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儿科医生、健康婴儿访视与视频干预疗法:在儿科初级卫生保健环境中进行视频反馈式婴儿心理健康支持干预的可行性

Pediatricians, Well-Baby Visits, and Video Intervention Therapy: Feasibility of a Video-Feedback Infant Mental Health Support Intervention in a Pediatric Primary Health Care Setting.

作者信息

Facchini Sergio, Martin Valentina, Downing George

机构信息

Pediatric Primary Care Unit, Azienda per l'Assistenza Sanitaria n. 5 "Friuli Occidentale" Pordenone, Italy.

Department of Developmental Psychology and Socialisation, University of Padova Padova, Italy.

出版信息

Front Psychol. 2016 Feb 16;7:179. doi: 10.3389/fpsyg.2016.00179. eCollection 2016.

Abstract

This case series study evaluated the feasibility and acceptability of a behavioral/cognitive psychological intervention in a pediatric primary health care setting during standard well-baby visits. The aim of the intervention was to support caregivers' sensitivity and mentalization in order to promote infant mental health (IMH). Four neonates from birth to 8 months were consecutively enrolled to test a short video-feedback intervention (Primary Care - Video Intervention Therapy, an adaptation of George Downing's Video Intervention Therapy to primary care) conducted by a pediatrician. The 5 min interaction recording and the video-feedback session were performed during the same well-baby visit and in the same pediatrician's office where the physical examination was conducted. During the study period, six video-feedback sessions were performed for each baby at different ages (1, 2, 3, 4, 6, 8 months). A series of different interactional situations were filmed and discussed: touch, cry, affective matching, descriptive language, feeding, separation and autonomy. The intervention was easily accepted and much appreciated by all four families enrolled. This study aimed to answer a dilemma which pediatric providers generally face: if the provider wishes to respond not only to physical but also IMH issues, how on a practical level can this be done? This case series study indicates that Primary Care - Video Intervention Therapy can be a promising new tool for such a purpose.

摘要

本病例系列研究评估了在标准的婴儿健康检查期间,在儿科初级卫生保健环境中进行行为/认知心理干预的可行性和可接受性。该干预的目的是提高照顾者的敏感性和心理化能力,以促进婴儿心理健康(IMH)。连续招募了4名从出生到8个月大的新生儿,以测试由一名儿科医生实施的短视频反馈干预(初级保健-视频干预疗法,这是对乔治·唐宁的视频干预疗法进行改编后应用于初级保健的方法)。5分钟的互动记录和视频反馈环节在同一次婴儿健康检查期间、在进行体格检查的同一位儿科医生的办公室内进行。在研究期间,针对每个婴儿在不同年龄(1、2、3、4、6、8个月)进行了6次视频反馈环节。拍摄并讨论了一系列不同的互动情境:触摸、哭泣、情感匹配、描述性语言、喂养、分离和自主性。该干预很容易被所有4个参与家庭接受并得到高度评价。本研究旨在回答儿科医疗服务提供者普遍面临的一个两难问题:如果医疗服务提供者不仅希望应对身体问题,还希望应对婴儿心理健康问题,那么在实际层面该如何做到这一点?本病例系列研究表明,初级保健-视频干预疗法可能是实现这一目的的一种有前景的新工具。

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