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深呼吸:一项在线团体干预随机对照试验的研究方案,该干预旨在减轻患有危及生命疾病或损伤儿童的父母的创伤应激。

Take A Breath: study protocol for a randomized controlled trial of an online group intervention to reduce traumatic stress in parents of children with a life threatening illness or injury.

作者信息

Rayner Meredith, Muscara Frank, Dimovski Anica, McCarthy Maria C, Yamada Jackie, Anderson Vicki A, Burke Kylie, Walser Robyn, Nicholson Jan M

机构信息

Clinical Sciences, Murdoch Childrens Research Institute, The Royal Children's Hospital, Flemington Road, Parkville, Victoria, 3052, Australia.

Children's Cancer Centre, The Royal Children's Hospital, Flemington Road, Parkville, Victoria, 3052, Australia.

出版信息

BMC Psychiatry. 2016 May 27;16:169. doi: 10.1186/s12888-016-0861-2.

Abstract

BACKGROUND

A substantial proportion of parents whose child is diagnosed with a life-threatening illness, experience high levels of distress that can lead to long-term difficulties in mental health, family functioning and child adjustment. This study evaluates the efficacy of an Acceptance Commitment Therapy-based group intervention designed to reduce distress symptoms in these parents. The program is delivered using videoconferencing to overcome factors that prevent participation in traditional face-to-face therapy.

METHOD/DESIGN: The study is a randomized control trial of the Take A Breath group intervention for parents demonstrating elevated symptoms of acute stress, delivered via videoconferencing in six 90 min group sessions. Participants are the primary caregivers of children aged 0 to 18 years admitted for a life threatening illness or injury to the Oncology, Cardiology, Neurology or Intensive Care Departments of a tertiary pediatric hospital. Parents will be randomized to intervention or waitlist control 4-10 months after their child's diagnosis. Measures will be collected prior to and immediately post intervention for intervention and waitlist parents to assess program efficacy. Intervention parents will be followed up at 6 months to assess the maintenance of program effects. We predict that intervention parents will show fewer symptoms post intervention than waitlist parents (primary outcomes: traumatic stress, depression, anxiety, stress symptoms), reflecting improvements in the psychological skills addressed in the intervention (mediating factors). It is anticipated that reductions in mental health difficulties for intervention parents will be maintained up to 6 months post-intervention and will be associated with broader improvements in parents' adjustment, child adjustment and child wellbeing (secondary outcomes).

DISCUSSION

This study is unique in evaluating a group intervention delivered to parents of children affected by of a diverse range life-threatening illness or injury. Online communication technology is employed to reduce participation barriers. If proven efficacious, this trans-diagnostic approach offers the potential for broad use as part of the suite of psychosocial services provided to families through tertiary pediatric settings.

TRIAL REGISTRATION

ACTRN12611000090910 . Trial Registration Date: 14/09/2011 Protocol Date/version: September 2015, version M Study Status: Ongoing.

摘要

背景

很大一部分孩子被诊断患有危及生命疾病的家长,会经历高度的痛苦,这可能导致心理健康、家庭功能和孩子适应方面的长期困难。本研究评估一种基于接受与承诺疗法的团体干预措施,旨在减轻这些家长的痛苦症状。该项目通过视频会议开展,以克服阻碍参与传统面对面治疗的因素。

方法/设计:本研究是一项随机对照试验,针对表现出急性应激症状加剧的家长开展“深呼吸”团体干预,通过视频会议进行六次90分钟的团体课程。参与者是0至18岁因危及生命的疾病或损伤入住三级儿科医院肿瘤科、心脏病科、神经科或重症监护科的孩子的主要照顾者。家长将在孩子确诊后4至10个月被随机分配到干预组或等待名单对照组。将在干预前和干预后立即收集干预组和等待名单对照组家长的测量数据,以评估项目效果。干预组家长将在6个月后接受随访,以评估项目效果的维持情况。我们预测干预组家长干预后出现的症状会比等待名单对照组家长少(主要结果:创伤应激、抑郁、焦虑、压力症状),这反映出干预中所涉及的心理技能有所改善(中介因素)。预计干预组家长心理健康困难的减轻将在干预后持续6个月,并将与家长适应、孩子适应和孩子幸福感的更广泛改善相关(次要结果)。

讨论

本研究在评估针对受各种危及生命疾病或损伤影响的孩子的家长开展的团体干预方面具有独特性。采用在线通信技术以减少参与障碍。如果被证明有效,这种跨诊断方法有可能作为通过三级儿科机构提供给家庭的一系列心理社会服务的一部分而广泛使用。

试验注册

ACTRN12611000090910。试验注册日期:2011年9月14日。方案日期/版本:2015年9月,版本M。研究状态:进行中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/884e/4884427/d1b19fa69c66/12888_2016_861_Fig1_HTML.jpg

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