医教结合对学龄期注意缺陷多动障碍儿童干预效果的研究

doi:10.11852/zgetbjzz2019-0060

中国儿童保健杂志 ›› 2019, Vol. 27 ›› Issue (9): 1034-1038.DOI: 10.11852/zgetbjzz2019-0060

医教结合对学龄期注意缺陷多动障碍儿童干预效果的研究

沈力¹, 王瑜², 田园², 于广军²

1 上海交通大学公共卫生学院,上海 200025;
2 上海市儿童医院,上海 200062

收稿日期:2019-01-12 发布日期:2019-09-10 出版日期:2019-09-10
通讯作者: 于广军, E-mail:gjyu@shchildren.com.cn
作者简介:沈力(1995-),女,在读硕士,主要研究方向为儿童保健。
基金资助:
上海市科学技术委员会2018年度上海市优秀学术技术带头人计划(18XD1403200);上海市科学技术委员会2017年度“科技创新行动计划”社会发展领域项目科研计划项目(17511108902);上海市科委医学引导类项目(16411970100)

Combination of education with medical treatment for school-aged children with attention deficit hyperactivity disorder

SHEN Li¹, WANG Yu², TIAN Yuan², YU Guang-jun²

1 School of Public Health,Shanghai Jiaotong University,Shanghai 200025,China;
2 Shanghai Children′s Hospital,Shanghai 200062,China

Received:2019-01-12 Online:2019-09-10 Published:2019-09-10
Contact: YU Guang-jun,E-mail:gjyu@shchildren.com.cn

摘要/Abstract

摘要： 目的探讨医教结合对学龄期注意缺陷多动障碍(ADHD)儿童的干预效果,为后续开展ADHD儿童的诊疗干预措施提供理论依据。方法 2018年1-12月采取随机整群抽样的方法,对上海市嘉定区14所小学一到五年级共9 295名儿童进行ADHD筛查并随机分组,确诊为ADHD的儿童共243名,干预组采用医教结合和药物治疗的综合干预措施,对照组采用药物治疗。两组研究对象分别于干预前、干预后和随访6个月时分别运用SNAP-Ⅳ、父母育儿压力问卷进行评估。结果本研究6个月后随访干预组共纳入105名,对照组共纳入99名儿童。运用线性混合效应模型分析,干预后,两组在SNAP-Ⅳ总分(t=5.04,P=0.026)和育儿压力总分(t=6.49,P=0.012)上差异均有统计学意义;随访6个月后,两组在SNAP-Ⅳ总分上差异有统计学意义(t=7.84,P=0.006),但在育儿压力总分上差异无统计学意义(t=2.11,P=0.148)。结论医教结合的综合干预措施改善了ADHD儿童的核心症状、缓解了父母的照顾压力,为ADHD儿童的多模式干预提供理论依据。

关键词: 注意缺陷多动障碍, 医教结合, 多模式干预

Abstract: Objective To explore the effect of combination of education with medical treatment for school-aged children with attention deficit hyperactivity disorder(ADHD),in order to provide theoretical evidence for the treatment of ADHD. Methods A random cluster sampling method was used to conduct ADHD screening in 9 295 children of grade 1 to 5 from 14 primary schools in Jiading District,Shanghai from January to December 2018,and 243 children were diagnosed with ADHD. The intervention group was given combination of education with medical treatment and medical treatment,while the control group received medical treatment. The two groups were both evaluated by Chinese version of Swan-son Nolan and Pelham,Version Ⅳ Scale-parent form(SNAP-Ⅳ) and Parent Stress Index(PSI) before intervention,after intervention and 6 months after follow up. Results A total of 105 children were included in the intervention group and 99 children in the control group in 6 months after follow up. Linear mixed-effect model analysis showed the difference on SNAP-Ⅳ scores(t=5.04,P=0.026) and PSI scores(t=6.49,P=0.012) were significant between the two groups after treatment. After six-year follow-up,there was significant difference on the SNAP-Ⅳ scores between the two groups(t=7.84,P=0.006),but no significant difference on the PSI scores(t=2.11,P=0.148). Conclusion Combination of education with medical treatment has improved the core symptoms of ADHD children,relived parental stress,and provided support for multimodal intervention in ADHD children.

Key words: attention deficit hyperactivity disorder, combination of education with medical treatment, multimodal intervention

中图分类号:

R749.94

沈力, 王瑜, 田园, 于广军. 医教结合对学龄期注意缺陷多动障碍儿童干预效果的研究[J]. 中国儿童保健杂志, 2019, 27(9): 1034-1038.

SHEN Li, WANG Yu, TIAN Yuan, YU Guang-jun. Combination of education with medical treatment for school-aged children with attention deficit hyperactivity disorder[J]. journal1, 2019, 27(9): 1034-1038.

参考文献

[1] Catala-Lopez F,Peiro S,Ridao M,et al. Prevalence of attention deficit hyperactivity disorder among children and adolescents in Spain:a systematic review and meta-analysis of epidemiological studies[J]. BMC Psychiatry,2012,12:168-181.
[2] Hughes S,Cohen D,Jaggi R. Differences in reporting serious adverse events in industry sponsored clinical trial registries and journal articles on antidepressant and antipsychotic drugs:a cross-sectional study[J]. BMJ Open,2014,4(7):e005535.
[3] Visser SN,Danielson ML,Bitsko RH,et al. Trends in the parent-report of health care provider-diagnosed and medicated attention-deficit/hyperactivity disorder:United States,2003-2011[J]. J Am Acad Child Adolesc Psychiatry,2014,53(1):34-46.
[4] Wolraich M,Brown L,Brown RT,et al. ADHD:clinical practice guideline for the diagnosis,evaluation,and treatment of attention-deficit/hyperactivity disorder in children and adolescents[J]. Pediatrics,2011,128(5):1007-1022.
[5] Power TJ,Mautone JA,Soffer SL,et al. A family-school intervention for children with ADHD:results of a randomized clinical trial[J]. J Consult Clin Psychol,2012,80(4):611-623.
[6] Jennifer AM,Elizabeth KL,Thomas JP. Promoting family and school success for children with ADHD:strengthening relationships while building skills[J]. Theory Pract,2011,50(1):43-51.
[7] 周晋波,郭兰婷,陈颖. 中文版注意缺陷多动障碍SNAP-Ⅳ评定量表-父母版的信效度[J]. 中国心理卫生杂志,2013,27(6):424-428.
[8] Yeh CH,Chen ML,Li W,et al. The Chinese version of the Parenting Stress Index:a psychometric study[J]. Acta Paediatr,2001,90(12):1470-1477.
[9] 王峰,杜亚松,周国权,等. 注意缺陷多动障碍家庭环境影响因素分析[J]. 中国儿童保健杂志,2016,24(6):579-582.
[10] Primack BA,Hendricks KM,Longacre MR,et al. Parental efficacy and child behavior in a community sample of children with and without attention-deficit hyperactivity disorder(ADHD)[J]. Atten Defic Hyperact Disord,2012,4(4):189-197.
[11]Dias TG,Kieling C,Graeff-Martins AS,et al. Developments and challenges in the diagnosis and treatment of ADHD[J]. Braz J Psychiatry,2013,35:40-50.
[12] Miguel S,Margaret W,Ulrich M. Systematic review of national and international guidelines on attention-deficit hyperactivity disorder[J]. J Psychopharmacol,2012,26(6):753-765.
[13] Villodas MT,Mcburnett K,Kaiser N,et al. Additive effects of parent adherence on social and behavioral outcomes of a collaborative school-home behavioral intervention for ADHD[J]. Child Psychiatry Hum Dev,2014,45(3):348-360.
[14] Thapar A,Cooper M. Attention deficit hyperactivity disorder[J]. The Lancet,2016,387(10024):1240-1250

[1]	李荣, 李年, 吴丹丹, 黄荣, 陈银花. 盐酸哌甲酯缓释片对注意缺陷多动障碍儿童生长的影响[J]. 中国儿童保健杂志, 2023, 31(7): 731-735.
[2]	张婕, 安英萍, 杨毅, 张艳楠, 田琳. 从全生命周期视角识别和治疗注意缺陷多动障碍女童和女性的专家共识(2020年版)解读[J]. 中国儿童保健杂志, 2023, 31(5): 570-575.
[3]	易文霞, 陈立. 注意缺陷多动障碍儿童父母养育压力研究进展[J]. 中国儿童保健杂志, 2023, 31(4): 408-411.
[4]	刘芮卓, 陈立. 儿童注意缺陷多动障碍与肥胖的相关性研究[J]. 中国儿童保健杂志, 2023, 31(4): 412-415.
[5]	朱笑彤, 任园春, 刘靖, 李雪, 王芳, 尹婷妮, 谢永涛, 宋懿芪, 范碧瑶, 吉宁. 注意缺陷多动障碍小学生精细动作发展特点研究[J]. 中国儿童保健杂志, 2023, 31(3): 322-326.
[6]	周梅君, 魏蓉美, 袁晓玲, 赵婷, 赵硕. 小组训练对学龄前注意缺陷多动障碍儿童注意品质的干预效果[J]. 中国儿童保健杂志, 2023, 31(3): 336-340.
[7]	黄琦, 黄欣欣, 钱沁芳, 王章琼, 李国凯. 注意缺陷多动障碍共患发育性协调障碍的学龄前儿童智力结构特征[J]. 中国儿童保健杂志, 2023, 31(2): 136-140.
[8]	柴润玉, 王康程, 林华伟, 张俊英, 邢婕, 张华, 曹爱华. 注意缺陷多动障碍儿童及其父母攻击行为相互作用的网络分析[J]. 中国儿童保健杂志, 2022, 30(8): 845-850.
[9]	邓岚柳, 陈立. 药物治疗对注意缺陷多动障碍患儿体格生长影响的研究进展[J]. 中国儿童保健杂志, 2022, 30(8): 874-878.
[10]	房海波, 王荣, 褚琳娜, 冯艳芳, 白容荣, 郭丰桐. 血清维生素D水平与伴中央颞区棘波的儿童良性癫痫共患注意缺陷多动障碍患儿认知功能的相关性分析[J]. 中国儿童保健杂志, 2022, 30(7): 775-778.
[11]	陈书进, 吴丹丹, 李晓南. 注意缺陷多动障碍和肥胖共病机制的研究进展[J]. 中国儿童保健杂志, 2022, 30(4): 401-404.
[12]	方圆, 孔维延, 马晨欢, 潘丽珠, 朱佩滢, 王瑜. 注意缺陷多动障碍儿童过敏性疾病发生情况的调查[J]. 中国儿童保健杂志, 2022, 30(4): 431-435.
[13]	陈文材, 佐飞燕, 万莹, 王玫玲. 脑源性神经营养因子基因Val66Met多态性与注意缺陷多动障碍易感性的Meta分析[J]. 中国儿童保健杂志, 2022, 30(3): 301-305.
[14]	刘蕊, 王燕, 姜艳蕊, 白桦, 张瑞芳. 儿童注意缺陷多动障碍DSM-Ⅳ和DSM-5诊断的比较研究[J]. 中国儿童保健杂志, 2022, 30(3): 306-309.
[15]	董爽, 季忆婷, 王丹, 毛广惠, 颜崇淮, 蔡世忠, 陈艳. 学龄期注意缺陷/多动障碍儿童血铅水平及其与社会功能情况分析[J]. 中国儿童保健杂志, 2022, 30(2): 207-211.

医教结合对学龄期注意缺陷多动障碍儿童干预效果的研究

Combination of education with medical treatment for school-aged children with attention deficit hyperactivity disorder

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics