积极育儿计划对注意缺陷多动障碍患儿疗效的研究

Effect of the Positive Parenting Program on children with attention-deficit/hyperactivity disorder

摘要

目的 探讨积极育儿计划(Triple P)对注意缺陷多动障碍(ADHD)患儿核心症状及家庭功能的干预效果,为ADHD患儿临床干预方案的选择与优化提供科学依据。方法 采用随机对照试验设计,纳入2023年7月—2024年6月在珠海市妇幼保健院儿童心理卫生科门诊公开招募的92例6~12岁ADHD患儿,随机分为干预组(常规治疗+15周积极育儿计划家长培训,n=46)和对照组(仅常规治疗,n=46)。采用SNAP-Ⅳ量表评估ADHD患儿核心症状,Weiss功能缺陷量表(WFIRS-P)评估家庭功能,比较两组干预前后ADHD核心症状及家庭功能的变化。结果 干预前,干预组和对照组ADHD患儿WFIRS-P和SNAP-Ⅳ各因子及总分差异均无统计学意义(P>0.05)。干预后,干预组SNAP-Ⅳ总分(Z=-3.000,P=0.003)、SNAP-Ⅳ注意缺陷维度(Z=-2.435,P=0.015)、多动/冲动维度(Z=-2.521,P=0.012)、对立违抗维度(Z=-2.084,P=0.037)和WEISS家庭维度(Z=-2.493,P =0.013)得分均显著低于对照组。结论 在常规治疗的基础上,积极育儿计划能更有效改善ADHD患儿注意缺陷、多动/冲动、对立违抗等核心症状,并对家庭功能具有保护作用。

Abstract

Objective To investigate the effects of the Positive Parenting Program (Triple P) on core symptoms and family functioning in children with attention-deficit/hyperactivity disorder (ADHD), in order to provide scientific evidence for the selection and optimization of clinical intervention strategies for children with ADHD. Methods A randomized controlled trial was conducted in 92 ADHD children aged 6 - 12 years, who were recruited from the outpatient clinic of Child Mental Health, Zhuhai Maternal and Child Health Hospital, between July 2023 and June 2024.The participants were randomly assigned to either the Triple P group (n=46) or the control group (n=46).The control group received routine treatment, while the intervention group received a 15-week Triple P parent training program additionally.SNAP-Ⅳ was used to assess core ADHD symptoms, and the Weiss Functional Impairment Rating Scale-Parent Form (WFIRS-P) was used to evaluate family functioning.Changes in core ADHD symptoms and family functioning before and after the intervention were compared between the two groups. Results There were no significant differences on the subscale scores and total score of WFIRS-P and SNAP-Ⅳ between the intervention group and control group before the intervention(P＞0.05).After the intervention, scores in the intervention group were significantly lower than those in the control group across several measures: the SNAP-Ⅳ total score(Z=-3.000, P=0.003), as well as the SNAP-Ⅳ subscale scores for inattention (Z=-2.435, P=0.015),hyperactivity/impulsivity (Z=-2.521, P=0.012) and oppositional defiance (Z=-2.084, P=0.037).Furthermore, the family domain score on the WFIRS-P scale was also significantly reduced in the intervention group (Z=-2.493, P=0.013). Conclusion When integrated with routine care, the Positive Parenting Program demonstrates superior efficacy in alleviating the core symptoms of ADHD, including inattention, hyperactivity/impulsivity, and oppositional defiance.Furthermore, the intervention is found to exert a significant protective effect on the children′s family functioning.

关键词

注意缺陷多动障碍 / 积极育儿计划 / 家庭干预

Key words

attention-deficit/hyperactivity disorder / Positive Pareroting Program / family-based intervention

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基金资助

珠海市社会发展领域科技计划项目支持(2320004000160);珠海市医学科研项目(2023)