Rapoff M A, Lindsley C B, Christophersen E R
Arch Phys Med Rehabil. 1984 May;65(5):267-9.
There is ample literature to suggest that a high percentage of pediatric patients with chronic diseases fail to comply adequately with their medical regimens. This study examined the effectiveness of a token reinforcement program in improving the compliance of a 7-year-old girl with juvenile rheumatoid arthritis. The parents were taught to manage the program in the home. The patient earned tokens for complying with her treatment regimen and lost tokens when she failed to comply. Tokens were exchanged for routine and special privileges. Compliance with medications, splint wearing, and lying prone was assessed by observation. Baseline data showed low levels of compliance, particularly with splint wearing and prone lying. Introduction of the token reinforcement program resulted in immediate improvement in compliance; improvement was maintained during 10 weeks of follow-up.
有大量文献表明，患有慢性病的儿科患者中有很大比例未能充分遵守其医疗方案。本研究考察了代币强化计划对一名患青少年类风湿性关节炎的7岁女孩提高依从性的效果。研究人员教导其父母在家中实施该计划。患者遵守治疗方案时可获得代币，不遵守则会失去代币。代币可兑换日常和特殊特权。通过观察评估患者对药物治疗、佩戴夹板和俯卧的依从性。基线数据显示依从性较低，尤其是佩戴夹板和俯卧方面。引入代币强化计划后，依从性立即得到改善；在10周的随访期间，这种改善一直保持。
