PROMOTING MASTERY IN CHILDREN AFTER TRAUMA

促进创伤后儿童的掌握

• 批准号: 3392263
• 负责人: Madelon Baranoski
• 金额: $ 21.14万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1991
• 资助国家: 美国
• 起止时间: 1991-06-01 至 1994-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3392263
• 关键词: accidents; anxiety; child (0-11); clinical trials; cognitive behavior therapy; coping; depression; emergency care; emotional crisis; human subject; longitudinal human study; nurse patient relations; nursing intervention; parent offspring interaction; pediatric nursing; placebos; posthospitalization care; psychological shock; psychological stressor; psychological tests; sleep disorders; social support network; statistics /biometry; trauma

Children with traumatic injury account for the second largest cohort of hospitalized children and yet there is little research on the psychological sequelae of such hospitalization or on interventions to help them master the sudden trauma. Previous work on psychological preparation of hospitalized children has focused primarily on planned hospitalization and on advance preparation for procedures. This study will build on previous research and will test an intervention designed for children who experience emergency admission for accidental trauma. 300 children, 7-11, will be randomly assigned to one of 5 groups after they are medically stable. Group I will receive a working-through intervention which will promote mastery of the event through accurate information, cognitive desensitization, directed recall and reframing. The intervention will have 4 components: Joining (establishment of empathetic rapport and supportive relationship); revisiting (structured review of the event); and integration (directed generalization and future implications). Children will receive this intervention during hospitalization and at 2 post-discharge sessions. In Group II, the parents will be instructed and supported as they guide the working-through process with their child. Group III will serve as a placebo control for the supportive relationship in the Group I intervention while Group IV will serve the same function for the Group II intervention. Group V will be the control group with no contact with the Investigator. Eight outcome measures (repeated during hospitalization and after discharge) will evaluate the interventions: Demographic and Life Events Measure for Children and Parents; Child Depression Inventory; Impact of Event Inventory for Child and Parent; Human Figure Drawings; Nurses' Ratings of Upset; Recovery Inventory; Length of Stay; and Post-Hospital Checklist. Parents will be asked to complete the Beck Depression Inventory, the Spielberger State-Trait Anxiety Scale and the Ways of Coping Checklist. A 2 factor (treatment by parental anxiety) repeated measures ANOVA will evaluate effectiveness. Pearson Product Moment Corrections will assess relationships among measures and child, parent, and event factors. The numbers of children involved in accidents and the potential impact of nursing on their paradigm for future research on promoting mastery for children experiencing different forms of trauma and violence.

创伤性损伤的儿童占第二大队列， 住院儿童，但很少有研究的心理 这种住院治疗的后遗症或干预措施，以帮助他们掌握 突如其来的创伤 以前的工作心理准备 住院儿童主要集中在计划住院， 关于提前准备程序。 这项研究将建立在以前的基础上。 研究，并将测试一种干预措施， 因意外创伤入院 300名7-11岁的儿童将在 在他们病情稳定后，随机分配到5组中的一组。 第一组将接受一项逐步解决的干预措施， 通过准确的信息掌握事件，认知 脱敏、定向回忆和重构。 干预将有 4个组成部分：加入（建立同情的融洽关系和支持 关系）;重访（对事件进行结构化审查）;以及整合 （指导性概括和未来影响）。 孩子们会收到 在住院期间和出院后的2次会议上进行这种干预。 在第二组，父母将得到指导和支持，因为他们指导 和孩子一起努力的过程。 第三组将作为 第I组干预中支持关系的安慰剂对照 而第四组的职能与第二组的职能相同。 第V组为对照组，不与研究者联系。 8项结局指标（住院期间和住院后重复 出院）将评估干预措施：人口统计学和生活事件 儿童及家长量表;儿童忧郁量表;影响 亲子事件量表;人物画;护士 心烦意乱的评级;恢复清单;住院时间;和出院后 清单。 父母将被要求完成贝克抑郁症 Spielberger状态-特质焦虑量表及其应对方式 清单。 A2因素（父母焦虑治疗）重复测量 ANOVA将评价有效性。 皮尔逊积矩修正将 评估措施与儿童，父母和事件因素之间的关系。 涉及事故的儿童人数以及 护理的未来研究范式，促进掌握 儿童遭受不同形式的创伤和暴力。