Perrin J M, MacLean W E, Gortmaker S L, Asher K N
Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
J Dev Behav Pediatr. 1992 Aug;13(4):241-7.
Children with asthma are at special risk for problems in psychological functioning, as are children with other chronic illnesses. We conducted a controlled trial of a combined education and stress management program among children ages 6 to 14 years with asthma. Eighty-one children were randomly assigned to an intervention or a control group; 56 children completed data collection, 29 intervention and 27 control. Psychological status was assessed by the Child Behavior Checklist (CBCL) before and after the intervention, as were children's knowledge of asthma, stress (as measured by children's life events), and functional status (as indicated by such activities as school attendance, time playing with friends, and daily chore performance). Children in the intervention group had a significant improvement in the total Behavior Problems score (p less than .04) and Internalizing scale (p less than .01) on the CBCL and a significant increase in daily chores (p less than .04) compared with the control group. Before intervention, the two groups had statistically significant positive relationships between negative life events and behavior problems scores. After intervention, children in the control group still demonstrated a significant relationship between negative life events and total and Internalizing Behavior Problem scores, although participation in the intervention group negated that relationship. Children in the intervention group whose knowledge of asthma increased were more likely to report an increase in daily chores (p less than .02). We conclude that the intervention had a beneficial effect on psychological status and on children's daily activities. The effect may have occurred in part by decreasing the likelihood that perceived stress from negative life events led to poorer adjustment.
与患有其他慢性疾病的儿童一样，哮喘儿童在心理功能方面面临特殊风险。我们对6至14岁的哮喘儿童开展了一项教育与压力管理相结合项目的对照试验。81名儿童被随机分配到干预组或对照组；56名儿童完成了数据收集，其中29名来自干预组，27名来自对照组。在干预前后，通过儿童行为量表（CBCL）评估心理状态，同时评估儿童对哮喘的了解程度、压力（通过儿童生活事件衡量）和功能状态（通过上学出勤率、与朋友玩耍时间和日常家务表现等活动来表明）。与对照组相比，干预组儿童在CBCL上的总行为问题得分（p小于0.04）和内化量表得分（p小于0.01）有显著改善，日常家务有显著增加（p小于0.04）。干预前，两组在负面生活事件与行为问题得分之间存在统计学上显著的正相关关系。干预后，对照组儿童在负面生活事件与总行为问题得分和内化行为问题得分之间仍表现出显著关系，而干预组儿童参与干预后消除了这种关系。哮喘知识增加的干预组儿童更有可能报告日常家务有所增加（p小于0.02）。我们得出结论，该干预对心理状态和儿童日常活动有有益影响。这种影响可能部分是通过降低负面生活事件带来的感知压力导致适应能力变差的可能性而产生的。
