareness and management attitude towards ASD.Results About 31.4% of participants could identify the symptoms of ASD,and 23.7% correctly understood the nature of the disease(developmental disorder).The differences among the three populations were statistically significant in terms of identification of ASD and understanding of the nature of the disease(both P<0.05).In response to the question of"whether or not seek medical advice when a child is found to have behavioral problems",85.4% of participants chose "seek medical advice immediately";as for the question of"whether or not early treatment and intervention of ASD may lead to disease improvement",76.5% of participants answered "yes";the differences among the three populations were also statistically significant for these two questions(both P<0.05).Notably,children's family members had the poorest understanding of ASD with the most negative attitude towards ASD management.Conclusion Overall,populations in close contact with children in Baotou have low awareness of ASD,but community medical workers and childhood educators have better awareness levels of ASD than children' s family members.Therefore,it is important to improve the awareness level for the three populations,especially children's family members,which may contribute to early recognition,early diagnosis and early intervention of ASD.
Objective To investigate the awareness and management attitude towards autism spectrum disorders(ASD)among different populations,so as to provide scientific evidence for early recognition,early diagnosis and early intervention of ASD.Methods Based on the method of multi-stage stratified cluster random sampling,a total of 879 subjects from three populations in Baotou urban area who were in close contact with children(family members,community medical workers,and childhood educators) participated in this survey.A self-administered questionnaire was used to investigate the awareness and management attitude towards ASD.Results About 31.4% of participants could identify the symptoms of ASD,and 23.7% correctly understood the nature of the disease(developmental disorder).The differences among the three populations were statistically significant in terms of identification of ASD and understanding of the nature of the disease(both P<0.05).In response to the question of"whether or not seek medical advice when a child is found to have behavioral problems",85.4% of participants chose "seek medical advice immediately";as for the question of"whether or not early treatment and intervention of ASD may lead to disease improvement",76.5% of participants answered "yes";the differences among the three populations were also statistically significant for these two questions(both P<0.05).Notably,children's family members had the poorest understanding of ASD with the most negative attitude towards ASD management.Conclusion Overall,populations in close contact with children in Baotou have low awareness of ASD,but community medical workers and childhood educators have better awareness levels of ASD than children' s family members.Therefore,it is important to improve the awareness level for the three populations,especially children's family members,which may contribute to early recognition,early diagnosis and early intervention of ASD.
引文
[1]静进.孤独症谱系障碍诊疗现状与展望[J].中山大学学报(医学科学版),2015,36(4):481-488.
[2]戴琼,徐海青,汪鸿,等.2000-2016年中国儿童孤独症谱系障碍患病率Meta分析[J].中国儿童保健杂志,2017,25(12):1243-1246. DOI:10. 11852/zgetbjzz2017-25-12-16.
[3]顾钰恒,施春华.国外对孤独症谱系障碍的心理治疗述评[J].中国健康心理学杂志,2017,25(6):957-960.DOI:CNKI:SUN:JKXL.0.2017-06-039.
[4] MALONE RP,GRATZ SS,DELANEY MA,et al. Advances in drug treatments for children and adolescents with autism and other pervasive developmental disorders[J].CNS Drugs,2005,19(11):923-934.DOI:10.2165/00023210-200519110-00003.
[5]徐秀.儿童孤独症谱系障碍早期筛查与诊断[J].中国实用儿科杂志,2013,28(8):576-579.
[6]邹小兵.儿童孤独症谱系障碍医学治疗与教育干预综述[J].残疾人研究,2014(2):25-28.
[7]傅毅,周爱琴,戴琼,等.孤独症谱系障碍儿童综合干预年龄及持续时间对治疗效果影响的探讨[J].中国儿童保健杂志,2016,24(12):1312-1314. DOI:10.11852/zgetbjzz2016-24-12-24.
[8]孙倩,梅峰.早期综合干预对儿童孤独症预后影响及相关因素研究[J].南通大学学报(医学版),2017,37(5):459-461.
[9]王佳.孤独症信息知晓、卫生服务利用现况及相关因素研究[D].哈尔滨:哈尔滨医科大学,2011.
[10] JORM AF. Mental health literacy. Public knowledge and beliefs about mental disorders[J]. Br J Psychiatry,2000,177(5):396-401.
[11]王冰,贾飞勇,杜琳,等.应用多量表分析幼儿孤独症特点[J/CD].中华临床医师杂志:电子版,2013,7(13):5866-5870.DOI:10.3969/cma.j.issn.1674-0785.2013.13.099.
[12]中华人民共和国卫生部.儿童孤独症诊疗康复指南(卫办医政发〔2010〕123号)[J].中国儿童保健杂志,2011,19(3):289-294.
[13]苏林雁.儿童孤独症的病因及发病机制[J].实用儿科临床杂志,2010,25(23):1765-1767.
[14]赵刚,吴惠娟,刘健,等.杭州市1~3岁儿童父母亲孤独症相关信息知晓情况调查[J].中国健康心理学杂志,2017,25(3):432-434.DOI:10.13342/j.cnki. cjhp.2017.03.031.
[15]王佳,吴晶,杨凤娟,等.3~6岁儿童抚养人孤独症相关信息知晓现况调查[J].中国心理卫生杂志,2013,27(6):451-456.
[16] MANDELL DS,LISTERUD J,LEVY SE,et al. Race differences in the age at diagnosis among medicaid-eligible children with autism[J].J Am Acad Child Adolesc Psychiatry,2002,41(12):1447-1453. DOI:10. 1097/00004583-200212000-00016.
[17]顾莉萍,叶春红,何淑华,等.中山市幼儿园保健人员孤独症认知现状[J].中国学校卫生,2016,37(11):1700-1701.DOI:10. 16835/j. cnki. 1000-9817. 2016. 11.032.
[18] LIAN WB,YING SH,TEAN SC,et al.Pre-school teachers'knowledge,attitudes and practices on childhood developmental and behavioural disorders in Singapore[J].J Paediatr Child Health,2008,44(4):187-194. DOI:10.1111/j.1440-1754.2007.01231.x.
[19]陈运迷,金宇,张玲,等.广州市小学教师对孤独症谱系障碍知晓情况与态度调查[J].社区医学杂志,2017,15(15):13-17.
[2]戴琼,徐海青,汪鸿,等.2000-2016年中国儿童孤独症谱系障碍患病率Meta分析[J].中国儿童保健杂志,2017,25(12):1243-1246. DOI:10. 11852/zgetbjzz2017-25-12-16.
[3]顾钰恒,施春华.国外对孤独症谱系障碍的心理治疗述评[J].中国健康心理学杂志,2017,25(6):957-960.DOI:CNKI:SUN:JKXL.0.2017-06-039.
[4] MALONE RP,GRATZ SS,DELANEY MA,et al. Advances in drug treatments for children and adolescents with autism and other pervasive developmental disorders[J].CNS Drugs,2005,19(11):923-934.DOI:10.2165/00023210-200519110-00003.
[5]徐秀.儿童孤独症谱系障碍早期筛查与诊断[J].中国实用儿科杂志,2013,28(8):576-579.
[6]邹小兵.儿童孤独症谱系障碍医学治疗与教育干预综述[J].残疾人研究,2014(2):25-28.
[7]傅毅,周爱琴,戴琼,等.孤独症谱系障碍儿童综合干预年龄及持续时间对治疗效果影响的探讨[J].中国儿童保健杂志,2016,24(12):1312-1314. DOI:10.11852/zgetbjzz2016-24-12-24.
[8]孙倩,梅峰.早期综合干预对儿童孤独症预后影响及相关因素研究[J].南通大学学报(医学版),2017,37(5):459-461.
[9]王佳.孤独症信息知晓、卫生服务利用现况及相关因素研究[D].哈尔滨:哈尔滨医科大学,2011.
[10] JORM AF. Mental health literacy. Public knowledge and beliefs about mental disorders[J]. Br J Psychiatry,2000,177(5):396-401.
[11]王冰,贾飞勇,杜琳,等.应用多量表分析幼儿孤独症特点[J/CD].中华临床医师杂志:电子版,2013,7(13):5866-5870.DOI:10.3969/cma.j.issn.1674-0785.2013.13.099.
[12]中华人民共和国卫生部.儿童孤独症诊疗康复指南(卫办医政发〔2010〕123号)[J].中国儿童保健杂志,2011,19(3):289-294.
[13]苏林雁.儿童孤独症的病因及发病机制[J].实用儿科临床杂志,2010,25(23):1765-1767.
[14]赵刚,吴惠娟,刘健,等.杭州市1~3岁儿童父母亲孤独症相关信息知晓情况调查[J].中国健康心理学杂志,2017,25(3):432-434.DOI:10.13342/j.cnki. cjhp.2017.03.031.
[15]王佳,吴晶,杨凤娟,等.3~6岁儿童抚养人孤独症相关信息知晓现况调查[J].中国心理卫生杂志,2013,27(6):451-456.
[16] MANDELL DS,LISTERUD J,LEVY SE,et al. Race differences in the age at diagnosis among medicaid-eligible children with autism[J].J Am Acad Child Adolesc Psychiatry,2002,41(12):1447-1453. DOI:10. 1097/00004583-200212000-00016.
[17]顾莉萍,叶春红,何淑华,等.中山市幼儿园保健人员孤独症认知现状[J].中国学校卫生,2016,37(11):1700-1701.DOI:10. 16835/j. cnki. 1000-9817. 2016. 11.032.
[18] LIAN WB,YING SH,TEAN SC,et al.Pre-school teachers'knowledge,attitudes and practices on childhood developmental and behavioural disorders in Singapore[J].J Paediatr Child Health,2008,44(4):187-194. DOI:10.1111/j.1440-1754.2007.01231.x.
[19]陈运迷,金宇,张玲,等.广州市小学教师对孤独症谱系障碍知晓情况与态度调查[J].社区医学杂志,2017,15(15):13-17.