Department of Social Policy and Intervention, University of Oxford, United Kingdom.
School of Sociology and Social Policy, University of Leeds, United Kingdom.
Trauma Violence Abuse. 2022 Apr;23(2):457-475. doi: 10.1177/1524838020915599. Epub 2020 Apr 23.
Millions of children in China are diagnosed with developmental disabilities (DD), many of whom are subject to physical abuse. While a significant body of research suggests that parenting interventions can reduce the incidence and risk of such abuse, there is currently limited evidence of their effectiveness for this population or from non-English-speaking countries. This review involved searches in both English and Chinese databases to identify randomized controlled trials and quasi-experimental studies of parenting interventions for families of children with DD in mainland China. Multilevel meta-analyses were undertaken to examine the effectiveness of parenting programs. Subgroup analyses and meta-regression were conducted to investigate heterogeneity and identify potential moderators with a focus on intervention and delivery components. Risk of bias was assessed for each study. Thirty-one studies were included. The results showed that parenting interventions could reduce child emotional and behavioral problems (CEBP) and improve the parent-child relationship, although only one study directly measured the actual incidence of abuse. Programs for autism and epilepsy had stronger treatment effects. Teaching knowledge about CEBP, skills to improve parental mental health, and techniques to cultivate empathy were associated with program success; however, positive reinforcement was associated with more problems. The results also supported the delivery of programs with longer duration, a combination of group and individual sessions, efforts to build rapport, ongoing communication outside the programs, and delivery in hospitals or service agencies. Further research is needed, however, in addition to improvements in the quality of research and reporting.
在中国，有数百万儿童被诊断患有发育障碍 (DD)，其中许多人遭受身体虐待。虽然大量研究表明，育儿干预可以降低这种虐待的发生率和风险，但目前针对这一人群或来自非英语国家的证据有限。本综述在中英文数据库中进行了检索，以确定中国大陆针对 DD 儿童家庭的育儿干预的随机对照试验和准实验研究。采用多层次荟萃分析来检验育儿方案的有效性。进行了亚组分析和荟萃回归，以调查异质性并确定潜在的调节因素，重点是干预和交付组件。对每项研究的偏倚风险进行了评估。共纳入 31 项研究。结果表明，育儿干预可以减少儿童情绪和行为问题 (CEBP) 并改善亲子关系，但只有一项研究直接测量了虐待的实际发生率。自闭症和癫痫的项目具有更强的治疗效果。教授关于 CEBP 的知识、改善父母心理健康的技能以及培养同理心的技术与项目成功相关；然而，正强化与更多问题相关。结果还支持提供持续时间更长、小组和个别会议相结合、努力建立融洽关系、在项目之外持续沟通以及在医院或服务机构提供的项目。然而，除了提高研究和报告的质量外，还需要进一步研究。
