Otizm Spektrum Bozukluğu: Birinci Basamakta Neden Az Tanı Almaktadır?

Year 2022, , 113 - 118, 10.11.2022

Adem Durmaz , Muammer Yılmaz

https://doi.org/10.38175/phnx.1146882

Cited By: 1

Abstract

Amaç: Otizm Spektrum Bozukluğu (OSB) erken teşhis edildiğinde çeşitli tedavilerle başarılı sonuçlar alınabildiği bilinmektedir. Birinci basamak hekimlerinin erken tanısında önemli rol oynayan OSB'ye yönelik farkındalıklarının araştırılması amaçlandı.
Gereç ve Yöntemler: Tanımlayıcı kesitsel tipteki bu çalışmada, Kütahya'da görev yapmakta olan Aile Hekimlerine ulaşılmış ve gönüllülük esasına dayalı olarak “Sağlık çalışanlarında çocukluk çağı otizmine ilişkin bilgiler (KCAHW) anketi” uygulanmıştır.
Bulgular: Çalışmaya katılan 151 Aile Hekiminin (FP) %81.5'i pratisyen hekim, %17.9'u Aile Hekimliği uzmanı ve %0.7'si diğer tıp alanı uzmanlarıdır. Katılımcıların %86,8'i otizm konusunda eğitim almış olmasına rağmen, %64,9'unun kendini yetersiz hissettiği belirlendi. OSB'li hastaları takip edenlerin, teorik eğitim alanların, kadınların ve mesleğe yeni başlayan AP'lerin KCAHW skoru ve farkındalıkları daha yüksekti, ancak sadece genç AP'lerin farkındalığı istatistiksel olarak anlamlıydı (p<0,05).
Sonuçlar: Hastaların, sağlıklı bebeklerin ve çocukların sağlık çalışanları ile ilk karşılaşma yeri olan birinci basamaktaki Aile Hekimlerinin OSB hakkında bilgi eksikliği olduğu, kendilerini yeterli hissetmediği saptandı. Bu nedenle tıp eğitimi sırasında özellikle pediatri, aile hekimliği, halk sağlığı ve çocuk psikiyatrisi stajlarında OSB'ye yeterince yer verilmelidir.

Keywords

Otizm, farkındalık, eğitim, Aile Hekimi, Birinci Basamak.

Supporting Institution

yok

Project Number

yok

Autism Spectrum Disorder: Why is It Underdiagnosed in Primary Care?

Abstract

Objectives: When Autism Spectrum Disorder (ASD) is diagnosed early, successful results can be obtained with various therapies. It was aimed to investigate the awareness of primary care physicians about ASD, which plays an important role in its early diagnosis.
Material and Methods: In this descriptive cross-sectional study, Family Physicians in Kütahya were reached and “Knowledge about childhood autism among health workers (KCAHW) questionnaire” was applied on a voluntary basis.
Results: Of the 151 family physicians (FPs) in the study, 81.5% were general practitioners, 17.9% were FP specialists and 0.7% were other medical field specialists. Although 86.8% of the participants had received training on autism, 64.9% were determined to feel inadequate. The KCAHW score and awareness of those who followed patients with ASD, those who received theoretical training, women, and newer FPs in the profession were higher, but the awareness of only young FPs was statistically significant (p<0,05).
Conclusions: FPs in primary care, the first meeting place for sick and healthy babies and children with health workers, have a lack of information about ASD; thus, they do not feel adequate. Therefore, ASD should be involved sufficiently especially in pediatrics, family medicine, public health and child psychiatry internships during medical education.

Keywords

Autism, awareness, education, family physician, primary care.

Project Number

yok

References

• APA. Diagnostic and statistical manual of mental disorders, 5th edition. Arlington, Texas: American Psychiatric Publishing. 2013:50-59.
• Siu MT, Weksberg R. Epigenetics of Autism Spectrum Disorder. Adv Exp Med Biol. 2017;978:63-90. doi:10.1007/978-3-319-53889-1_4.
• Bastaki KN, Alwan S, Zahir FR. Maternal Prenatal Exposures in Pregnancy and Autism Spectrum Disorder: An Insight into the Epigenetics of Drugs and Diet as Key Environmental Influences. Adv Neurobiol. 2020;24:143-162. doi:10.1007/978-3-030-30402-7_5.
• Saxena R, Babadi M, Namvarhaghighi H, Roullet FI. Role of environmental factors and epigenetics in autism spectrum disorders. Prog Mol Biol Transl Sci. 2020;173:35-60. doi:10.1016/bs.pmbts.2020.05.002).
• Kanner L. Autistic disturbances of affective contact. Acta Paedopsychiatr. 1968;35(4):100-136.
• Zablotsky B, Black LI, Maenner MJ, Schieve LA, Blumberg SJ. Estimated Prevalence of Autism and Other Developmental Disabilities Following Questionnaire Changes in the 2014 National Health Interview Survey. Natl Health Stat Report. 2015;(87):1-20.
• Loomes R, Hull L, Mandy WPL. What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis. J Am Acad Child Adolesc Psychiatry. 2017;56(6):466-474. doi:10.1016/j.jaac.2017.03.013 .
• Brugha TS, Spiers N, Bankart J, Cooper SA, McManus S, Scott FJ, et al. Epidemiology of autism in adults across age groups and ability levels. Br J Psychiatry. 2016;209(6):498-503. doi:10.1192/bjp.bp.115.174649 .
• Zwaigenbaum L, Brian JA, Ip A. Early detection for autism spectrum disorder in young children. Paediatr Child Health. 2019;24(7):424-443. doi:10.1093/pch/pxz119.
• Lord C, Brugha TS, Charman T, Cusack J, Dumas G, Frazier T, et al. Autism spectrum disorder. Nat Rev Dis Primers. 2020;6(1):5. doi:10.1038/s41572-019-0138-4.
• Lyall K, Croen L, Daniels J, Fallin MD, Ladd-Acosta C, Lee BK, et al. The Changing Epidemiology of Autism Spectrum Disorders. Annu Rev Public Health. 2017;38:81-102. doi:10.1146/annurev-publhealth-031816-044318.
• Bastaki KN, Alwan S, Zahir FR. Maternal Prenatal Exposures in Pregnancy and Autism Spectrum Disorder: An Insight into the Epigenetics of Drugs and Diet as Key Environmental Influences. Adv Neurobiol. 2020;24:143-162. doi:10.1007/978-3-030-30402-7_5.
• Aydos S, Çalış ES. Diagnosis Before And After Autism Spectrum Disorder: A Review Of The Child Development Specialist Overview. Tusbad. 2021;4(1):31-53. doi: 10.51536/tusbad.779103.
• Bakare MO, Ebigbo PO, Agomoh AO, Menkiti NC. Knowledge about childhood autism among health workers (KCAHW) questionnaire: description, reliability and internal consistency. Clin Pract Epidemiol Ment Health. 2008;4:17. doi:10.1186/1745-0179-4-17.
• Gürbüz Özgür B, Aksu H, Eser E. Validity and reliability of the Turkish version of the knowledge about childhood autism among health workers questionnaire. Psychiatry and Clinical Psychopharmacology. 2019;29(4):765-773. doi: 10.1080/24750573.2019.163 732.
• Keklik D, Nazik E. Knowledge about childhood autism among nurses in Turkey: A cross-sectional descriptive study. Perspect Psychiatr Care. 2021;57(4):1637-1644. doi:10.1111/ppc.12729.
• Fuentes J, Hervás A, Howlin P; (ESCAP ASD Working Party). ESCAP practice guidance for autism: a summary of evidence-based recommendations for diagnosis and treatment. Eur Child Adolesc Psychiatry. 2021;30(6):961-984. doi:10.1007/s00787-020-01587-4.
• Charman T & Gotham K Measurement issues: screening and diagnostic instruments for autism spectrum disorders—lessons from research and practice. Child Adolesc. Ment. Health 2013;18(1):52–64. doi:10.1111/j.1475-3588.2012.00664.x
• Chlebowski C, Robins DL, Barton ML, Fein D. Large-scale use of the modified checklist for autism in low-risk toddlers. Pediatrics. 2013;131(4):e1121-e1127. doi:10.1542/peds.2012-1525.
• Stenberg N, Bresnahan M, Gunnes N, Hirtz D, Hornig M, Lie KK, et al. Identifying children with autism spectrum disorder at 18 months in a general population sample. Paediatr Perinat Epidemiol. 2014;28(3):255-262. doi:10.1111/ppe.12114.
• Øien RA, Schjølberg S, Volkmar FR, Shic F, Cicchetti DV, Nordahl-Hansen A, et al. Clinical Features of Children With Autism Who Passed 18-Month Screening. Pediatrics. 2018;141(6):e20173596. doi:10.1542/peds.2017-3596.
• Zwaigenbaum L, Brian JA, Ip A. Early detection for autism spectrum disorder in young children. Paediatr Child Health. 2019;24(7):424-443. doi:10.1093/pch/pxz119.
• Araz Altay M. Family Physicians’ Awareness of Autism Spectrum Disorder: Results from a Survey Study. Open Access Maced J Med Sci. 2019;7(6):967-972. https://doi.org/10.3889/oamjms.2019.199.
• Al-Mazidi SH, Al-Ayadhi LY. National Profile of Caregivers’ Perspectives on Autism Spectrum Disorder Screening and Care in Primary Health Care: The Need for Autism Medical Home. Int J Environ Res Public Health. 2021;18(24):13043. doi:10.3390/ijerph182413043
• Imran N, Chaudry MR, Azeem MW, Bhatti MR, Choudhary ZI, Cheema MA. A survey of Autism knowledge and attitudes among the healthcare professionals in Lahore, Pakistan. BMC Pediatr. 2011;11:107. doi:10.1186/1471-2431-11-107.
• van’t Hof M, van Berckelaer-Onnes I, Deen M, Neukerk MC, Bannink R, Daniels AM, et al. Novel Insights into Autism Knowledge and Stigmatizing Attitudes Toward Mental Illness in Dutch Youth and Family Center Physicians. Community Ment Health J. 2020;56(7):1318-1330. doi:10.1007/s10597-020-00568-w.