目的 研究新森林教养方案(NFPP)对注意缺陷多动障碍(ADHD)儿童的干预效果,为ADHD的非药物治疗提供依据。 方法 选取2023年2—10月在柳州市某三甲医院确诊的45名6～9岁ADHD儿童及其亲密照养人为研究对象,根据知情同意原则,分为对照组(n=24)和干预组(n=21)。对照组使用常规健康教育,干预组在此基础上增加每周1次的NFPP课程,持续8周。采用SNAP-Ⅳ评定量表、长处与困难问卷(SDQ)、Weiss功能缺陷评定量表父母版(WFIRS-P)对两组患儿干预前后的核心症状和社会功能损害情况进行评估。 结果 最终干预组和对照组分别有18人和23人完成干预及随访。干预前,干预组和对照组患儿SNAP-Ⅳ、SDQ和WFIRS-P 3个量表的各因子得分差异均无统计学意义(P＞0.05);经过8周干预,干预组SNAP-Ⅳ注意缺陷(Z=-2.232)、多动/冲动(t=-3.598)和对立违抗(t=-2.053)维度得分均低于对照组,同时均低于干预前,差异均有统计学意义(P<0.05);干预组SDQ品行问题(Z=-2.513)、多动问题(Z=-3.719)的得分和困难总分(Z=-3.231)均低于对照组,同时SDQ的6个因子评分均低于干预前,差异均有统计学意义(P<0.05);干预组WFIRS-P家庭(Z=-2.332)、学校和学习因子(t=-10.734)、生活技能(Z=-3.667)、自我管理(t=-3.471)因子得分和WFIRS-P总分(t=-5.251)均低于对照组,同时均低于干预前,差异均有统计学意义(P<0.05)。 结论 NFPP方案可以有效改善ADHD的核心症状,减轻其社会功能损害。
Abstract
Objective To investigate the feasibility and effectiveness of New Forest Parenting Program (NFPP) in the intervention of children with attention deficit hyperactivity disorder(ADHD), in order to provide evidence for non-pharmacological treatments for ADHD. Methods A total of 45 children aged 6 to 9 years diagnosed with ADHD at a tertiary hospital in Liuzhou from February to October 2023, along with their primary caregivers, were selected as subjects and were divided into control group (n=24) and intervention group (n=21) based on informed consent. The control group received routine health education, while the intervention group participated in weekly NFPP sessions for 8 weeks additionally. The SNAP-Ⅳ rating scale, Strengths and Difficulties Questionnaire (SDQ), and Weiss Functional Impairment Rating Scale-Parent (WFIRS-P) were used to assess core symptoms and social functional impairment before and after the intervention in both groups. Results Ultimately, 18 participants in the intervention group and 23 in the control group completed the intervention and follow-up. Before the intervention, there were no statistically significant differences in scores on the SNAP-Ⅳ, SDQ, and WFIRS-P scales between the intervention and control groups (P>0.05). After 8 weeks of intervention, the intervention group had significantly lower scores than the control group on the SNAP-Ⅳ for inattention (Z=-2.232), hyperactivity/impulsivity (t=-3.598), and oppositional defiance (t=-2.053), with all scores also lower than pre-intervention levels (P<0.05). Similarly, the intervention group scored lower on the SDQ for conduct problems (Z=-2.513) and hyperactivity problems (Z=-3.719), as well as the total difficulties score (Z=-3.231) compared to the control group, with all six dimensions scoring lower than post-intervention (P<0.05). Scores on the WFIRS-P for family (Z=-2.332), school and learning (t=-10.734), life skills (Z=-3.667), self-management (t=-3.471), and the total WFIRS-P score (t=-5.251) were significantly lower in the intervention group than in the control group and pre-intervention(P<0.05). Conclusion The NFPP program effectively improves core symptoms of ADHD and reduces associated social functional impairment.
关键词
注意缺陷多动障碍 /
新森林教养方案 /
核心症状
Key words
attention deficit hyperactivity disorder /
New Forest Parenting Program /
core symptoms
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基金
柳州市科学研究与技术开发计划课题(2017BD20201)
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