A Virtual Resiliency Intervention Promoting Resiliency for Parents of Children with Learning and Attentional Disabilities: A Randomized Pilot Trial
A Virtual Resiliency Intervention Promoting Resiliency for Parents of Children with Learning and Attentional Disabilities: A Randomized Pilot Trial
复制标题
DOI：
10.1007/s10995-019-02815-3
复制
发表时间：
2019-10-24
影响因子：
2.3
通讯作者：
Kuhlthau, Karen A.
中科院分区：
文献类型：
--
作者：
Park, Elyse R.;Perez, Giselle K.;Kuhlthau, Karen A.
五分之一的儿童有学习和注意力障碍（LAD）。LAD患儿的父母易受困扰，但尚未开发出循证治疗方法。方法从2016年6月至2017年11月，我们进行了一项混合方法研究，以适应和评估身心团体弹性计划的虚拟交付，压力管理和弹性训练-放松反应弹性计划（SMART-3RP），以满足LAD儿童家长的需求;这是一个每周8次的团体干预。在第一阶段，我们进行了4次家长焦点小组访谈、2次专业焦点小组访谈、5次专业个人访谈和1次试点小组访谈，以适应SMART-3RP针对LAD患儿家长的需要。在第二阶段，我们进行了一个试点的等待名单控制的研究，以评估的可行性，可接受性和初步的适应计划的视频会议交付的有效性。父母被随机分配到即时干预组（IG）或等待列表控制组（WC）。在基线（时间1）、IG干预结束或WC基线后3个月（时间2）和IG治疗后3个月或WC干预结束（时间3）时进行调查。结果定性研究结果表明，高水平的父母的压力，与主要的压力源，包括导航的教育系统，与其他父母的互动，家庭的关注，以及经济和专业的牺牲。我们调整了手册，以针对这些压力源，并修改了会议后勤和交付。53名父母（平均年龄= 46.8岁; 90.6%为女性）参加了全国范围内的试点试验。62.5%的参与者完成了>= 6/8次训练; 81.8%的人报告了持续的每日/每周放松反应练习。T1-T2比较发现，IG与WC参与者在痛苦[VAS]，增量M =-1.95; d = 0.83和弹性[CES]，增量M = 6.38; d = 0.83，以及压力应对[MOCS-A]增量M = 8.69; d = 1.39;抑郁和焦虑[PHQ-4]，增量M =-1.79; d = .71;社会支持[MOS-SSS]，增量M = 5.47; d = 0.71;同理心[IRI]，增量M = 3.17; d = 0.77;干预后3个月随访时持续改善。结论前瞻性等待名单随机试验结果显示，SMART-3RP干预适用于LAD儿童家长的可行性、可接受性和初步疗效。这种虚拟交付的弹性干预改善了父母的痛苦，弹性和压力应对，这是持续的。
Objectives One in five children have a learning and attentional disability (LAD). Parents of children with LAD are vulnerable to distress, but an evidence-based treatment has not been developed. Methods From June 2016 to November 2017, we conducted a mixed methods study to adapt and assess the virtual delivery of a mind-body group resiliency program, the Stress Management and Resiliency Training-Relaxation Response Resiliency Program (SMART-3RP), to meet the needs of parents of children with LAD; this is an 8-session weekly group intervention. In the first phase, we conducted 4 parent focus group interviews, 2 professional focus group interviews, and 5 professional individual interviews, and 1 pilot group to adapt the SMART-3RP to target the needs of parents of children with LAD. In the second phase, we conducted a pilot wait-list controlled study to assess the feasibility, acceptability, and preliminary efficacy of a videoconferencing delivery of the adapted program. Parents were randomized to an immediate intervention group (IG) or wait-list control group (WC). Surveys were administered at baseline (time 1), end of intervention for the IG or 3 months post-baseline for the WC (time 2), and 3 months post treatment for the IG or end of intervention for the WC (time 3). Results Qualitative findings illustrated high levels of parental stress, with primary stressors including navigating the educational system, interactions with other parents, familial concerns, and financial and professional sacrifices. We adapted the manual to target these stressors and modified session logistics and delivery. Fifty-three parents (mean age = 46.8; 90.6% female) participated nationally in the pilot trial. 62.5% of participants completed >= 6/8 sessions; 81.8% reported continued daily/weekly relaxation response exercise practice. T1-T2 comparisons found that IG versus WC participants showed significant improvements in distress [VAS], increment M = - 1.95; d = .83 and resilience [CES], increment M = 6.38; d = .83, as well as stress coping [MOCS-A] increment M = 8.69; d = 1.39; depression and anxiety [PHQ-4], increment M = - 1.79; d = .71; social support [MOS-SSS], increment M = 5.47; d = .71; and empathy [IRI], increment M = 3.17; d = .77; improvements were sustained at the 3 month post intervention follow-up. Conclusion Pilot wait-list randomized trial findings showed promising feasibility, acceptability, and preliminary efficacy for the SMART-3RP intervention adapted for parents of children with LAD. This virtually-delivered resiliency intervention improved parents' distress, resiliency, and stress coping, which were sustained.