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基于互联网与面对面行为家长培训对注意力缺陷/多动障碍儿童家长的相对疗效:一项非随机对照试验

Relative Efficacy of Internet-based and Face-to-face Behavioural Parent Training for Parents of Children with Attention-deficit/ hyperactivity disorder: a Non-randomised Controlled Trial.

作者信息

Miklosi Monika, Hayes Hanna, Gallai Maria

机构信息

Eötvös Loránd University, Faculty of Education and Psychology, Psychological Institute, Budapest, Hungary.

Heim Pál National Paediatric Institute, Centre of Mental Health, Budapest, Hungary.

出版信息

Neuropsychopharmacol Hung. 2024 Dec;26(4):204-217.

PMID:39760674
Abstract

BACKGROUND/OBJECTIVE: Behavioural Parent Training (BPT) is an evidence-based psychosocial intervention for attention-deficit/hyperactivity disorder (ADHD) in children. The use of online technologies significantly increases the accessibility of these interventions. This study aimed to assess the relative efficacy of face-to-face and online training in the use of parenting strategies taught. We also explored the impact of parental ADHD symptom levels.

METHOD

A massive open online course (MOOC) version of a BPT program was designed and evaluated. A total of ninety parents of children diagnosed with ADHD were recruited. Randomisation was not employed; parents gave their preferences in choosing between face-to-face and online training formats. One month after the completion of the training and at a three-month follow-up, parents were queried regarding the implementation and frequency of use of the parenting strategies taught. The two groups were compared along these variables. The Adult ADHD Rating Scale (ASRS-A) was employed to screen parental ADHD symptoms, with the two groups (positively/negatively screened) subsequently compared in terms of their choice of training format and the use of the parenting strategies. The psychopathological symptoms of the child were evaluated using the Strengths and Difficulties Questionnaire (SDQ).

RESULTS

Thirty parents elected to participate in the face- to-face training, while sixty parents registered for the online programme. The drop-out rate was high, data from 21 and 39 parents was included in the analysis from the two groups, respectively. The two groups did not differ in the ASRS-A screening outcome. The only difference was the implementation of the reward system, which was reported by more parents in the face-to-face group than in the online group. The only difference between the groups that screened positive and negative in the ASRS-A was found in the use of proactive parenting strategies. We found no significant differences between the two time points in the use of most parenting strategies.

DISCUSSION

Our results suggest that the online format may be similarly effective in teaching parenting techniques as the face-to-face parenting training. The level of parental ADHD symptoms had little effect; the difficulties regarding proactive strategies may be due to deficits in executive functioning. Parent training delivered through telemedicine can significantly improve access and is cost-effective; therefore, we recommend its use in the treatment of ADHD in children. Nevertheless, this necessitates appropriate regulation and funding of telemedicine. (Neuropsychopharmacol Hung 2024; 26(4): 204-217)

摘要

背景/目的:行为家长培训(BPT)是一种针对儿童注意力缺陷多动障碍(ADHD)的循证心理社会干预措施。在线技术的使用显著提高了这些干预措施的可及性。本研究旨在评估面对面培训和在线培训在教授的育儿策略使用方面的相对疗效。我们还探讨了父母ADHD症状水平的影响。

方法

设计并评估了一个BPT项目的大规模在线开放课程(MOOC)版本。共招募了90名被诊断患有ADHD儿童的家长。未采用随机分组;家长自行选择面对面培训或在线培训形式。在培训结束后1个月和3个月随访时,询问家长所教授育儿策略的实施情况和使用频率。对两组在这些变量上进行比较。采用成人ADHD评定量表(ASRS-A)筛查家长的ADHD症状,然后比较两组(筛查阳性/阴性)在培训形式选择和育儿策略使用方面的情况。使用优势与困难问卷(SDQ)评估儿童的心理病理症状。

结果

30名家长选择参加面对面培训,60名家长注册了在线课程。辍学率较高,两组分别有21名和39名家长的数据纳入分析。两组在ASRS-A筛查结果上无差异。唯一的差异在于奖励系统的实施,面对面组报告使用奖励系统的家长比在线组更多。在ASRS-A筛查中呈阳性和阴性的两组之间,唯一的差异在于积极育儿策略的使用。我们发现大多数育儿策略在两个时间点的使用上无显著差异。

讨论

我们的结果表明,在线形式在教授育儿技巧方面可能与面对面家长培训同样有效。家长ADHD症状水平影响不大;积极策略方面的困难可能归因于执行功能缺陷。通过远程医疗提供的家长培训可显著提高可及性且具有成本效益;因此,我们建议将其用于儿童ADHD的治疗。然而,这需要对远程医疗进行适当监管和提供资金。(《匈牙利神经精神药理学》2024年;26(4):204 - 217)

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