Service médico-psychologique régional, Centre hospitalier Lorquin, Metz, France.
J Adolesc Health. 2013 Mar;52(3):344-50. doi: 10.1016/j.jadohealth.2012.06.017. Epub 2012 Aug 15.
To determine whether patients' perception of early therapeutic alliance (TA) could predict time to achieve a target weight among adolescents undergoing treatment for anorexia nervosa.
TA was assessed in a prospective cohort recruited from both inpatient and outpatient settings by self-administered and validated questionnaires. Kaplan-Meier survival curves were compared by log rank test, and Cox regression was used to test whether patients' perception of early TA predicted time to achieve a target weight.
In total, 108 patients were included, and 79.6% achieved a target weight. Better patient perception of early TA increased the hazard ratio (HR) of achieving a target weight (HR = 2.7, 95% confidence interval: 1.7-4.4, p < .001) such as being in the inpatient setting by 6.7. Being very severely underweight at admission decreased the HR of achieving the target weight.
Patients' perception of early TA is a good predictor of achieving a target weight. Because TA is a modifiable construct, it could be a target for intervention.
确定青少年在接受神经性厌食症治疗过程中，患者对早期治疗联盟的感知是否可以预测达到目标体重的时间。
通过自我管理和验证的问卷，前瞻性地从住院和门诊环境中招募参与者来评估治疗联盟。通过对数秩检验比较 Kaplan-Meier 生存曲线，并用 Cox 回归检验患者对早期治疗联盟的感知是否可以预测达到目标体重的时间。
共纳入 108 例患者，79.6%的患者达到目标体重。患者对早期治疗联盟的感知越好，达到目标体重的风险比（HR）越高（HR=2.7，95%置信区间：1.7-4.4，p<0.001），住院治疗的效果增加 6.7 倍。入院时非常严重的体重不足会降低达到目标体重的 HR。
患者对早期治疗联盟的感知是达到目标体重的良好预测指标。由于治疗联盟是一个可改变的结构，因此它可能是干预的目标。
