Gies Lisa M, Narad Megan, Moscato Emily L, Sidol Craig, Makoroff Kathi, Schmidt Matthew, Rhine Tara, Wade Shari L
Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Department of Psychology, University of Cincinnati, Cincinnati, OH, USA.
Disabil Rehabil. 2025 Jun;47(12):3070-3077. doi: 10.1080/09638288.2024.2413177. Epub 2024 Oct 14.
Families experience stress and burden following their child's traumatic brain injury (TBI). Parenting styles are related to parent stress and child behavior problems and executive dysfunction. Parent-child interactions are shown to be a promising intervention target. We aimed to examine the preliminary efficacy of Gaining Real life skills Over the Web (GROW) in improving responsive parenting and reducing parent stress and depression in parents of children ages 0-4 who experienced TBI.
Participants ( = 11) were parents of children four years old or younger, at the time of enrollment, and previously hospitalized overnight for TBI. Parent-reported measures included the Center for Epidemiologic Studies Depression Scale, Parenting Stress Inventory-Short Form, and Patient-Reported Outcomes Measurement Information System. Recordings of parent-child interactions were coded using the Play and Learning Strategies coding scheme. Study hypotheses were analyzed using independent samples -tests, chi square analyses, and linear mixed models.
Parental warmth (=-3.64, = 0.001, =.97), responsiveness (-2.09, 0.047, = 0.70), and verbal stimulation (-2.30, 0.029, = 0.75) increased significantly from pretreatment to posttreatment. Improvements in parental warmth were maintained 3 months posttreatment (-3.15, 0.004, = 1.16). There were no significant changes in depression, parental stress, or quality of life.
Results provide preliminary support for the efficacy of GROW in improving responsive parenting for children following early TBI. Future directions include tailoring GROW to better fit the needs of families and testing the utility through a randomized control trial.
儿童创伤性脑损伤（TBI）后，家庭会经历压力和负担。养育方式与父母压力、儿童行为问题及执行功能障碍有关。亲子互动被证明是一个有前景的干预目标。我们旨在研究通过网络获取现实生活技能（GROW）在改善0至4岁经历TBI儿童的父母的反应性养育方式、减轻父母压力和抑郁方面的初步疗效。
参与者（n = 11）是在入组时孩子年龄为4岁或更小且此前因TBI住院过夜的父母。父母报告的测量指标包括流行病学研究中心抑郁量表、养育压力量表简版和患者报告结局测量信息系统。使用游戏与学习策略编码方案对亲子互动记录进行编码。研究假设通过独立样本t检验、卡方分析和线性混合模型进行分析。
从治疗前到治疗后，父母的温暖程度（t = -3.64，p = 0.001，d = 0.97）、反应性（t = -2.09，p = 0.047，d = 0.70）和言语刺激（t = -2.30，p = 0.029，d = 0.75）显著增加。治疗后3个月，父母温暖程度的改善得以维持（t = -3.15，p = 0.004，d = 1.16）。抑郁、父母压力或生活质量没有显著变化。
结果为GROW在改善早期TBI儿童的父母反应性养育方式方面的疗效提供了初步支持。未来的方向包括调整GROW以更好地满足家庭需求，并通过随机对照试验测试其效用。
