Factors Associated with Knowledge, Attitude, and Practices of Physicians related to Autism spectrum disorder in Romania

Abstract

Background An inadequate level of general knowledge of physicians regarding mental health, including Autism Spectrum Disorder (ASD) not only could have adverse effects on affected individuals’ health and quality of life, but also could further delay its diagnosis and initiation of timely interventions. The purpose of this survey was to assess the level of knowledge, attitudes, and practices (KAP) of physicians regarding ASD in Romania and identify their associated factors. Methods For conducting this cross-sectional survey, investigators in the US collaborated with faculty at “Carol Davila” University of Medicine and Pharmacy (UMF) and developed a questionnaire by modifying similar questionnaires used in Pakistan and Turkey, to assess KAP of physicians and specialists regarding ASD in Romania. The Questionnaire was administered to a convenient sample of 383 practicing physicians or specialists. Exploratory Factor Analysis on 12 variables revealed five composite sub-scores: stigma, potential causes, children’s behavior, misconceptions, and educational needs associated with ASD knowledge. We determined the variables associated additively or interactively with KAP regarding ASD by applying General Linear Models to the five sub-scores as dependent variables. Results Approximately 75% of the responding physicians were female and more than 80% were over the age of 30 years. The majority (73%-94%) of physicians in Romania have correctly responded to some basic questions regarding knowledge about ASD. We also found that younger physicians (age < 35 years) were more knowledgeable about potential causes of ASD than older physicians, age ≥ 35 years, (adjusted mean sub-scores: 2.70 vs. 2.13, P = 0.04, adjusted for the “type of medical school attended” and “city where the clinic is located”), while older physicians knew more about the behavior of children with ASD (P = 0.02). We found a significant interaction between source of ASD knowledge and (city where the clinic is located) in relation to knowledge of the physicians’ regarding stigma related to ASD. There were no significant interactions in relation to the physician’s knowledge of behaviors of children with ASD. Conclusion Though Romanian physicians are knowledgeable about ASD, greater attention is needed on symptoms, causes, and awareness of stigma and misconceptions surrounding ASD.