Mitchell Amy E, Morawska Alina, Casey Emily, Forbes Elana, Filus Ania, Fraser Jennifer, Rowell David, Johnston Aimee, Birch Stephen
School of Nursing, Midwifery and Social Work, The University of Queensland, St Lucia, Australia.
Parenting and Family Support Centre, The University of Queensland, St Lucia, Australia.
J Pediatr Psychol. 2024 Jun 13;49(6):429-441. doi: 10.1093/jpepsy/jsae023.
To evaluate the efficacy and costs of a brief, group-delivered parenting intervention for families of children with eczema.
A randomized controlled trial design was used. Families attending the Queensland Children's Hospital and from the community (n = 257) were assessed for eligibility (child 2-10 years, diagnosed with eczema, prescribed topical corticosteroids). Families who consented to participate (N = 59) were assessed at baseline for clinician-rated eczema severity, parent-reported eczema symptom severity, and electronically-monitored topical corticosteroid adherence (primary outcomes); and parenting behavior, parents' self-efficacy and task performance when managing eczema, eczema-related child behavior problems, and child and parent quality of life (secondary outcomes). Families were randomized (1:1, unblinded) to intervention (n = 31) or care-as-usual (n = 28). The intervention comprised two, 2-hr Healthy Living Triple P group sessions (face-to-face/online) and 28 intervention families attended one/both sessions. All families were offered standardized eczema education. Families were reassessed at 4-weeks post-intervention and 6-month follow-up, with clinician-raters blinded to condition. Costs of intervention delivery were estimated.
Multilevel modeling across assessment timepoints showed significant intervention effects for ineffective parenting (d = .60), self-efficacy (d = .74), task performance (d = .81), and confidence with managing eczema-related child behavior (d = .63), but not disease/symptom severity, treatment adherence or quality of life. Mean cost per participating family with parenting behavior (clinically) improved was $159.
Healthy Living Triple P is effective in reducing ineffective parenting practices and improving parents' self-efficacy and task performance when managing children's eczema and eczema-related behavior difficulties. There was no effect on disease/symptom severity, treatment adherence, or quality of life.
ACTRN12618001332213.
评估一种简短的、以小组形式开展的育儿干预措施对湿疹患儿家庭的疗效和成本。
采用随机对照试验设计。对前往昆士兰儿童医院就诊及来自社区的家庭(n = 257)进行资格评估(孩子年龄在2至10岁,被诊断为湿疹,正在使用外用糖皮质激素)。同意参与的家庭(N = 59)在基线时接受评估,内容包括临床医生评定的湿疹严重程度、家长报告的湿疹症状严重程度以及电子监测的外用糖皮质激素依从性(主要结局);以及育儿行为、家长在管理湿疹时的自我效能感和任务表现、与湿疹相关的儿童行为问题以及儿童和家长的生活质量(次要结局)。家庭被随机分组(1:1,非盲法),分为干预组(n = 31)或常规护理组(n = 28)。干预措施包括两次时长为2小时的“健康生活三重P”小组课程(面对面/在线),28个干预组家庭参加了其中一次或两次课程。所有家庭均接受标准化的湿疹教育。在干预后4周和6个月随访时对家庭进行重新评估,临床评估人员对分组情况不知情。估计了干预实施的成本。
跨评估时间点的多水平模型显示,干预措施对无效育儿(d = 0.60)、自我效能感(d = 0.74)、任务表现(d = 0.81)以及处理与湿疹相关儿童行为的信心(d = 0.63)有显著影响,但对疾病/症状严重程度、治疗依从性或生活质量没有影响。育儿行为(临床方面)得到改善的每个参与家庭的平均成本为159美元。
“健康生活三重P”在减少无效育儿行为以及提高家长管理儿童湿疹和与湿疹相关行为困难时的自我效能感和任务表现方面是有效的。对疾病/症状严重程度、治疗依从性或生活质量没有影响。
ACTRN12618001332213。