Knowledge Gaps about Autism Spectrum Disorders and its Clinical Management among Child and Adolescent Health Care Workers in Uganda: A Cross-Sectional Study.

EC psychology and psychiatry Pub Date : 2020-09-01 Epub Date: 2020-08-31
Justine Diana Namuli, Etheldreda Nakimuli-Mpungu, Emmanuel K Mwesiga, Nalugya S Joyce
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Abstract

Background: There is limited literature on the knowledge about Autism Spectrum Disorder (ASD) among child and adolescent health professionals from resource limited settings.

Methods: 40 child and adolescent health professionals were purposively sampled from the two national referral hospitals in Uganda. Participants completed a standardized questionnaire that collected data on socio-demographic characteristics, the Knowledge about Childhood Autism among Health Workers (KCAHW) and the challenges related to diagnosing and managing ASD. General linear model with the Poisson regression was used to evaluate bivariate and multivariate factors associated with limited knowledge about ASD.

Results: The study participation rate was 90% with the majority being females (N = 21, 58%). Also, most (N = 20, 55.6%) were mental health professionals working at the Butabika pediatric out-patient clinic while (N = 16, 44.4%) were pediatric health professionals working at the Mulago mental and neurological pediatric clinics. The mean score on KCAHW was 11.8 (SD = 3.75). The participants (36.1%) who scored below the mean score were regarded as having limited knowledge about ASD. Health workers with limited knowledge about ASD (KCAHW score < 11.8) were less likely to have a degree [adjusted Prevalence rate ratio (aPRR) = 0.26, 95%CI = 0.08 to 0.78, p-value = 0.018. Mental health and Non-mental health workers had comparable KCAHW mean scores. Clinical Psychologists, Psychiatrists, psychiatry residents and pediatric nurses had the highest KCAHW scores while psychiatric nurses and medical social workers had the lowest scores.

Conclusion: The proportion of child and adolescent health professionals with limited knowledge about ASD is substantial. There is urgent need to increase focus on training in autism spectrum disorders especially among non-specialist health workers.

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乌干达儿童和青少年卫生保健工作者关于自闭症谱系障碍及其临床管理的知识差距:一项横断面研究。
背景:在资源有限的环境中,儿童和青少年卫生专业人员对自闭症谱系障碍(ASD)的了解文献有限。方法:有目的地从乌干达两家国家转诊医院抽样40名儿童和青少年卫生专业人员。参与者完成了一份标准化问卷,收集了社会人口统计学特征、卫生工作者关于儿童自闭症的知识(KCAHW)以及与诊断和管理ASD相关的挑战的数据。使用泊松回归的一般线性模型来评估与ASD知识有限相关的双变量和多变量因素。结果:研究参与率为90%,以女性居多(N = 21, 58%)。此外,大多数(N = 20, 55.6%)是在Butabika儿科门诊工作的精神卫生专业人员,而(N = 16, 44.4%)是在Mulago精神和神经儿科诊所工作的儿科卫生专业人员。KCAHW评分平均为11.8分(SD = 3.75)。得分低于平均分的参与者(36.1%)被认为对ASD了解有限。对ASD知识了解有限的卫生工作者(KCAHW评分< 11.8)获得学位的可能性较低[调整患病率比(aPRR) = 0.26, 95%CI = 0.08 ~ 0.78, p值= 0.018]。精神卫生工作者和非精神卫生工作者的KCAHW平均得分相当。临床心理学家、精神科医生、精神科住院医师和儿科护士的KCAHW得分最高,而精神科护士和医务社工的得分最低。结论:儿童和青少年卫生专业人员对ASD了解有限的比例很大。迫切需要加强对自闭症谱系障碍的培训,特别是对非专业卫生工作者的培训。
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