Churchill Shervin S, Kieckhefer Gail M
Family and Child Nursing, University of Washington, Seattle, WA, 98195-7266, USA.
Nursing & Health Studies, University of Washington-Bothell, Bothell, WA, 98011, USA.
Matern Child Health J. 2018 Jun;22(6):913-921. doi: 10.1007/s10995-018-2467-4.
Objectives Test the 12-month efficacy of an inclusive non-diagnosis-specific, parent education program with seven in-person sessions. Methods Parents of 110 children, 2-11 years old, with a variety of special health care conditions, were recruited to participate in a randomized clinical trial. At twelve months data from 104 parents were available for longitudinal analysis. Linear mixed models, with the interaction term of group by time, were used to assess the efficacy of the intervention over 12 months using data from 3 time points: baseline, 6 and 12 months. The outcome measures were self-efficacy, parent and child shared management of chronic condition, coping skills, parental depressive symptoms and quality of life. Results All of the outcomes improved within the intervention group over 12 months. Self-efficacy was the strongest outcome which remained significantly different from the control group 12 months post intervention, without any statistical adjustment (p = 0.045). The coefficient of the interaction term for study group (intervention or control) by time, quantifying the intervention effect, was statistically significant for four of five pre-specified study outcomes, favorably so toward the intervention group (p < 0.05, with the 5th outcome, parental depression, p = 0.052). Conclusions for Practice The Building on Family Strengths intervention was efficacious in improving self-efficacy, shared management, coping skills, and quality of life and decreasing depressive symptoms in parents, in particular for parents who were most impacted by the lack of these strengths and skills at baseline. These results are encouraging and future studies to investigate the efficacy of this intervention in an Internet-based setting or other modalities are encouraged.
目的 测试一项包含七次面对面课程的、非特定诊断的家长教育项目的12个月疗效。方法 招募110名2至11岁患有各种特殊医疗状况的儿童的家长，参与一项随机临床试验。在12个月时，有104名家长的数据可用于纵向分析。使用带有组×时间交互项的线性混合模型，利用来自基线、6个月和12个月这3个时间点的数据，评估干预在12个月内的疗效。结果指标包括自我效能感、家长与孩子对慢性病的共同管理、应对技巧、家长抑郁症状和生活质量。结果 在12个月内，干预组的所有结果指标均有所改善。自我效能感是最显著的结果，在干预后12个月时与对照组仍存在显著差异，无需任何统计调整（p = 0.045）。研究组（干预组或对照组）×时间的交互项系数，量化了干预效果，对于预先设定的五项研究结果中的四项在统计学上具有显著意义，对干预组有利（p < 0.05，第五项结果家长抑郁，p = 0.052）。实践结论 “基于家庭优势”干预措施在提高自我效能感、共同管理、应对技巧和生活质量以及减轻家长的抑郁症状方面是有效的，特别是对于那些在基线时受这些优势和技能缺乏影响最大的家长。这些结果令人鼓舞，鼓励未来开展研究以调查该干预措施在基于互联网的环境或其他模式中的疗效。
