A A TOMADA DE DECISÃO NO TRATAMENTO DE CRIANÇAS COM INDICADORES DE TDAH
Résumé
O diagnóstico de Transtorno de Déficit de Atenção e Hiperatividade – TDAH é bastante complexo, podendo ser influenciado por fatores contextuais, e seu tratamento pode envolver diferentes intervenções. A participação dos usuários nas decisões a respeito do tratamento vem sendo promovida por instituições de diversos países e, no Brasil, é prevista pelas legislações do Sistema Único de Saúde. Este estudo investigou o processo de tomada de decisão no tratamento de crianças com indicadores de TDAH a partir da percepção de oito profissionais de serviços públicos de saúde mental, que foram entrevistados individualmente. Os dados foram examinados através da análise temática, revelando desafios relativos ao excesso de demanda nos serviços e à complexidade do processo diagnóstico. O envolvimento de usuários e familiares nas decisões foi percebido como parcial, ocorrendo geralmente após a elaboração do plano terapêutico pelas equipes, e envolvendo dificuldades na comunicação entre profissionais e pacientes e divergências de interesses entre as crianças e seus familiares. Esses aspectos poderão ser abordados em futuros estudos e intervenções a fim de facilitar e melhorar a qualidade da tomada de decisão nesse contexto.
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Références
American Psychiatric Association (2013). Manual diagnóstico e estatístico de transtornos mentais: DSM-5. Artmed.
Autor (2020). Dissertação de Mestrado, [Dissertação de mestrado não publicada]. Universidade [OMITIDA].
Barun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa
Boland, L., Graham, I. D., Légaré, F., Lewis, K., Jull, J., Shephard, A., Lawson, M. L., Davis, A., Yameogo, A., & Stacey, D. (2019). Barriers and facilitators of pediatric shared-decision making: a systematic review. Implementation science, 14(1), 7. https://doi.org/10.1186/s13012-018-0851-5
Brinkman, W. B., Majcher, J. H., Poling, L. M., Shi, G., Zender, M., Sucharew, H., Britto, M. T., & Epstein, J. N. (2013). Shared decision-making to improve attention-deficit hyperactivity disorder care. Patient. Educ. Couns., 93(1), 95-101. https://doi.org/10.1016/j.pec.2013.04.009
Buchanan, A. E., & Brock, D. W. (1989). Deciding for others: the ethics of surrogate decision making. Cambridge University Press.
Cheng, H., Hayes, D., Edbrooke-Childs, J., Martin, K., Chapman, L., & Wolpert, M. (2017). What approaches for promoting shared decision-making are used in child mental health? A scoping review. Clin. Psyhol. Psychother., 24(6), 1495-1511. https://doi.org/10.1002/cpp.2106
Clark, L. A., Cuthbert, B., Lewis-Fernández, R., Narrow, W. E., & Reed, G. M. (2017). Three approaches to understanding and classifying mental disorder: ICD-11, DSM-5, and the National Institute of Mental Health’s Research Domain Criteria (RDoC). Psychological Science in the Public Interest, 18(2), 72-145. https://doi.org/10.1177/1529100617727266
Coghill, D. R., Seth, S., & Matthews, K. (2014). A comprehensive assessment of memory, delay aversion, timing, inhibition, decision making and variability in attention deficit hyperactivity disorder: advancing beyond the three-pathway models. Psychological medicine, 44(9), 1989-2001. https://doi.org/10.1017/S0033291713002547
Connell, C. M., & Javenic, M. R. (2003). Health and human development. In R. M. Lerner, M. A. Easterbrooksc, J. Mistry, & I. B. Weiner (Eds.). Handbook of psychology: Vol. 6. Developmental psychology (Cap. 24, pp. 579-600). John Wiley & Sons.
Elwyn, G., Frosch, D., Thomson, R., Joseph-Williams, N., Lloyd, A., Kinnersley, P., Cording, E., Tomson, D., Dodd, C., Rollnick, S., & Edwards, A. (2012). Shared decision making: a model for clinical practice. Journal of general internal medicine, 27(10), 1361-1367. https://doi.org/10.1007/s11606-012-2077-6
Galanter, C. A., & Patel, V. L. (2005). Medical decision making: a selective review for child psychiatrists and psychologists. Journal of Child Psychology and Psychiatry, 46(7), 675-689. https://doi.org/10.1111/j.1469-7610.2005.01452.x
Hinshaw, S. P., & Scheffler, R. M. (2018). ADHD in the twenty-first century. In. Banaschewski, T., Coghill, D., & Zuddas, A. (Eds.), Oxford Textbook of Attention Deficit Hyperactivity Disorder (Cap. 2, pp. 9-15). Oxford University Press.
Hughes, T. M., Merath, K., Chen, Q., Sun, S., Palmer, E., Idrees, J. J., Okunrintemi, V., Squires, M., Beal, E. W., & Pawlik, T. M. (2018). Association of shared decision-making on patient-reported health outcomes and healthcare utilization. The American Journal of Surgery, 216(1), 7-12. https://doi.org/10.1016/j.amjsurg.2018.01.011
Kashaf, M. S., McGill, E. T., & Berger, Z. D. (2017). Shared decision-making and outcomes in type 2 diabetes: A systematic review and meta-analysis. Patient
education and counseling, 100(12), 2159-2171. https://doi.org/10.1016/j.pec.2017.06.030
Klein, G. A. (2008). Naturalistic Decision Making. Human Factors: The Journal of the Human Factors and Ergonomics Society, 50(3), 456–460. https://doi.org/10.1518/001872008X288385
Kodjebacheva, G. D., Sabo, T., & Xiong, J. (2016). Interventions to improve child-parent-medical provider communication: A systematic review. Social Science & Medicine, 166, 120-127. https://doi.org/10.1016/j.socscimed.2016.08.003
Krockow, E. M., Riviere, E., & Frosch, C. A. (2019). Improving shared health decision making for children and adolescents with chronic illness: A narrative literature review. Patient education and counseling, 102(4), 623-630. https://doi.org/10.1016/j.pec.2018.11.017
Larrick, R. P., & Feiler, D. C. (2015). Expertise in decision making. In G. Keren & G. Wu (Eds.), The Wiley Blackwell handbook of judgement and decision making (Cap. 24, pp. 696-722). Chichester: John Wiley & Sons, Ltd.
Légaré, F., Adekpedjou, R., Stacey, D., Turcotte, S., Kryworuchko, J., Graham, I. D., Lyddiatt, A., Politi, M. C., Thomson, R., Elwyn, G., & Donner-Banzhoff, N. (2018). Interventions for increasing the use of shared decision making by healthcare professionals. The Cochrane database of systematic reviews, 7(7), CD006732. https://doi.org/10.1002/14651858.CD006732.pub4
NHS (2019). Universal personalised care: implementing the comprehensive model. https://www.england.nhs.uk/wp-content/uploads/2019/01/universal-personalised-care.pdf
Portaria GM/MS 1.130, de 5 de agosto de 2015 (2015). Institui a Política Nacional de Atenção Integral à Saúde da Criança (PNAISC) no âmbito do Sistema Único de Saúde (SUS). http://bvsms.saude.gov.br/bvs/saudelegis/gm/2015/prt1130_05_08_2015.html
Rapaport, S., Leshno, M., & Fink, L. (2012). A design process for using normative models in shared decision making: a case study in the context of prenatal testing. Health Expectations, 17(6), 863-875. https://doi.org/10.1111/hex.12004
Scott, I. A., Soon, J., Elshaug, A. G., & Lindner, R. (2017). Countering cognitive biases in minimising low value care. Medical Journal of Australia, 206(9), 407-411. https://doi.org/10.5694/mja16.00999
Schwandt, H., & Wuppermann, A. (2016). The youngest get the pill: ADHD misdiagnosis in Germany, its regional correlates and international comparison. Labour Economics, 43, 72-86. https://doi.org/10.1016/j.labeco.2016.05.018
Stake, R. E. (2006). Multiple case study analysis. The Guilford Press.
Wyatt, K. D., List, B., Brinkman, W. B., Lopez, G. P., Asi, N., Erwin, P., Wang, Z., Garces, J. P. D., Montori, V. M. & LeBlanc, A. (2015). Shared decision making in pediatrics: a systematic review and meta-analysis. Acad. Pediatr., 15(6), 573-583. https://doi.org/10.1016/j.acap.2015.03.011
Wolraich, M. L., Hagan, J. F., Jr, Allan, C., Chan, E., Davison, D., Earls, M., Evans, S. W., Flinn, S. K., Froehlich, T., Frost, J., Holbrook, J. R., Lehmann, C. U., Lessin, H. R., Okechukwu, K., Pierce, K. L., Winner, J. D., Zurhellen, W., & Subcommittee on children and adolescents with attention-deficit/huperactive disorder (2019). Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics, 144(4), e20192528. https://doi.org/10.1542/peds.2019-2528
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