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通过WhatsApp对沙特阿拉伯王国自闭症谱系障碍(ASD)儿童母亲进行心理教育干预的效果:一项随机对照试验。

The Effectiveness of a Psychoeducation Intervention delivered via WhatsApp for mothers of children with Autism Spectrum Disorder (ASD) in the Kingdom of Saudi Arabia: A randomized controlled trial.

作者信息

Hemdi A, Daley D

机构信息

Division of Psychiatry & Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.

Special Education Department, Institute of Educational Graduate Studies, King Abdulaziz University, Jeddah, Saudi Arabia.

出版信息

Child Care Health Dev. 2017 Nov;43(6):933-941. doi: 10.1111/cch.12520. Epub 2017 Sep 20.

Abstract

BACKGROUND

Mothers of children with autism spectrum disorder (ASD) report high levels of stress and lower levels of well-being than parents of typically developing children. Current interventions for ASD typically focus on working with the child rather than delivering strategies to help support parents.

OBJECTIVE

To evaluate the effectiveness of a psychoeducation intervention developed to support mothers of children with ASD in Saudi Arabia.

METHOD

Sixty-two mothers (23-52 years) of children (26-78 months) were recruited to a multisite randomized controlled trials of the intervention. The intervention consisted of one face-to-face session (60 min) and four virtual sessions (30 min each) delivered using WhatsApp. Parenting stress was the primary outcome, with secondary outcomes focusing on maternal depression, anxiety, and happiness, and child behaviour problems and ASD symptoms. Data were collected at baseline T1, immediately postintervention T2 and 8-week follow-up T3.

RESULTS

One-way analysis of covariance was used at T2 and T3 with T1 scores entered as a covariate. Improvements were found at T2 for stress (F = 234.34, p = .00, and d = -1.52) and depression (F = 195.70, p = .00, and d = -2.14) but not anxiety, and these results were maintained at T3. Changes in child behaviour problems were limited to improvements in hyperactivity at T2 (F = 133.66, p = .00, and d = -1.54). Although changes in stress and depression were statistically significant, change to clinically normal levels was limited to depression. None of the participants had recovered after the intervention (Parent Stress Index Short Form stress scores), whereas 23 mothers (71.87%) in the intervention group had recovered at T2 and 22 (68.75%) at T3 (Hospital Anxiety and Depression Scale depression scores).

CONCLUSION

This intervention with WhatsApp support is beneficial but may need to be augmented with other forms of support for mothers of children with ASD including more condensed sessions on stress and interventions targeting anxiety.

摘要

背景

与发育正常儿童的父母相比,自闭症谱系障碍(ASD)儿童的母亲报告的压力水平更高,幸福感更低。目前针对ASD的干预措施通常侧重于与孩子合作,而不是提供帮助支持父母的策略。

目的

评估为支持沙特阿拉伯ASD儿童母亲而开发的心理教育干预措施的有效性。

方法

招募了62名儿童(26至78个月)的母亲(23至52岁)参加该干预措施的多中心随机对照试验。干预措施包括一次面对面会议(60分钟)和使用WhatsApp进行的四次虚拟会议(每次30分钟)。育儿压力是主要结果,次要结果侧重于母亲的抑郁、焦虑和幸福感,以及儿童行为问题和ASD症状。在基线T1、干预后立即T2和8周随访T3时收集数据。

结果

在T2和T3时使用协方差单向分析,将T1分数作为协变量输入。在T2时发现压力(F = 234.34,p = .00,d = -1.52)和抑郁(F = 195.70,p = .00,d = -2.14)有所改善,但焦虑没有改善,这些结果在T3时得以维持。儿童行为问题的变化仅限于T2时多动症状的改善(F = 133.66,p = .00,d = -1.54)。虽然压力和抑郁的变化具有统计学意义,但恢复到临床正常水平仅限于抑郁。干预后没有参与者恢复(父母压力指数简表压力分数),而干预组中有23名母亲(71.87%)在T2时恢复,22名(68.75%)在T3时恢复(医院焦虑抑郁量表抑郁分数)。

结论

这种有WhatsApp支持的干预措施是有益的,但可能需要增加其他形式的支持,以帮助ASD儿童的母亲,包括更简短的压力课程和针对焦虑的干预措施。

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