Diabetes Research and Training Center, School of Medicine, Vanderbilt University, Nashville, TN 37212, USA.
Patient Educ Couns. 1994 Jun;23(2):115-24. doi: 10.1016/0738-3991(94)90049-3.
This study's hypotheses were that both shortly after instruction and after an 8-month follow-up, diabetic children taught via anchored instruction (AI), a format for problem solving, would outperform controls. Subjects were 81 9-15-year-old campers with insulin dependent diabetes who were randomly assigned to AI or control groups for two 45-min small group teaching sessions. Als viewed a video about a girl who mismanages her diabetes during intercurrent illness, and they were challenged to identify, define and solve her errors. Controls learned sick-day management via conventional direct instruction. At the end of the 2-week camp, AI and control groups' scores on factual knowledge were equal. AIs were more likely than controls at the end of the camp (0.75 vs. 0.54, P < 0.05) and 8 months later (0.59 vs. 0.38, P < 0.02) to provide a rationale for the use of remembered guidelines. Across all campers, this ability to link guidelines and their rationales was significantly correlated (r = 0.55, P < 0.01) with the number of self-management practices employed by campers who suffered an illness between the end of camp and the 8-month follow-up. Only one long-term behavioral difference between groups emerged: Als' parents shared in making most diabetes decisions on sick days, while controls' parents left more decision making to their children. AI appears at least as good as conventional teaching, and may better 'link' rules and reasons, perhaps aiding daily real-life problem solving.
本研究的假设是，在接受指导后的短时间内和 8 个月的随访后，通过锚定指导（AI）接受教学的糖尿病儿童（AI）将比对照组表现更好。研究对象为 81 名 9-15 岁的夏令营营员，他们患有胰岛素依赖型糖尿病，被随机分配到 AI 或对照组，接受两次 45 分钟的小组教学。夏令营营员观看了一段关于一个女孩在疾病发作期间管理糖尿病不当的视频，他们的任务是识别、定义和解决她的错误。对照组通过传统的直接指导学习疾病日管理。在两周的夏令营结束时，AI 和对照组在事实知识方面的得分相等。在夏令营结束时（0.75 对 0.54，P < 0.05）和 8 个月后（0.59 对 0.38，P < 0.02），AI 比对照组更有可能提供使用记忆中指南的理由。在所有夏令营营员中，这种将指南与其理由联系起来的能力与夏令营营员在夏令营结束和 8 个月随访期间患病期间采用的自我管理实践数量呈显著相关（r = 0.55，P < 0.01）。只有一个组间长期行为差异出现：AI 组的父母在疾病日共同做出大多数糖尿病决策，而对照组的父母则将更多的决策留给孩子。AI 似乎至少与传统教学一样好，并且可能更好地“链接”规则和理由，也许有助于日常生活中的问题解决。
