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针对矫正年龄为18个月的极早产儿的预防性育儿干预措施的可行性:一项随机试点试验。

Feasibility of a Preventive Parenting Intervention for Very Preterm Children at 18 Months Corrected Age: A Randomized Pilot Trial.

作者信息

Flierman Monique, Koldewijn Karen, Meijssen Dominique, van Wassenaer-Leemhuis Aleid, Aarnoudse-Moens Cornelieke, van Schie Petra, Jeukens-Visser Martine

机构信息

Department of Rehabilitation, Academic Medical Center, Amsterdam, University of Amsterdam, Amsterdam, The Netherlands.

Department of Rehabilitation, Academic Medical Center, Amsterdam, University of Amsterdam, Amsterdam, The Netherlands.

出版信息

J Pediatr. 2016 Sep;176:79-85.e1. doi: 10.1016/j.jpeds.2016.05.071. Epub 2016 Jul 9.

Abstract

OBJECTIVE

To evaluate the feasibility and potential efficacy of an age-appropriate additional parenting intervention for very preterm born toddlers.

STUDY DESIGN

In a randomized controlled pilot study, 60 of 94 eligible very preterm born children who had received a responsive parenting intervention in their first year were randomized to usual care or the additional intervention, consisting of 4-6 home visits between 18 and 22 months' corrected gestational age (CA). Parents were supported to responsively interact during increasingly complex daily activities and play. Parental satisfaction with the intervention was evaluated with a questionnaire. At baseline and 24 months CA, parents completed the Infant Toddler Social and Emotional Assessment, the Ages and Stages Questionnaire, and the Dutch Schlichting Lexilist for receptive language. At 24 months CA, motor, and cognitive development was measured by the Bayley Scales of Infant and Toddler Development, Third Edition Dutch version, and parent-child interaction was evaluated by the Emotional Availability Scales.

RESULTS

Parental compliance and satisfaction with the intervention was high. Effect sizes (after correction for baseline variables) were small for internalizing and competence behavior, receptive language, and problem solving; medium for cognitive development and parent-child interaction; and large for externalizing and dysregulation behavior and motor development.

CONCLUSION

After a postdischarge intervention during the first year, an additional responsive parenting support at toddler-age is feasible and associated with positive outcomes in a broad array of parental and child outcome measures.

TRIAL REGISTRATION

www.toetsingonline.nl: NL40208.018.12.

摘要

目的

评估针对极早早产儿的适龄额外育儿干预措施的可行性和潜在效果。

研究设计

在一项随机对照试验性研究中,94名符合条件的极早早产儿在其出生后第一年接受了响应式育儿干预,其中60名被随机分为常规护理组或额外干预组,额外干预组在矫正胎龄18至22个月期间进行4至6次家访。在日益复杂的日常活动和游戏过程中,帮助家长进行响应式互动。通过问卷调查评估家长对干预措施的满意度。在基线期和矫正胎龄24个月时,家长完成婴幼儿社会与情感评估、年龄与阶段问卷以及荷兰语施利希廷词汇接受性语言测试。在矫正胎龄24个月时,使用贝利婴幼儿发展量表第三版荷兰语版测量运动和认知发展情况,并通过情感可及性量表评估亲子互动。

结果

家长对干预措施的依从性和满意度较高。内化和能力行为、接受性语言以及问题解决方面的效应量(校正基线变量后)较小;认知发展和亲子互动方面为中等效应量;外化和行为失调以及运动发展方面为较大效应量。

结论

在出生后第一年进行出院后干预之后,在幼儿期提供额外的响应式育儿支持是可行的,并且在一系列家长和儿童结局指标方面都能产生积极结果。

试验注册

www.toetsingonline.nl: NL40208.018.12

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