O'Regan Orla, Doyle Yvonne, Murray Marguerite, McCarthy Vera J C, Saab Mohamad M
Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland.
Int J Dev Disabil. 2022 Mar 28;70(1):20-39. doi: 10.1080/20473869.2022.2052416. eCollection 2024.
Challenging behaviours are common among children and adolescents with intellectual disabilities. Such behaviours often result in poor quality of life outcomes such as physical injury, difficulties with relationships and community integration. This systematic review aimed to synthesise evidence from studies that assessed the effect of interventions used to reduce/manage challenging behaviour among children with intellectual disabilities in community settings. Studies published between January 2015 and January 2021 were sought from five electronic databases. The quality of studies was assessed, and a narrative synthesis was conducted. A total of 11 studies were included which utilised various non-pharmacological interventions including multi-model interventions, microswitch technology, cognitive behavioural therapy, art, music and illustrated stories. Microswitch cluster technology was the most used intervention. Studies using pharmacological interventions were not retrieved. Results indicated that a person-centred planning approach was key to offering individualised treatment. The superiority of one intervention or a combination of interventions could not be determined from this review given the heterogeneity of studies. Future research is required to explore the use and effects of pharmacological interventions to compare outcomes and improve quality of care of children with intellectual disabilities.
挑战性行为在智障儿童和青少年中很常见。此类行为往往会导致生活质量低下,如身体受伤、人际关系困难和融入社区受阻。本系统评价旨在综合评估社区环境中用于减少/管理智障儿童挑战性行为的干预措施效果的研究证据。从五个电子数据库中检索了2015年1月至2021年1月发表的研究。评估了研究质量,并进行了叙述性综合分析。共纳入11项研究,这些研究采用了各种非药物干预措施,包括多模式干预、微动开关技术、认知行为疗法、艺术、音乐和图文故事。微动开关集群技术是使用最多的干预措施。未检索到使用药物干预的研究。结果表明,以人为本的规划方法是提供个性化治疗的关键。鉴于研究的异质性,本次评价无法确定一种干预措施或多种干预措施组合的优越性。未来需要开展研究,探索药物干预的使用和效果,以比较结果并提高智障儿童的护理质量。