School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; and.
School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; and
Pediatrics. 2019 Feb;143(2). doi: 10.1542/peds.2018-1723. Epub 2019 Jan 18.
Few trials have been conducted to address the psychological difficulties of parents in managing their child's asthma. Fostering parental psychological flexibility through Acceptance and Commitment Therapy (ACT) may help parents to accept these psychological difficulties and improve their management of childhood asthma.
In this randomized controlled trial, a 4-session, group-based ACT plus asthma education (ACT group) was compared with an asthma education talk plus 3 telephone follow-ups (control group) to train parents of children diagnosed with asthma. The use of health care services due to asthma exacerbations in children and the psychological well-being of their parents were assessed before, immediately after, and at 6 months after the intervention.
A total of 168 parents and their children aged 3 to 12 years with asthma were consecutively recruited in a public hospital in Hong Kong. When compared with the control group, children whose parents were in the ACT group made significantly fewer emergency department visits (adjusted 6-month incidence rate ratio = 0.20; confidence interval [CI] 0.08 to 0.53; = .001) due to asthma exacerbations at 6 months postintervention. These parents also reported a decrease in psychological inflexibility (mean difference = -5.45; CI -7.71 to -3.30; = .014), less anxiety (mean difference = -2.20; CI -3.66 to -0.73; = .003), and stress (mean difference = -2.50; CI -4.54 to -0.47; = .016).
Integrating ACT into parental asthma education was effective at decreasing parental anxiety and stress and reducing the asthma-related emergency department visits of children at 6 months postintervention.
针对父母在管理孩子哮喘方面所面临的心理困难，目前开展的相关试验较少。通过接受与承诺疗法（ACT）培养父母的心理灵活性，可能有助于他们接受这些心理困难，并改善对儿童哮喘的管理。
在这项随机对照试验中，将 4 节小组式 ACT 加哮喘教育（ACT 组）与哮喘教育谈话加 3 次电话随访（对照组）进行对比，以培训确诊患有哮喘的儿童的父母。在干预之前、干预之后即刻和干预 6 个月时，评估儿童因哮喘加重而使用医疗保健服务的情况和父母的心理健康状况。
在香港一家公立医院，连续纳入了 168 名父母及其年龄 3 至 12 岁的哮喘患儿。与对照组相比，接受 ACT 组干预的患儿在干预后 6 个月因哮喘加重而前往急诊就诊的次数明显减少（调整后 6 个月发生率比 = 0.20；95%置信区间 [CI] 0.08 至 0.53； =.001）。这些父母还报告称心理不灵活性降低（平均差值 = -5.45；CI -7.71 至 -3.30； =.014），焦虑程度降低（平均差值 = -2.20；CI -3.66 至 -0.73； =.003），压力减轻（平均差值 = -2.50；CI -4.54 至 -0.47； =.016）。
将 ACT 纳入父母哮喘教育中，在干预后 6 个月时可有效降低父母的焦虑和压力，减少儿童因哮喘相关而前往急诊就诊的次数。
