BACKGROUND Attention Deficit Hyperactivity Disorder (ADHD) is underdiagnosed in many European countries and the process of accessing care and diagnosis is complex and variable. In many countries, general practitioners (GPs) refer on to secondary care where individuals receive an assessment and, if appropriate, a diagnosis and access to care. It is therefore essential that GPs have a clear understanding of the disorder and its care pathways. While previous studies have highlighted potential barriers in GPs' ADHD awareness, this qualitative study aims to further explore individual stakeholders' experiences. METHODS Semi-structured interviews explored the views of multiple stakeholders- GPs (n = 5), healthcare specialists (n = 5), patients (adults with ADHD n = 5) and parents (n = 5) with experience of the presentation and management of ADHD in primary care. These interviews were analysed using thematic analyses and following principles of grounded theory. RESULTS Stakeholders described ADHD assessment, diagnosis and treatment as an intricate process. Many factors affected this process such as complex pathways, lack of services, limited GP recognition and knowledge, and communicative difficulties between and within multiple stakeholders. CONCLUSION This analysis underlines the significant impact that receiving (or not) a diagnosis can have, and further explores muddled ADHD care pathways, highlighting key issues around GP identification and the shortage of adult services. Implications for practice and future research are discussed, suggesting a strong need for more commissioned pathways and GP specific educational programs.

中文翻译：

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初级保健中对多动症的认识：利益相关者的观点。

背景技术在许多欧洲国家中，注意力缺陷多动障碍（ADHD）的诊断不足，并且获得护理和诊断的过程复杂而多变。在许多国家/地区，全科医生（GPs）会在个人接受评估以及在适当情况下获得诊断和获得护理的机会时，提及二级护理。因此，GP必须对疾病及其护理途径有清楚的了解。虽然先前的研究强调了全科医生ADHD意识的潜在障碍，但这项定性研究旨在进一步探索各个利益相关者的经验。方法半结构化访谈探讨了多个利益相关者的意见-全科医生（n = 5），医疗保健专家（n = 5），在初级保健中有ADHD的表现和管理经验的患者（成人多动症n = 5）和父母（n = 5）。使用主题分析和遵循扎根理论的原则对这些访谈进行了分析。结果利益相关者将ADHD评估，诊断和治疗描述为一个复杂的过程。影响此过程的因素很多，例如复杂的途径，缺乏服务，GP认识和知识有限以及多个利益相关者之间和内部的沟通困难。结论该分析强调了接受（或不接受）诊断可能产生的重大影响，并进一步探讨了多动症多动症的护理途径，强调了有关全科医生识别和成人服务短缺的关键问题。讨论了对实践和未来研究的影响，