國民教育階段注意力缺陷過動症學生家長的ADHD知識與藥物治療態度之相關研究

Abstract

本研究旨在了解國民教育階段ADHD學生家長之ADHD知識與藥物治療態度現況，並探討二者間之相關及背景變項之調節效果。研究工具整合Sciutto與Feldhamer（2005）所編製之「注意力缺陷過動症知識量表」（KADDS）、Ferrin等人（2012）編製之注意力缺陷過動症治療態度問卷（QATT），重新編修和整合為「ADHD學生家長知識與藥物治療態度調查問卷」。採線上問卷、立意取樣方式，邀請493位就讀於國民教育階段的ADHD學生家長作答，整體樣本的學生有近八成為正在用藥，一成的學生為曾用藥但目前停藥，未用藥的學生佔一成，家長近八成五具大專以上學歷。研究結果顯示：一、家長於KADDS整體答對率為67%，其中對症狀之認識最高（84.2%），對治療相關知識最低（53.7%）；二、正使用藥物治療的學生家長之藥物治療態度比曾用藥及未使用藥物治療的家長較佳；形成家長藥物治療態度的動力為ADHD學生對治療具有正向的態度、對疾病及醫療需求較認同以及擁有良好的醫病關係；阻力為子女的協助需求低、家長對ADHD治療和替代療法具擔憂、汙名化感受度高以及對副作用的擔心程度高；三、僅正使用藥物治療的學生家長之ADHD知識與藥物治療態度呈中等偏高正相關；四、調節分析發現獲確診年數、診斷、協助需求、親職角色及用藥決策者五變項均顯著調節正用藥組家長的ADHD知識與藥物治療態度之相關。建議實務上提供不同背景的家長階段化與差異化之衛教、父親加入治療及親子共同決策，並結合縱向與質性研究以深化後續探究。This study examined parents’ ADHD knowledge and attitudes toward pharmacotherapy among students with ADHD in elementary and junior high school, and investigated their correlation and the moderating variables of the relationships. Measures comprised the Knowledge of Attention Deficit Disorders Scale (KADDS; Sciutto& Feldhamer, 2005) and the Questionnaire on Attitudes Toward ADHD Treatment (QATT; Ferrin et al., 2012), adapted and integrated into a survey aligned with the study purposes. An online, purposive sample of 493 parents of students in the compulsory education stage participated. Approximately 80% of students among the sample were currently receiving medication, about 10% had discontinued prior medication, and about 10% had never used medication; nearly 85% of parents reported to receive tertiary education or higher.Results were as follows: (1) Parents answered 67% of KADDS items correctly overall; accuracy was highest in the symptom recognition (84.2%) and lowest in the treatment knowledge (53.7%). (2) Parents of currently medicated students reported more favorable attitudes toward ADHD pharmacotherapy than those whose children had previously or never used medication; moreover, more favorable attitudes were associated with children’s positive views of treatment, greater recognition of the ADHD diagnosis and its healthcare needs, and a strong patient–doctor relationship; less favorable attitudes were related to lower perception of assistance needs, worries about treatments and alternative treatments for ADHD, higher concerns about stigma and side effects. (3) A moderate-to-strong positive correlation between ADHD knowledge and attitudes toward pharmacotherapy was observed only among parents of currently medicated students. (4) Moderation analyses indicated that years since diagnosis, diagnostic, severity of ADHD symptoms, parental role, and the medication decision-maker significantly moderated the relationship between ADHD knowledge and attitudes toward pharmacotherapy among parents in the currentlymedicated subgroup.Recommendations were made: Provide staged and differentiated psychoeducation for parents of children with ADHD, encourage fathers’ active involvement, and promote shared parent–child decision-making on medication. Future research should adopt longitudinal and qualitative approaches to further elucidate parents’ decision-making dynamics.