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。
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.
关键词
注意缺陷多动障碍 /
医教结合 /
多模式干预
Key words
attention deficit hyperactivity disorder /
combination of education with medical treatment /
multimodal intervention
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参考文献
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基金
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)
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