Adair Brooke, Ullenhag Anna, Keen Deb, Granlund Mats, Imms Christine
School of Allied Health, Australian Catholic University, Fitzroy, Vic., Australia.
Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
Dev Med Child Neurol. 2015 Dec;57(12):1093-104. doi: 10.1111/dmcn.12809. Epub 2015 May 24.
Enhancement of participation has been described as the ultimate outcome for health and educational interventions. The goal of this systematic review was to identify and critically appraise studies that aimed to improve the participation outcomes of children with disabilities.
Nine databases that index literature from the fields of health, psychology, and education were searched to retrieve information on research conducted with children with disabilities aged between 5 years and 18 years. Articles were included if the author(s) reported that participation was an intended outcome of the intervention. The articles included were limited to those reporting high-level primary research, as defined by Australia's National Health and Medical Research Council evidence hierarchy guidelines. No restrictions were placed on the type of intervention being investigated.
Seven randomized controlled or pseudo-randomized studies were included. Only three of these studies identified participation as a primary outcome. Both individualized and group-based approaches to enhancing participation outcomes appeared to be effective. Studies of interventions with a primary focus on body function or activity level outcomes did not demonstrate an effect on participation outcomes.
Few intervention studies have focused on participation as a primary outcome measure. Approaches using individually tailored education and mentoring programmes were found to enhance participation outcomes, while exercise programmes, where participation was a secondary outcome, generally demonstrated little effect.
增强参与度已被描述为健康和教育干预的最终成果。本系统评价的目的是识别并严格评估旨在改善残疾儿童参与成果的研究。
检索了九个索引健康、心理学和教育领域文献的数据库，以获取有关对5至18岁残疾儿童开展的研究的信息。如果作者报告参与是干预的预期成果，则纳入相关文章。纳入的文章仅限于那些报告澳大利亚国家卫生与医学研究委员会证据等级指南所定义的高水平原始研究。对所研究的干预类型没有限制。
纳入了七项随机对照或准随机研究。其中只有三项研究将参与确定为主要成果。个性化和基于小组的增强参与成果的方法似乎都有效。主要关注身体功能或活动水平成果的干预研究未显示对参与成果有影响。
很少有干预研究将参与作为主要结局指标。发现采用个性化教育和指导计划的方法可增强参与成果，而参与作为次要结局的运动计划通常效果甚微。
