Loma Linda University Behavioral Medicine Center, Redlands, CA.
Department of Counseling and Family Sciences, Loma Linda University Health Behavioral Medicine Center, Loma Linda, CA.
Fam Process. 2018 Mar;57(1):83-99. doi: 10.1111/famp.12288. Epub 2017 Mar 15.
Psychosocial interventions for pediatric chronic illness (CI) have been shown to support health management. Interventions that include a family systems approach offer potentially stronger and more sustainable improvements. This study explores the biopsychosocial benefits of a novel family systems psychosocial intervention (MEND: Mastering Each New Direction). Forty-five families participated in a 21-session intensive outpatient family systems-based program for pediatric CI. Within this single arm design, families were measured on five domains of Health-Related Quality of Life (HRQL) self-report measures; Stress, Cognitive Functioning, Mental Health, Child HRQL, Family Functioning. Both survey and biological measures (stress: catecholamine) were used in the study. Results from multivariate general linear models showed positive pre-, post-, and 3-month posteffects in all five domains. The program effects ranged from small to moderate (η = .07-.64). The largest program effects were seen in the domains of cognitive functioning (η = .64) and stress (η = .27). Also, between disease groups, differences are noted and future implications for research and clinical practice are discussed. Conclusions suggest that the MEND program may be useful in helping families manage pediatric chronic illnesses. Study results also add to the growing body of literature suggesting that psychosocial interventions for pediatric chronic illness benefit from a family systems level of intervention.
心理社会干预措施已被证明对儿童慢性疾病（CI）的健康管理具有支持作用。包含家庭系统方法的干预措施可能提供更强大和更可持续的改善。本研究探讨了一种新型家庭系统心理社会干预措施（MEND：掌握每个新方向）的生物心理社会益处。45 个家庭参加了针对儿科 CI 的 21 次强化门诊家庭系统为基础的方案。在这种单一臂设计中，家庭在五个健康相关生活质量（HRQL）自我报告测量领域进行了测量；压力、认知功能、心理健康、儿童 HRQL、家庭功能。研究中同时使用了调查和生物测量（压力：儿茶酚胺）。多元一般线性模型的结果显示，所有五个领域的前、后和 3 个月后都有积极的效果。该方案的效果范围从小到中等（η = 0.07-0.64）。在认知功能（η = 0.64）和压力（η = 0.27）两个领域，方案效果最大。此外，还注意到了不同疾病组之间的差异，并讨论了对研究和临床实践的未来影响。研究结果表明，MEND 方案可能有助于家庭管理儿科慢性疾病。研究结果还增加了越来越多的文献，表明儿科慢性疾病的心理社会干预措施受益于家庭系统层面的干预。
