未能证实针对高功能广泛性发育障碍儿童母亲的简短团体心理教育方案的有效性：一项随机对照试点试验。
A failure to confirm the effectiveness of a brief group psychoeducational program for mothers of children with high-functioning pervasive developmental disorders: a randomized controlled pilot trial.
机构信息
Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Department of Psychiatric and Mental Health Nursing, Nagoya City University School of Nursing, Nagoya, Japan.
出版信息
Neuropsychiatr Dis Treat. 2014 Jun 30;10:1141-53. doi: 10.2147/NDT.S60058. eCollection 2014.
OBJECTIVE
The purpose of this study was to examine the effectiveness of group psychoeducation to relieve the psychological distress of mothers of children with high-functioning pervasive developmental disorders (HFPDD) and to improve the behaviors of the children.
METHODS
Seventy-two mothers of preschool outpatients with HFPDD were randomly assigned to a four-session brief group psychoeducational program (GP). The sessions were held every second week in addition to the usual treatment (GP + treatment as usual [TAU] group), or to a TAU-alone group. The primary outcome was self-reported symptoms of maternal mental health as assessed using the 28-item General Health Questionnaire (GHQ-28) at 21 weeks post-randomization (week 21). The GHQ-28 at the end of the intervention (week 7), Aberrant Behavior Checklist (ABC) for the behavior of the children, the Zarit Burden Interview (ZBI), and the Medical Outcomes Study 36-item Short Form Health Survey (SF-36) were carried out at weeks 7 and 21. We tested the group effects with the interaction between the intervention and the evaluation points.
RESULTS
The GHQ-28 score at week 21 was significantly higher in the GP + TAU group as compared to that in the TAU-alone group, indicating a greater improvement in the TAU-alone group. There was no evidence that GP + TAU led to a greater improvement of maternal mental health than TAU-alone at week 7. Similarly, no evidence was obtained to indicate that GP + TAU led to a reduction in the ABC or ZBI scores by week 7 or 21. The adjusted scores for the RF (role emotional) and MH (mental health) subscales of the SF-36 at week 21 were also significantly lower in the GP + TAU group, indicating a similar tendency to that of the change of the GHQ-28 score at week 21.
CONCLUSION
The psychoeducational program did not alleviate maternal distress, aberrant behaviors of the children, or caregiver burden.
目的
本研究旨在考察团体心理教育对缓解高功能广泛性发育障碍（HFPDD）患儿母亲心理困扰的效果，并改善患儿的行为。
方法
72 名 HFPDD 学龄前门诊患儿的母亲被随机分为四节简短团体心理教育课程（GP）组。在常规治疗（GP+常规治疗[TAU]组）之外，或在 TAU 单独组之外，每两周进行一次团体心理教育课程。主要结局是使用 28 项一般健康问卷（GHQ-28）评估母亲心理健康的自我报告症状，在随机分组后 21 周（第 21 周）进行评估。在干预结束时（第 7 周）、儿童行为的异常行为检查表（ABC）、Zarit 负担访谈（ZBI）和医疗结果研究 36 项简明健康调查（SF-36）在第 7 周和第 21 周进行评估。我们通过干预和评估点之间的相互作用来检验组间效应。
结果
与 TAU 单独组相比，GP+TAU 组第 21 周的 GHQ-28 评分显著更高，表明 TAU 单独组的改善更大。没有证据表明 GP+TAU 在第 7 周时比 TAU 单独组更能改善母亲的心理健康。同样，没有证据表明 GP+TAU 在第 7 周或第 21 周能降低 ABC 或 ZBI 评分。SF-36 的 RF（角色情感）和 MH（心理健康）子量表的调整评分在第 21 周也显著低于 GP+TAU 组，表明与第 21 周 GHQ-28 评分的变化趋势相似。
结论
心理教育计划并没有减轻母亲的痛苦、儿童的异常行为或照顾者的负担。
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