随机对照试验 Triple P 对哮喘或湿疹儿童父母的影响：对育儿和儿童行为的影响。

Randomized controlled trial of Triple P for parents of children with asthma or eczema: Effects on parenting and child behavior.

机构信息

Parenting and Family Support Centre, School of Psychology, The University of Queensland.

Lady Cilento Children's Hospital.

出版信息

J Consult Clin Psychol. 2017 Apr;85(4):283-296. doi: 10.1037/ccp0000177.

DOI:10.1037/ccp0000177

PMID:28333531

Abstract

OBJECTIVE

Parents play an important role in children's illness management, in promoting child adjustment and reducing behavior problems. Little research has focused on the evaluation of parenting interventions in the context of childhood chronic illness. The aim of this study was to test the efficacy of a brief, group parenting intervention (Healthy Living Triple P) in improving parenting skills and parent adjustment, and reducing child behavioral and emotional difficulties in the context of childhood asthma and eczema.

METHOD

One hundred seven parents of children with a diagnosis of asthma and/or eczema were randomly assigned to intervention (n = 52) or care as usual (CAU; n = 55). Parents completed self-report measures of their child's behavioral and emotional adjustment, their own parenting, and their own level of adjustment at pre- and postintervention and at 6-month follow-up. Parent-child interactions were observed and coded at each time point. The intervention consisted of 2 group sessions of 2 hr each delivered by trained, accredited practitioners.

RESULTS

Attrition was low, with T2 and T3 assessment completed by 84.6% and 80.8% of intervention families and 92.7% and 81.8% of CAU families, respectively. Intention-to-treat analyses indicated that overall parent-reported ineffective parenting as well as parental overreactivity reduced as a result of intervention. Parent report of child behavior problems also decreased, but there were no changes in children's emotional adjustment. No changes in observed parent or child behavior were found. Stress reduced for parents in the intervention group compared to the CAU group, but there were no changes in parental anxiety or depression. Effects showed evidence of reliable and clinical change and were maintained at 6-month follow-up.

CONCLUSIONS

The intervention shows promise as an addition to clinical services for children with asthma and eczema and may have broader application to other chronic health conditions. (PsycINFO Database Record

摘要

目的

父母在儿童疾病管理中扮演着重要角色，有助于促进儿童适应和减少行为问题。但针对儿童慢性病背景下养育干预措施的评估研究甚少。本研究旨在测试一种简短的小组养育干预（健康生活三重 P）在改善养育技能、父母自身调整以及减少儿童行为和情绪困难方面的效果，这些效果是在儿童哮喘和湿疹的背景下产生的。

方法

107 名患有哮喘和/或湿疹的儿童的父母被随机分配至干预组（n=52）或常规护理组（CAU；n=55）。父母在干预前、干预后和 6 个月随访时完成了关于孩子行为和情绪调整、自身养育以及自身调整的自我报告测量。在每个时间点都观察和编码了亲子互动。该干预包括由经过培训和认证的从业者提供的 2 次 2 小时的小组会议。

结果

失访率较低，分别有 84.6%和 80.8%的干预家庭以及 92.7%和 81.8%的 CAU 家庭完成了 T2 和 T3 评估。意向性治疗分析表明，由于干预，父母普遍报告无效养育和过度反应减少。父母报告的儿童行为问题也有所减少，但儿童情绪调整没有变化。观察到的父母或儿童行为没有变化。与 CAU 组相比，干预组父母的压力降低，但父母的焦虑或抑郁没有变化。效果显示出可靠和临床变化的证据，并在 6 个月随访时得到维持。