Recovery Trajectories of Child and Family Outcomes Following Online Family Problem-Solving Therapy for Children and Adolescents after Traumatic Brain Injury.
Recovery Trajectories of Child and Family Outcomes Following Online Family Problem-Solving Therapy for Children and Adolescents after Traumatic Brain Injury.
复制标题
脑外伤后儿童和青少年在线家庭问题解决治疗后儿童和家庭结果的恢复轨迹。
DOI：
10.1017/s1355617719000778
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Zhang,Nanhua
中科院分区：
文献类型：
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作者：
Wade,ShariL;Fisher,AllisonP;Kaizar,EloiseE;Yeates,KeithO;Taylor,HGerry;Zhang,Nanhua
ObjectivesWe进行了联合分析，从五个随机临床试验（RCT）的在线家庭解决问题的治疗（OFPST）的儿童创伤性脑损伤（TBI），以确定儿童和家长的结果最敏感的OFPST和轨迹的恢复随时间推移。MethodsWe检查了359名儿童的数据复杂的轻度至重度TBI，年龄5-18岁，随机OFPST或控制条件。使用轮廓分析，我们检查了父母报告的儿童（内化和外化行为问题，执行功能行为，社会能力）和家庭结果（父母抑郁、心理困扰、家庭功能、亲子冲突）。结果我们发现，对儿童和家庭结果的测量有主效应[F（3，731）= 7.35，p <0.001; F（3，532）= 4.79，p = 0.003]，反映了两组的各项指标均有不同程度的改善。显著的组与时间的相互作用表明，在基线后6个月和18个月，OFPST组的儿童和家庭的问题比对照组少[t（731）=-5.15，p <0.001，t（731）=-3.90，p = 0.002，分别为儿童结局; t（532）=-4.81，p < .001，t（532）=-3.80，p < .001，分别用于家庭结局].结论结果表明，在改善儿童行为问题和父母/家庭功能方面，这些措施对治疗的反应性差异有限。组间差异在治疗完成时和治疗后延长时间后最大。
ObjectivesWe conducted joint analyses from five randomized clinical trials (RCTs) of online family problem-solving therapy (OFPST) for children with traumatic brain injury (TBI) to identify child and parent outcomes most sensitive to OFPST and trajectories of recovery over time.MethodsWe examined data from 359 children with complicated mild to severe TBI, aged 5–18, randomized to OFPST or a control condition. Using profile analyses, we examined group differences on parent-reported child (internalizing and externalizing behavior problems, executive function behaviors, social competence) and family outcomes (parental depression, psychological distress, family functioning, parent–child conflict).ResultsWe found a main effect for measure for both child and family outcomes [F(3, 731) = 7.35, p < .001; F(3, 532) = 4.79, p = .003, respectively], reflecting differing degrees of improvement across measures for both groups. Significant group-by-time interactions indicated that children and families in the OFPST group had fewer problems than controls at both 6 and 18 months post baseline [t(731) = −5.15, p < .001, and t(731) = −3.90, p = .002, respectively, for child outcomes; t(532) = −4.81, p < .001, and t(532) = −3.80, p < .001, respectively, for family outcomes].ConclusionsThe results suggest limited differences in the measures’ responsiveness to treatment while highlighting OFPST’s utility in improving both child behavior problems and parent/family functioning. Group differences were greatest at treatment completion and after extended time post treatment.