Simulation and Counterconditioning as Adjuncts to Pharmacotherapy for Invasive Pediatric Procedures
Simulation and Counterconditioning as Adjuncts to Pharmacotherapy for Invasive Pediatric Procedures
复制标题
模拟和反调节作为侵入性儿科手术药物治疗的辅助手段
DOI：
10.1097/00004703-199506000-00001
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发表时间：
1995
影响因子：
2.4
通讯作者：
Marilyn D. Cataldo
中科院分区：
文献类型：
--
作者：
K. Slifer;R. L. Babbitt;Marilyn D. Cataldo
在模拟医疗常规过程中进行行为对抗，以补充侵入性手术（骨髓穿刺、腰椎穿刺、气管切开术护理、静脉穿刺和手指穿刺）期间5名儿童痛苦的医疗管理。首选的活动配对在体内与医疗刺激，并提供差分正强化视情况与首选的活动，并遵守成人的指示，首先在模拟过程中，后来在实际程序。合作，逃避/回避，和消极发声的数据进行了评估，使用单一主题的实验方法和基线治疗组的统计比较。结果支持这种方法的好处，作为一种预防性干预，以减少一些需要重复侵入性程序的儿童的行为困扰。讨论强调了培训医务人员预防性地实施这些技术的潜力，减少或停止局部麻醉下治疗的一些儿童的镇静，并为有发育障碍的儿童准备侵入性手术。J Dev Behav Pediatr 16：133-141，1995.索引术语：侵入性操作、行为治疗。
Behavioral counterconditioning was conducted during simulated medical routines to supplement medical management of five children's distress during invasive procedures (bone marrow aspiration, lumbar puncture, tracheostomy care, venipuncture, and finger pricks). Preferred activities were paired in vivo with medical stimuli, and differential positive reinforcement was provided contingent on engagement with the preferred activities and on compliance with adult instructions, first during simulations and later during actual procedures. Data on cooperation, escape/avoidance, and negative vocalizations were evaluated using both single-subject experimental methods and a baseline-treatment group statistical comparison. Results support the benefits of this approach as an adjunctive intervention to decrease behavioral distress in some children requiring repeated invasive procedures. Discussion emphasizes the potential for training medical personnel to implement these techniques preventively, for decreasing or discontinuing sedation for some children treated under local anesthesia, and for preparing children with developmental disabilities for invasive procedures. J Dev Behav Pediatr 16:133–141, 1995. Index terms: invasive procedures, behavior therapy.