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脑损伤婴儿的干预措施:一项随机对照研究的结果

Intervention for infants with brain injury: results of a randomized controlled study.

作者信息

Badr Lina Kurdahi, Garg Meena, Kamath Meghna

机构信息

School of Nursing, 901 East Alosta Avenue, Azusa Pacific University, Azusa, CA 90095, USA.

出版信息

Infant Behav Dev. 2006 Jan;29(1):80-90. doi: 10.1016/j.infbeh.2005.08.003. Epub 2005 Aug 31.

Abstract

A randomized clinical trail (RCT) employed a 12-month individualized cognitive/sensorimotor stimulation program to look at the efficacy of the intervention on 62 infants with suspected brain injury. The control group infants received the State-funded follow-up program provided by the Los Angeles (LA) Regional Centers while the intervention group received intensive stimulation using the Curriculum and Monitoring System (CAMS) taught by public health nurses (PHNs). The developmental assessments and outcome measures were performed at 6, 12 and 18 months corrected age and included the Bayley motor and mental development, the Home, mother-infant interaction (Nursing Child Assessment Feeding Scale (NCAFS) and Nursing Child Assessment Teaching Scale (NCATS)), parental stress and social support. At 18 months, 43 infants remained in the study. The results indicate that the intervention had minimal positive effects on the Bayley mental and motor development scores of infants in the intervention group. Likewise, the intervention did not contribute to less stress or better mother-infant interaction at 12 or 18 months although there were significant differences in the NCAFS scores favoring the intervention group at 6 months. There was a significant trend, however, for the control group to have a significant decrease over time on the Bayley mental scores. Although the sample was not large and attrition was at 31%, this study provides further support to the minimal effects of stimulation and home intervention for infants with brain injury and who may have more significant factors contributing to their developmental outcome.

摘要

一项随机临床试验(RCT)采用了为期12个月的个体化认知/感觉运动刺激方案,以研究该干预措施对62名疑似脑损伤婴儿的疗效。对照组婴儿接受洛杉矶地区中心提供的国家资助的随访方案,而干预组则接受由公共卫生护士(PHNs)使用课程与监测系统(CAMS)进行的强化刺激。在矫正年龄6个月、12个月和18个月时进行发育评估和结果测量,包括贝利运动和智力发育、家庭、母婴互动(儿童护理评估喂养量表(NCAFS)和儿童护理评估教学量表(NCATS))、父母压力和社会支持。在18个月时,43名婴儿仍在参与研究。结果表明,该干预措施对干预组婴儿的贝利智力和运动发育得分仅有极小的积极影响。同样,尽管在6个月时NCAFS得分有利于干预组,但该干预措施在12个月或18个月时并没有减轻压力或改善母婴互动。然而,对照组的贝利智力得分随时间有显著下降趋势。尽管样本量不大且失访率为31%,但这项研究进一步支持了刺激和家庭干预对脑损伤婴儿的影响极小,且可能有更重要的因素影响其发育结果。

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