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一项基于网络的新型干预措施预防儿童医疗事件后创伤后应激的试点随机对照试验。

Pilot Randomized Controlled Trial of a Novel Web-Based Intervention to Prevent Posttraumatic Stress in Children Following Medical Events.

作者信息

Kassam-Adams Nancy, Marsac Meghan L, Kohser Kristen L, Kenardy Justin, March Sonja, Winston Flaura K

机构信息

Children's Hospital of Philadelphia, University of Pennsylvania,

Children's Hospital of Philadelphia, University of Pennsylvania.

出版信息

J Pediatr Psychol. 2016 Jan-Feb;41(1):138-48. doi: 10.1093/jpepsy/jsv057. Epub 2015 Jun 18.

Abstract

OBJECTIVE

To assess feasibility and estimate effect size of a self-directed online intervention designed to prevent persistent posttraumatic stress after acute trauma.

METHODS

Children aged 8-12 years with a recent acute medical event were randomized to the intervention (N = 36) or a 12-week wait list (N = 36). Posttraumatic stress, health-related quality of life, appraisals, and coping were assessed at baseline, 6, 12, and 18 weeks.

RESULTS

Most children used the intervention; half completed it. Medium between-group effect sizes were observed for change in posttraumatic stress severity from baseline to 6 weeks (d = -.68) or 12 weeks (d = -.55). Exploratory analyses suggest greatest impact for at-risk children, and a small effect for intervention initiated after 12 weeks. Analysis of covariance did not indicate statistically significant group differences in 12-week outcomes.

CONCLUSIONS

This pilot randomized controlled trial provides preliminary evidence that a self-directed online preventive intervention is feasible to deliver, and could have an effect in preventing persistent posttraumatic stress.

摘要

目的

评估一项旨在预防急性创伤后持续性创伤后应激障碍的自主在线干预措施的可行性,并估计其效应大小。

方法

将近期经历急性医疗事件的8至12岁儿童随机分为干预组(N = 36)或12周等待名单组(N = 36)。在基线、第6周、第12周和第18周评估创伤后应激障碍、健康相关生活质量、评估和应对情况。

结果

大多数儿童使用了该干预措施;一半儿童完成了干预。从基线到第6周(d = -0.68)或第12周(d = -0.55),创伤后应激严重程度变化的组间效应大小为中等。探索性分析表明,该干预措施对高危儿童影响最大,对12周后开始的干预效果较小。协方差分析未显示12周结果存在统计学上的显著组间差异。

结论

这项初步随机对照试验提供了初步证据,表明自主在线预防干预措施可行,且可能对预防持续性创伤后应激障碍有效果。

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