Priprema osoba sa autizmom za scintigrafiju štitnjače

Abstract

Autizam je neurorazvojni poremećaj koji često prate različita komorbidna stanja, u koje, između ostalog, spadaju i bolesti štitaste žlezde. Jedna od često korišćenih dijagnostičkih metoda za utvrđivanje izgleda i funkcije štitaste žlezde je scintigrafija. Iako se u centrima za nuklearnu medicinu scintigrafija štitnjače izvodi rutinski, sa aspekta osobe sa autizmom i stručnjaka koji joj pružaju podršku priprema za snimanje može da bude veoma kompleksna. Mnoge osobe sa autizmom imaju tripanofobiju (strah od igle), zbog čega se moraju posebno pripremati za venepunkciju tokom koje se radiofarmak ubrizgava u organizam. Osim toga, snimanje gama-kamerom, iako potpuno bezbolno, može da bude veoma zahtevno za pacijenta sa autizmom, koji sve vreme snimanja mora da miruje, da ne govori i da ne vokalizuje. Kliničko osoblje može da se suoči sa poteškoćama i u realizaciji svih ostalih faza ove dijagnostičke procedure. Zato je u ovom radu predložena grupa intervencija, zasnovanih na dokazima, koje se mogu koristiti u pripremi osoba sa autizmom za scintigrafiju štitnjače. Predložene su tehnike postepenog izlaganja, gašenja, potkrepljivanja, modelovanja, pisanja socijalnih priča, koje pripadaju kategoriji fokusiranih intervencija za osobe sa autizmom.

Autism is a neurodevelopmental disorder that is often accompanied by various co-morbid conditions, among other things, thyroid diseases. One of the frequently used diagnostic methods to determine the appearance and function of the thyroid gland is scintigraphy. Although thyroid scintigraphy is routinely performed at Clinics for Nuclear Medicine, preparation for nuclear imaging can be very complex from the perspective of people with autism and the experts who support them. Many people with autism have trypanophobia (fear of needles), which is why they have to be specially prepared for venipuncture, during which radiopharmaceutical is injected into the organism. In addition, nuclear imaging with a gamma camera, though completely painless, can be very demanding for a patient with autism who must remain still, without speaking and vocalising during the entire imaging. Clinical staff may also face difficulties in implementing all other stages of this diagnostic procedure. Therefore, this paper proposes a set of evidence-based interventions that can be used to prepare people with autism for thyroid scintigraphy. Techniques of gradual exposure, extinction, reinforcement, modelling, and writing social stories, belonging to the category of focused interventions for people with autism, are proposed.