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减少日常牙科就诊中的破坏性行为:针对幼儿的视频示范干预。

Decreasing disruptive behaviour during routine dental visits: a video modelling intervention for young children.

机构信息

Department of Pediatrics and the Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA.

Department of Pediatric Dentistry, University of Nebraska Medical Center, Omaha, NE, USA.

出版信息

Int Dent J. 2019 Aug;69(4):265-272. doi: 10.1111/idj.12457. Epub 2018 Nov 29.

Abstract

OBJECTIVE

To evaluate the benefits of a collaborative partnership between paediatric dentists and behavioural health providers in which a practical video modelling intervention, with the aim to reduce disruptive behaviours in young children, is implemented.

METHODS

The video was created by a dentist using readily available technology and implemented in a busy practice setting. A clinical sample of 40 children, 3-6 years old, was recruited from a continuous sample of patients seen at the clinic. Participants were randomised into two groups and shown either the brief video model or a control video prior to a routine dental visit. All sessions were videotaped and independently scored by blinded observers. Behavioural data were recorded using 15-second partial-interval recording and included physical and vocal disruptions. Subjective measures of cooperation were also completed by observers and dental professionals.

RESULTS

Independent samples t-tests show that the treatment group had a significantly lower mean percentage of intervals in which disruptive behaviour was observed [t(38) = 2.94, P = 0.008] compared with the control group. Subjective rating scales revealed significantly higher ratings of cooperation for the treatment group from the dentist [t(38) = -5.19, P = 0.000], the dental assistant [t(38) = -4.01, P = 0.001] and the blinded coder [t(38) = -3.54, P = 0.002]. Significant relationships were found between the percentage of actual disruptive behaviour and subjective ratings of the dentist (r = -0.82, P < 0.01).

CONCLUSIONS

Watching a brief dentist-created video model of expected procedures can reduce disruptive behaviour and increase cooperation for young children making their first visit to a busy medical setting.

摘要

目的

评估小儿牙医与行为健康提供者之间建立合作关系的益处,其中实施了一项实用的视频模型干预措施,旨在减少幼儿的破坏性行为。

方法

该视频由一名牙医使用现成的技术创建,并在繁忙的实践环境中实施。从诊所就诊的连续患者样本中招募了 40 名 3-6 岁的临床样本儿童。参与者被随机分为两组,并在常规牙科就诊前观看简短的视频模型或对照视频。所有课程都被录像,并由盲眼观察员进行独立评分。行为数据使用 15 秒的部分间隔记录进行记录,包括身体和声音干扰。观察者和牙科专业人员还完成了合作的主观度量。

结果

独立样本 t 检验显示,治疗组观察到的破坏性行为的平均间隔百分比明显较低[ t (38) = 2.94,P = 0.008],与对照组相比。主观评分量表显示,治疗组的牙医[ t (38) = -5.19,P = 0.000],牙科助理[ t (38) = -4.01,P = 0.001]和盲法编码员[ t (38) = -3.54,P = 0.002]的合作评分明显更高。实际破坏性行为的百分比与牙医的主观评分之间存在显著关系( r = -0.82,P < 0.01)。

结论

观看简短的由牙医创建的预期程序视频模型可以减少幼儿在繁忙的医疗环境中首次就诊时的破坏性行为,并提高合作度。

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