Miller D L, Manne S, Palevsky S
Memorial Sloan-Kettering Cancer Center, USA.
J Pediatr Psychol. 1998 Aug;23(4):267-71. doi: 10.1093/jpepsy/23.4.267.
To examine the treatment acceptability of behavioral interventions targeting noncompliance in children with cancer, in medical versus general situations.
Participants included 40 parents of children on active medical treatment for cancer, 42 pediatric oncology nurses, and 34 parents of medically healthy children. After reading a clinical vignette, participants rated the acceptability of five behavioral interventions via the Treatment Evaluation Inventory-Short Form.
Positive reinforcement, response cost, and reprimand generally were perceived as moderately acceptable. Overcorrection was perceived as unacceptable by all groups. Compared with nurses and parents of medically well children, parents of children with cancer provided significantly lower acceptability ratings for response cost and time-out, two of the punitive strategies studied.
Results suggest that clinicians should assess the acceptability of specific treatments prior to intervening. Methods for enhancing acceptability should be explored in future research.
考察针对癌症患儿不依从行为的行为干预措施在医疗情境与一般情境中的治疗可接受性。
参与者包括40名正在接受癌症积极治疗的患儿的父母、42名儿科肿瘤护士以及34名身体健康儿童的父母。在阅读一个临床案例后,参与者通过简易治疗评估量表对五种行为干预措施的可接受性进行评分。
正强化、反应代价和斥责通常被认为具有中等可接受性。过度矫正被所有组认为不可接受。与护士和身体健康儿童的父母相比,癌症患儿的父母对反应代价和暂停这两种所研究的惩罚策略的可接受性评分显著更低。
结果表明临床医生在干预前应评估特定治疗的可接受性。未来研究应探索提高可接受性的方法。