Conhecimento sobre Transtorno do Espectro Autista entre profissionais da atenção básica de saúde
Palavras-chave:
autismo, atenção primária à saúde, diagnóstico precoceResumo
Introdução: O Transtorno do Espectro Autista (TEA) é um transtorno do neurodesenvolvimento caracterizado por déficits na comunicação social e na interação social de forma persistente, além de padrões restritos e repetitivos de comportamento, interesses ou atividades. As Unidades de Atenção Básica são a porta de entrada de pacientes com TEA no Sistema Único de Saúde (SUS), sendo importante que os profissionais de saúde tenham conhecimento sobre o tema. Objetivo: Investigar o conhecimento dos profissionais de saúde (médicos e enfermeiros) que atuam na Atenção Básica de um município do interior de São Paulo, em relação ao TEA. Material e Métodos: O estudo consistiu na aplicação do questionário KCAHW (Knowledge about Childhood Autism among Health Workers) a 40 profissionais de saúde (médicos e enfermeiros), que atuam em Unidades de Atenção Básica do município. O KCAHW avalia o conhecimento do profissional sobre o TEA, sendo dividido em 4 domínios e com um total de 19 questões. Resultados: Observou-se uma diferença significativa na média de acertos total entre médicos (média=14,3; desvio padrão=2,4) e enfermeiros (média=12,8; desvio padrão=2,1) e não foi encontrada diferença entre o tempo de experiência e o número total de acertos. Conclusão: Os médicos apresentam um melhor conhecimento em relação ao TEA quando comparados com os enfermeiros, no entanto, é necessária a existência de um programa de educação continuada sobre o TEA para profissionais de saúde que atuam na Atenção Primária.
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Referências
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2. Governo do estado de São Paulo. Secretaria da Saúde. Protocolo do Estado de São Paulo de Diagnóstico, Tratamento e Encaminhamento de Pacientes com Transtorno do Espectro Autista (TEA). São Paulo: Secretaria de Estado da Saúde e dos Direitos da Pessoa com Deficiência,. 2013.
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6. Lyall K, Croen L, Daniels J, et al. The Changing Epidemiology of Autism Spectrum Disorders. Annu Rev Public Health 2017; 38: 81-102. 2017/01/10. DOI: 10.1146/annurev-publhealth-031816-044318.
7. Myers SM, Voigt RG, Colligan RC, et al. Autism Spectrum Disorder: Incidence and Time Trends Over Two Decades in a Population-Based Birth Cohort. J Autism Dev Disord 2019; 49: 1455-1474. 2018/12/07. DOI: 10.1007/s10803-018-3834-0.
8. Dawson G, Rogers S, Munson J, et al. Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics 2010; 125: e17-23. 2009/12/02. DOI: 10.1542/peds.2009-0958.
9. Howlin P, Magiati I and Charman T. Systematic review of early intensive behavioral interventions for children with autism. Am J Intellect Dev Disabil 2009; 114: 23-41. 2009/01/16. DOI: 10.1352/2009.114:23;nd41.
10. Reichow B. Overview of meta-analyses on early intensive behavioral intervention for young children with autism spectrum disorders. J Autism Dev Disord 2012; 42: 512-520. 2011/03/16. DOI: 10.1007/s10803-011-1218-9.
11. Matson JL, Rieske RD and Tureck K. Additional considerations for the early detection and diagnosis of autism: Review of available instruments. Research in Autism Spectrum Disorders 2011; 5: 1319-1326. DOI: https://doi.org/10.1016/j.rasd.2011.03.006.
12. Ribeiro SH, Paula CSd, Bordini D, et al. Barriers to early identification of autism in Brazil. Rev Bras Psiquiatr 2017; 39: 352-354.
13. Skellern C, McDowell M and Schluter P. Diagnosis of autistic spectrum disorders in Queensland: variations in practice. J Paediatr Child Health 2005; 41: 413-418. 2005/08/17. DOI: 10.1111/j.1440-1754.2005.00667.x.
14. Nicolaidis C, Kripke CC and Raymaker D. Primary care for adults on the autism spectrum. Med Clin North Am 2014; 98: 1169-1191. 2014/08/20. DOI: 10.1016/j.mcna.2014.06.011.
15. Tyler CV, Schramm SC, Karafa M, et al. Chronic disease risks in young adults with autism spectrum disorder: forewarned is forearmed. Am J Intellect Dev Disabil 2011; 116: 371-380. 2011/09/13. DOI: 10.1352/1944-7558-116.5.371.
16. Kohane IS, McMurry A, Weber G, et al. The co-morbidity burden of children and young adults with autism spectrum disorders. PLoS One 2012; 7: e33224. 2012/04/19. DOI: 10.1371/journal.pone.0033224.
17. Hughes RB, Lund EM, Gabrielli J, et al. Prevalence of interpersonal violence against community-living adults with disabilities: a literature review. Rehabil Psychol 2011; 56: 302-319. 2011/11/30. DOI: 10.1037/a0025620.
18. Shavelle RM, Strauss DJ and Pickett J. Causes of death in autism. J Autism Dev Disord 2001; 31: 569-576. 2002/01/30. DOI: 10.1023/a:1013247011483.
19. Woolfenden S, Sarkozy V, Ridley G, et al. A systematic review of two outcomes in autism spectrum disorder - epilepsy and mortality. Dev Med Child Neurol 2012; 54: 306-312. 2012/02/22. DOI: 10.1111/j.1469-8749.2012.04223.x.
20. Perkins EA and Berkman KA. Into the unknown: aging with autism spectrum disorders. Am J Intellect Dev Disabil 2012; 117: 478-496. 2012/11/22. DOI: 10.1352/1944-7558-117.6.478.
21. Bakare MO, Ebigbo PO, Agomoh AO, et al. Knowledge about childhood autism among health workers (KCAHW) questionnaire: description, reliability and internal consistency. Clin Pract Epidemiol Ment Health 2008; 4: 17. 2008/06/10. DOI: 10.1186/1745-0179-4-17.
22. Shah K. What Do Medical Students Know about Autism? Autism 2001; 5: 127-133. DOI: 10.1177/1362361301005002003.
23. Harrison AJ, Bradshaw LP, Naqvi NC, et al. Development and Psychometric Evaluation of the Autism Stigma and Knowledge Questionnaire (ASK-Q). J Autism Dev Disord 2017; 47: 3281-3295. 2017/07/27. DOI: 10.1007/s10803-017-3242-x.
24. Crane L, Davidson I, Prosser R, et al. Understanding psychiatrists' knowledge, attitudes and experiences in identifying and supporting their patients on the autism spectrum: online survey. BJPsych Open 2019; 5: e33. 2019/09/19. DOI: 10.1192/bjo.2019.12.
25. Muller C. Conhecimento dos estudantes de medicina acerca do autismo em uma universidade do Rio Grande do Sul. Universidade Federal do Rio Grande do Sul, Porto Alegre, 2012.
26. Igwe MN, Bakare MO, Agomoh AO, et al. Factors influencing knowledge about childhood autism among final year undergraduate Medical, Nursing and Psychology students of University of Nigeria, Enugu State, Nigeria. Ital J Pediatr 2010; 36: 44. 2010/06/15. DOI: 10.1186/1824-7288-36-44.
27. Shaukat F, Fatima A, Zehra N, et al. Assessment of knowledge about childhood autism among medical students from private and public universities in Karachi. J Pak Med Assoc 2014; 64: 1331-1334. 2015/04/04.
28. Kostiukow A, Poniewierski P, Strzelecki W, et al. Assessment of student's knowledge and awareness of autism spectrum disorder. Pol Merkur Lekarski 2020; 48: 87-92. 2020/05/01.
29. Eseigbe EE, Nuhu FT, Sheikh TL, et al. Knowledge of Childhood Autism and Challenges of Management among Medical Doctors in Kaduna State, Northwest Nigeria. Autism Res Treat 2015; 2015: 892301. 2015/04/17. DOI: 10.1155/2015/892301.
30. Hayat AA, Meny AH, Salahuddin N, et al. Assessment of knowledge about childhood autism spectrum disorder among healthcare workers in Makkah- Saudi Arabia. Pak J Med Sci 2019; 35: 951-957. 2019/08/03. DOI: 10.12669/pjms.35.4.605.
31. McCormack G, Dillon AC, Healy O, et al. Primary Care Physicians’ Knowledge of Autism and Evidence-Based Interventions for Autism: A Systematic Review. Review Journal of Autism and Developmental Disorders 2020; 7: 226-241. DOI: 10.1007/s40489-019-00189-4.
32. Sampson WG and Sandra AE. Comparative Study on Knowledge About Autism Spectrum Disorder Among Paediatric and Psychiatric Nurses in Public Hospitals in Kumasi, Ghana. Clin Pract Epidemiol Ment Health 2018; 14: 99-108. 2018/05/23. DOI: 10.2174/1745017901814010099.
33. Igwe MN, Ahanotu AC, Bakare MO, et al. Assessment of knowledge about childhood autism among paediatric and psychiatric nurses in Ebonyi state, Nigeria. Child Adolesc Psychiatry Ment Health 2011; 5: 1. 2011/01/11. DOI: 10.1186/1753-2000-5-1.
34. Figueiredo ARC. Estratégias de comunicação clínica com crianças autistas. . Faculdade de Medicina da Universidade do Porto, Porto, 2011.
35. Austriaco K, Aban I, Willig J, et al. Contemporary Trainee Knowledge of Autism: How Prepared Are Our Future Providers? Front Pediatr 2019; 7: 165. 2019/05/21. DOI: 10.3389/fped.2019.00165.
36. Unigwe S, Buckley C, Crane L, et al. GPs' confidence in caring for their patients on the autism spectrum: an online self-report study. Br J Gen Pract 2017; 67: e445-e452. 2017/05/10. DOI: 10.3399/bjgp17X690449.
37. Coughlan B, Duschinsky R, O'Connor ME, et al. Identifying and managing care for children with autism spectrum disorders in general practice: A systematic review and narrative synthesis. Health Soc Care Community 2020 2020/07/16. DOI: 10.1111/hsc.13098.
2. Governo do estado de São Paulo. Secretaria da Saúde. Protocolo do Estado de São Paulo de Diagnóstico, Tratamento e Encaminhamento de Pacientes com Transtorno do Espectro Autista (TEA). São Paulo: Secretaria de Estado da Saúde e dos Direitos da Pessoa com Deficiência,. 2013.
3. U.S. Department of Health & Human Services. Centers for disease control and prevention. Autism Spectrum Disorders (ASDs): Data & Statistics, http://www.cdc.gov/NCBDDD/autism/data.html (2012, accessed mar 2018).
4. Paula CS, Ribeiro SH, Fombonne E, et al. Brief report: prevalence of pervasive developmental disorder in Brazil: a pilot study. J Autism Dev Disord 2011; 41: 1738-1742. 2011/02/22. DOI: 10.1007/s10803-011-1200-6.
5. Organização Mundial da Saúde (OMS). https://www.who.int/news-room/fact-sheets/detail/autism-spectrum-disorders (2019).
6. Lyall K, Croen L, Daniels J, et al. The Changing Epidemiology of Autism Spectrum Disorders. Annu Rev Public Health 2017; 38: 81-102. 2017/01/10. DOI: 10.1146/annurev-publhealth-031816-044318.
7. Myers SM, Voigt RG, Colligan RC, et al. Autism Spectrum Disorder: Incidence and Time Trends Over Two Decades in a Population-Based Birth Cohort. J Autism Dev Disord 2019; 49: 1455-1474. 2018/12/07. DOI: 10.1007/s10803-018-3834-0.
8. Dawson G, Rogers S, Munson J, et al. Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics 2010; 125: e17-23. 2009/12/02. DOI: 10.1542/peds.2009-0958.
9. Howlin P, Magiati I and Charman T. Systematic review of early intensive behavioral interventions for children with autism. Am J Intellect Dev Disabil 2009; 114: 23-41. 2009/01/16. DOI: 10.1352/2009.114:23;nd41.
10. Reichow B. Overview of meta-analyses on early intensive behavioral intervention for young children with autism spectrum disorders. J Autism Dev Disord 2012; 42: 512-520. 2011/03/16. DOI: 10.1007/s10803-011-1218-9.
11. Matson JL, Rieske RD and Tureck K. Additional considerations for the early detection and diagnosis of autism: Review of available instruments. Research in Autism Spectrum Disorders 2011; 5: 1319-1326. DOI: https://doi.org/10.1016/j.rasd.2011.03.006.
12. Ribeiro SH, Paula CSd, Bordini D, et al. Barriers to early identification of autism in Brazil. Rev Bras Psiquiatr 2017; 39: 352-354.
13. Skellern C, McDowell M and Schluter P. Diagnosis of autistic spectrum disorders in Queensland: variations in practice. J Paediatr Child Health 2005; 41: 413-418. 2005/08/17. DOI: 10.1111/j.1440-1754.2005.00667.x.
14. Nicolaidis C, Kripke CC and Raymaker D. Primary care for adults on the autism spectrum. Med Clin North Am 2014; 98: 1169-1191. 2014/08/20. DOI: 10.1016/j.mcna.2014.06.011.
15. Tyler CV, Schramm SC, Karafa M, et al. Chronic disease risks in young adults with autism spectrum disorder: forewarned is forearmed. Am J Intellect Dev Disabil 2011; 116: 371-380. 2011/09/13. DOI: 10.1352/1944-7558-116.5.371.
16. Kohane IS, McMurry A, Weber G, et al. The co-morbidity burden of children and young adults with autism spectrum disorders. PLoS One 2012; 7: e33224. 2012/04/19. DOI: 10.1371/journal.pone.0033224.
17. Hughes RB, Lund EM, Gabrielli J, et al. Prevalence of interpersonal violence against community-living adults with disabilities: a literature review. Rehabil Psychol 2011; 56: 302-319. 2011/11/30. DOI: 10.1037/a0025620.
18. Shavelle RM, Strauss DJ and Pickett J. Causes of death in autism. J Autism Dev Disord 2001; 31: 569-576. 2002/01/30. DOI: 10.1023/a:1013247011483.
19. Woolfenden S, Sarkozy V, Ridley G, et al. A systematic review of two outcomes in autism spectrum disorder - epilepsy and mortality. Dev Med Child Neurol 2012; 54: 306-312. 2012/02/22. DOI: 10.1111/j.1469-8749.2012.04223.x.
20. Perkins EA and Berkman KA. Into the unknown: aging with autism spectrum disorders. Am J Intellect Dev Disabil 2012; 117: 478-496. 2012/11/22. DOI: 10.1352/1944-7558-117.6.478.
21. Bakare MO, Ebigbo PO, Agomoh AO, et al. Knowledge about childhood autism among health workers (KCAHW) questionnaire: description, reliability and internal consistency. Clin Pract Epidemiol Ment Health 2008; 4: 17. 2008/06/10. DOI: 10.1186/1745-0179-4-17.
22. Shah K. What Do Medical Students Know about Autism? Autism 2001; 5: 127-133. DOI: 10.1177/1362361301005002003.
23. Harrison AJ, Bradshaw LP, Naqvi NC, et al. Development and Psychometric Evaluation of the Autism Stigma and Knowledge Questionnaire (ASK-Q). J Autism Dev Disord 2017; 47: 3281-3295. 2017/07/27. DOI: 10.1007/s10803-017-3242-x.
24. Crane L, Davidson I, Prosser R, et al. Understanding psychiatrists' knowledge, attitudes and experiences in identifying and supporting their patients on the autism spectrum: online survey. BJPsych Open 2019; 5: e33. 2019/09/19. DOI: 10.1192/bjo.2019.12.
25. Muller C. Conhecimento dos estudantes de medicina acerca do autismo em uma universidade do Rio Grande do Sul. Universidade Federal do Rio Grande do Sul, Porto Alegre, 2012.
26. Igwe MN, Bakare MO, Agomoh AO, et al. Factors influencing knowledge about childhood autism among final year undergraduate Medical, Nursing and Psychology students of University of Nigeria, Enugu State, Nigeria. Ital J Pediatr 2010; 36: 44. 2010/06/15. DOI: 10.1186/1824-7288-36-44.
27. Shaukat F, Fatima A, Zehra N, et al. Assessment of knowledge about childhood autism among medical students from private and public universities in Karachi. J Pak Med Assoc 2014; 64: 1331-1334. 2015/04/04.
28. Kostiukow A, Poniewierski P, Strzelecki W, et al. Assessment of student's knowledge and awareness of autism spectrum disorder. Pol Merkur Lekarski 2020; 48: 87-92. 2020/05/01.
29. Eseigbe EE, Nuhu FT, Sheikh TL, et al. Knowledge of Childhood Autism and Challenges of Management among Medical Doctors in Kaduna State, Northwest Nigeria. Autism Res Treat 2015; 2015: 892301. 2015/04/17. DOI: 10.1155/2015/892301.
30. Hayat AA, Meny AH, Salahuddin N, et al. Assessment of knowledge about childhood autism spectrum disorder among healthcare workers in Makkah- Saudi Arabia. Pak J Med Sci 2019; 35: 951-957. 2019/08/03. DOI: 10.12669/pjms.35.4.605.
31. McCormack G, Dillon AC, Healy O, et al. Primary Care Physicians’ Knowledge of Autism and Evidence-Based Interventions for Autism: A Systematic Review. Review Journal of Autism and Developmental Disorders 2020; 7: 226-241. DOI: 10.1007/s40489-019-00189-4.
32. Sampson WG and Sandra AE. Comparative Study on Knowledge About Autism Spectrum Disorder Among Paediatric and Psychiatric Nurses in Public Hospitals in Kumasi, Ghana. Clin Pract Epidemiol Ment Health 2018; 14: 99-108. 2018/05/23. DOI: 10.2174/1745017901814010099.
33. Igwe MN, Ahanotu AC, Bakare MO, et al. Assessment of knowledge about childhood autism among paediatric and psychiatric nurses in Ebonyi state, Nigeria. Child Adolesc Psychiatry Ment Health 2011; 5: 1. 2011/01/11. DOI: 10.1186/1753-2000-5-1.
34. Figueiredo ARC. Estratégias de comunicação clínica com crianças autistas. . Faculdade de Medicina da Universidade do Porto, Porto, 2011.
35. Austriaco K, Aban I, Willig J, et al. Contemporary Trainee Knowledge of Autism: How Prepared Are Our Future Providers? Front Pediatr 2019; 7: 165. 2019/05/21. DOI: 10.3389/fped.2019.00165.
36. Unigwe S, Buckley C, Crane L, et al. GPs' confidence in caring for their patients on the autism spectrum: an online self-report study. Br J Gen Pract 2017; 67: e445-e452. 2017/05/10. DOI: 10.3399/bjgp17X690449.
37. Coughlan B, Duschinsky R, O'Connor ME, et al. Identifying and managing care for children with autism spectrum disorders in general practice: A systematic review and narrative synthesis. Health Soc Care Community 2020 2020/07/16. DOI: 10.1111/hsc.13098.
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2020-12-30
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Rezende, L. de O., Petroucic, R. T., Costa, R. F. A. da, & Monteiro, M. A. (2020). Conhecimento sobre Transtorno do Espectro Autista entre profissionais da atenção básica de saúde. Manuscripta Medica, 3, 31–39. Recuperado de https://manuscriptamedica.com.br/revista/index.php/mm/article/view/42
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