目的:为了评估一个简短的疗效和成本,对湿疹患儿家庭进行集体育儿干预。
方法:采用随机对照试验设计。对昆士兰儿童医院和社区的家庭(n=257)进行了资格评估(儿童2-10岁,确诊为湿疹,规定的局部皮质类固醇)。同意参与的家庭(N=59)在基线时评估临床医生评定的湿疹严重程度,父母报告的湿疹症状严重程度,和电子监测局部皮质类固醇依从性(主要结果);和育儿行为,父母在管理湿疹时的自我效能和任务表现,湿疹相关的儿童行为问题,以及儿童和父母的生活质量(次要结果)。家庭被随机(1:1,非盲化)接受干预(n=31)或照常护理(n=28)。干预包括两个,2小时健康生活三重P小组会议(面对面/在线)和28个干预家庭参加了一次/两次会议。所有家庭都接受了标准化的湿疹教育。在干预后4周和6个月随访时对家庭进行了重新评估,临床医生对病情视而不见。估计了干预交付的成本。
结果:跨评估时间点的多水平建模显示了对无效育儿的显着干预效果(d=.60),自我效能感(d=0.74),任务性能(d=.81),以及对管理湿疹相关儿童行为的信心(d=0.63),但不是疾病/症状的严重程度,治疗依从性或生活质量。每个参与家庭的父母行为(临床)得到改善的平均成本为$159。
结论:健康生活三重P在管理儿童湿疹和湿疹相关行为困难时,可有效减少无效的育儿行为,提高父母的自我效能和任务绩效。对疾病/症状严重程度没有影响,治疗依从性,或生活质量。
背景:ACTRN12618001332213。
OBJECTIVE: To evaluate the efficacy and costs of a brief, group-delivered parenting intervention for families of children with eczema.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
BACKGROUND: ACTRN12618001332213.