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家长培训教育项目:一项涉及普拉德-威利综合征患儿家庭的试点研究。

Parent training education program: a pilot study, involving families of children with Prader-Willi syndrome.

作者信息

Kodra Yllka, Kondili Loreta A, Ferraroni Alessia, Serra Maria Antonietta, Caretto Flavia, Ricci Maria Antonietta, Taruscio Domenica

机构信息

Centro Nazionale Malattie Rare, Istituto Superiore di Sanità, Rome, Italy.

Centro per la Ricerca e la Valutazione dei Prodotti Immunologici, Istituto Superiore di Sanità, Rome, Italy.

出版信息

Ann Ist Super Sanita. 2016 Jul-Sep;52(3):428-433. doi: 10.4415/ANN_16_03_15.

Abstract

INTRODUCTION

Prader-Willi syndrome (PWS) is a rare genetic disorder characterized by severe hypotonia during the neonatal period and the first two years of life, the onset of hyperphagia with a risk of obesity during infancy and adulthood, learning difficulties and behavioral or severe psychiatric problems. This complex disease has severe consequences and difficult management issues also for patients' families. Parents of children with PWS need appropriate psychoeducational intervention in order to better manage their children with PWS. The purpose of this study was the implementation and evaluation of a PWS psychoeducational parent training program.

METHODS

The Italian National Center for Rare Diseases implemented a pilot parent training program offered to parents of children with PWS. The intervention's effects was evaluated using questionnaires comprised of 11 items rated on a 7 point Likert scale.

RESULTS

The intervention was offered to 43 parents. The behavior problems management, dietary restrictions, autonomy and relationships were indicated by parents as the priority topics which needed to be addressed. Evaluations, immediately post-intervention and after 6 months, were reported by parents, fulfilling specific questionnaires. 90% of parents involved in the study, appreciated the methodology, 86% felt more informed about PWS, 47-62% felt more capable to better approach behaviour's problems, 20-25% felt better about the child's health situation and future expectations. Feeling more capable to help the child autonomy and relationships were reported in 62% and 63% of parents respectively, which decreased significantly (p < 0.05) according to the evaluation 6 months after the intervention. Younger age of parents (< 44 years of age) was significantly correlated with better understanding on how to help the child's autonomy (OR: 0.05; CI: 0.04-0.8) and to better collaborate with the child's teachers (OR: 0.02; CI: 0.001-0.9).

CONCLUSION

Parent training is a promising intervention for parents of children with behavior's problems. Interventions with a behaviorally oriented program, addressed to parents of PWS affected children, is a useful tool in increasing their ability to manage the problems related to the disease.

摘要

引言

普拉德-威利综合征(PWS)是一种罕见的遗传性疾病,其特征为新生儿期及生命的头两年出现严重肌张力减退,婴儿期和成年期出现食欲亢进并伴有肥胖风险、学习困难以及行为或严重精神问题。这种复杂的疾病给患者家庭也带来了严重后果和棘手的管理问题。PWS患儿的父母需要适当的心理教育干预,以便更好地照料他们患有PWS的孩子。本研究的目的是实施并评估一项针对PWS患儿父母的心理教育培训项目。

方法

意大利国家罕见病中心实施了一项针对PWS患儿父母的试点培训项目。使用由11个项目组成的问卷进行评估,这些项目采用7点李克特量表评分。

结果

该干预措施提供给了43位家长。家长们指出行为问题管理、饮食限制、自主性和人际关系是需要解决的首要主题。家长们填写了特定问卷,报告了干预后即刻及6个月后的评估情况。参与研究的家长中,90%对该方法表示赞赏,86%觉得对PWS有了更多了解,47% - 62%觉得更有能力更好地处理行为问题,20% - 25%对孩子的健康状况和未来期望感觉更好。分别有62%和63%的家长表示更有能力帮助孩子实现自主性和处理人际关系,但在干预6个月后的评估中,这一比例显著下降(p < 0.05)。年龄较小的家长(< 44岁)与更好地理解如何帮助孩子实现自主性(比值比:0.05;置信区间:0.04 - 0.8)以及更好地与孩子的老师合作(比值比:0.02;置信区间:0.001 - 0.9)显著相关。

结论

家长培训对于有行为问题患儿的父母来说是一种有前景的干预措施。针对PWS患儿父母开展的以行为为导向的项目干预,是提高他们管理与该疾病相关问题能力的有用工具。

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