Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica.
School of Health and Human Performance, Georgia College, Milledgeville, Georgia, United States of America.
PLoS One. 2021 Jun 9;16(6):e0252513. doi: 10.1371/journal.pone.0252513. eCollection 2021.
To assess the feasibility of a problem-solving skills training intervention in improving psychological outcomes in mothers of infants with sickle cell disease (SCD).
This parallel randomized controlled trial recruited 64 babies with SCD, 6 to 12 months of age, and their mothers. Baseline measurements assessed mothers' coping and problem-solving skills, depression, and parental stress before random assignment to intervention or control groups (n = 32 each). Problem-solving skills intervention was delivered through 6 monthly sessions, when babies attended for routine penicillin prophylaxis. All measurements were repeated for both groups at the end of the intervention period. Intention to treat analysis used repeated measures mixed models with the restricted estimation maximum likelihood approach.
The problem-solving intervention had no significant effect on mothers' problem-solving skills (adjusted treatment effect: -1.69 points (95% CI:-5.62 to 2.25)), coping behaviours (adjusted treatment effect: 0.65 points (95% CI:- -7.13 to 8.41)) or depressive symptoms (adjusted treatment effect: -0.41 (95% CI: -6.00 to 5.19)). It reduced mothers' level of difficulty in managing stressful events by 9.5 points (95% CI (-16.86 to -2.16); effect size: 0.21 SD). In the subgroup of mothers at risk of depression (n = 31 at baseline), the intervention reduced depression scores with treatment effect of 10.4 points (95%CI: -18.83 to -1.88; effect size: 0.67 SD).
This problem-solving skills intervention study suggests feasibility and possible efficacy in improving some maternal outcomes. Further refinement and culturally appropriate adaptations of the intervention could lead to stronger effects.
评估解决问题技能培训干预在改善镰状细胞病 (SCD) 婴儿母亲心理结局方面的可行性。
这项平行随机对照试验招募了 64 名 6-12 个月大的 SCD 婴儿及其母亲。在随机分配到干预组或对照组（每组 32 名）之前，基线测量评估了母亲的应对和解决问题的技能、抑郁和父母压力。解决问题的技能干预通过 6 次每月的课程进行，当婴儿接受常规青霉素预防时。在干预期结束时，对两组都重复了所有测量。意向治疗分析使用重复测量混合模型，采用受限估计最大似然法。
解决问题的干预对母亲的解决问题技能（调整后的治疗效果：-1.69 分（95%CI：-5.62 至 2.25））、应对行为（调整后的治疗效果：0.65 分（95%CI：-7.13 至 8.41））或抑郁症状（调整后的治疗效果：-0.41（95%CI：-6.00 至 5.19））没有显著影响。它使母亲管理应激事件的难度水平降低了 9.5 分（95%CI（-16.86 至 -2.16）；效应大小：0.21 SD）。在有抑郁风险的母亲亚组（基线时有 31 名母亲）中，干预的治疗效果为降低抑郁评分 10.4 分（95%CI：-18.83 至 -1.88；效应大小：0.67 SD）。
这项解决问题技能干预研究表明该方法具有可行性和改善某些母婴结局的潜在效果。进一步改进和文化适应性调整干预措施可能会产生更强的效果。
