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亲子沙盘游戏疗法对自闭症谱系障碍儿童及其母亲的影响:一项随机对照试验。

Effects of Parent-Child Sandplay Therapy for preschool children with autism spectrum disorder and their mothers: A randomized controlled trial.

机构信息

Department of Child Health Care, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China; The School of Nursing, Fujian Medical University, Fuzhou, China.

The School of Nursing, Xiamen Medical College, Xiamen, China.

出版信息

J Pediatr Nurs. 2023 Jul-Aug;71:6-13. doi: 10.1016/j.pedn.2023.02.006. Epub 2023 Mar 20.

DOI:10.1016/j.pedn.2023.02.006
PMID:36947897
Abstract

PURPOSE

To evaluate the effects of the Parent-Child Sandplay Therapy (PCST) Program on autism behaviors, social responsiveness and sleep quality among preschool children with autism spectrum disorder (ASD), and their mothers' parenting stress.

DESIGN AND METHODS

A prospective, randomized controlled, parallel-group trial was employed. Fifty-two child-mother dyads were randomly assigned to an intervention group (n = 26) or a control group (n = 26) from February 2017 to February 2019. The intervention group was treated with a 20-week PCST Program plus an Applied Behavior Analysis-based program (ABA-based program), whereas the control group received only the ABA-based program. Outcome measures included the Autism Behavior Checklist total scores, Social Responsiveness Scale scores, Children's Sleep Habits Questionnaire scores, and Parenting Stress Index-Short Form scores, measured at baseline, post-intervention (20 weeks after baseline) and follow-up assessments (32 weeks after baseline).

RESULTS

Finally, 43 dyads completed the study. The linear mixed model analysis resulted in a significant group*time interaction effect of ABC score (Est = 2.027, t = 3.277; p < 0.01), SRS score (Est = 3.377, t = 6.095; p < 0.01), PSI-SF score (Est = 3.873, t = 4.253, p < 0.01), and CSHQ score (Est = 3.158, t = 6.485; p < 0.05).

CONCLUSION

Our findings suggested that the PCST Program could potentially improve social interaction and sleep quality of preschool children with ASD while decreasing parenting stress.

PRACTICE IMPLICATIONS

The PCST Program was found to be a feasible and a promising treatment for children with mild-to-moderate ASD as well as for their parents. It was a nurse-led program, which could be integrated into the usual nursing care of children with autism spectrum disorder in special education schools.

TRIAL REGISTRATION

Chinese Clinical Trials Registry, ChiCTR2100047699.

摘要

目的

评估亲子沙盘游戏疗法(PCST)对学龄前自闭症谱系障碍(ASD)儿童自闭症行为、社会反应能力和睡眠质量及其母亲育儿压力的影响。

设计与方法

采用前瞻性、随机对照、平行组试验。2017 年 2 月至 2019 年 2 月,52 对母子被随机分配到干预组(n=26)或对照组(n=26)。干预组接受 20 周 PCST 方案加基于应用行为分析的方案(ABA 方案)治疗,对照组仅接受 ABA 方案。结局测量包括自闭症行为检查表总分、社会反应量表评分、儿童睡眠习惯问卷评分和父母压力指数-短式量表评分,分别于基线、干预后(基线后 20 周)和随访评估(基线后 32 周)时进行测量。

结果

最终,43 对母子完成了研究。线性混合模型分析显示,ABC 评分(Est=2.027,t=3.277;p<0.01)、SRS 评分(Est=3.377,t=6.095;p<0.01)、PSI-SF 评分(Est=3.873,t=4.253,p<0.01)和 CSHQ 评分(Est=3.158,t=6.485;p<0.05)的组×时间交互效应均具有统计学意义。

结论

我们的研究结果表明,PCST 方案可能有助于改善学龄前 ASD 儿童的社会互动和睡眠质量,同时降低育儿压力。

实践意义

PCST 方案被发现是一种可行且有前途的治疗轻度至中度 ASD 儿童及其父母的方法。它是一种由护士主导的方案,可以纳入特殊教育学校自闭症谱系障碍儿童的常规护理中。

试验注册

中国临床试验注册中心,ChiCTR2100047699。

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