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癌症患儿的健康兄弟姐妹在接受以家庭为导向的住院康复期间,增加心理教育课程的强化研究结果。

Outcomes of an enhancement study with additional psychoeducational sessions for healthy siblings of a child with cancer during inpatient family-oriented rehabilitation.

机构信息

University of Ulm Medical Centre, Clinic for Child and Adolescent Psychiatry/Psychotherapy, Ulm, Germany.

出版信息

Psychooncology. 2018 Mar;27(3):892-899. doi: 10.1002/pon.4599. Epub 2017 Dec 19.

Abstract

OBJECTIVE

Chronic illness of a child puts healthy children of the family at risk of distress. Previous studies have demonstrated that healthy children's psychological symptoms can be reduced when the child knows more about the disease. So far, there is limited evidence of the effectiveness of psychoeducational interventions for healthy children.

AIMS

To compare the effectiveness of an inpatient family-oriented rehabilitation program with vs without additional psychoeducational sessions for healthy children of families with children with cancer.

PATIENTS AND METHODS

We performed a controlled study in 4 German family-oriented rehabilitation clinics. The outcomes of n = 73 healthy children (mean age: M = 9.55; SD = 3.14; range: 4-18), who participated in 5 additional psychoeducational sessions, were compared with the outcomes of n = 111 healthy children (mean age: M = 8.85; SD = 3.28; range: 4-17), who underwent the usual inpatient rehabilitation program. Primary outcomes were the healthy children's cancer-specific knowledge and their emotional symptoms. Secondary outcomes were family satisfaction and quality of life.

RESULTS

Intention-to-treat analyses showed that both groups improved significantly from preintervention to postintervention. Improvements comprised knowledge about cancer (F(1,174) = 11.03, p < 0.001), self-reported emotional symptoms (F(1,135) = 31.68, p < 0.001), and parent-proxy-reported emotional symptoms (F(1,179) = 37.07, p < 0.001). The additional psycho-educational program did not significantly enhance the outcomes. The same pattern of significant improvement in both conditions emerged for all secondary outcomes. The immediate effects of the intervention persisted until 2 months after discharge from the rehabilitation program.

CONCLUSIONS

Inpatient family-oriented rehabilitation is effective in improving multiple psychosocial outcomes of healthy children in families which have a child with cancer. Additional psycho-educational sessions did not show any substantial additional improvement.

摘要

目的

儿童的慢性疾病会使家庭中的健康儿童面临痛苦的风险。先前的研究表明,当孩子更多地了解疾病时,健康儿童的心理症状可以减轻。到目前为止,针对健康儿童的心理教育干预措施的有效性证据有限。

目的

比较针对癌症患儿家庭的住院家庭为导向的康复计划与增加额外心理教育课程对健康儿童的效果。

患者和方法

我们在德国 4 家以家庭为导向的康复诊所进行了一项对照研究。对参加 5 次额外心理教育课程的 n=73 名健康儿童(平均年龄:M=9.55;SD=3.14;范围:4-18)和接受常规住院康复计划的 n=111 名健康儿童(平均年龄:M=8.85;SD=3.28;范围:4-17)的结果进行了比较。主要结果是健康儿童的癌症特定知识和他们的情绪症状。次要结果是家庭满意度和生活质量。

结果

意向治疗分析表明,两组从干预前到干预后都有显著改善。改善包括癌症知识(F(1,174)=11.03,p<0.001)、自我报告的情绪症状(F(1,135)=31.68,p<0.001)和父母报告的情绪症状(F(1,179)=37.07,p<0.001)。额外的心理教育课程并没有显著提高结果。所有次要结果在两种情况下都出现了显著改善的相同模式。干预的即时效应持续到康复计划出院后 2 个月。

结论

住院家庭为导向的康复对改善有癌症患儿家庭的健康儿童的多个社会心理结果是有效的。额外的心理教育课程没有显示出任何实质性的额外改善。

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