目的 对家庭干预在儿童非器质性喂养困难管理中的应用进行范围综述,识别干预要素并总结干预效果,为临床实践和研究提供一定的思路。方法 遵循范围综述研究框架,系统检索PubMed、Web of Science、Scopus、Embase、Cochrane Library、CINAHL、中国知网、维普数据库、万方数据库、中国生物医学文献数据库,时限为建库至2025年1月,并根据纳排标准对文献进行筛选、汇总、提取和分析。结果 共纳入11篇文献。家庭干预内容主要涵盖知识宣教、行为干预技巧、心理支持及用餐卫生等方面,干预时长从2周到12个月不等,主要结局指标包括生长发育、进食行为、喂养行为、心理情绪及可行性评价。纳入研究表明家庭干预可改善患儿的饮食行为,促进其生长发育,并优化家长喂养方式,提升其自我效能及亲子互动质量,但评价工具和干预时长等方面缺乏统一标准。结论 家庭干预在儿童非器质性喂养困难管理中具有可行性和积极效果。未来需在多学科协作下构建标准化干预体系,融入个性化调整,并通过构建适合本土的“客观测量主导、主观信息补充、生化指标验证”的三维评价模型,以优化干预的针对性与有效性。
Abstract
Objective To conduct a scoping review on the application of family interventions in managing children's non-organic feeding difficulties, identify key intervention components, and summarize their effectiveness, so as to provide certain insights and directions for clinical practice and research. Methods Following the scoping review framework, a systematic search was performed across PubMed, Web of Science, Scopus, Embase, Cochrane Library, CINAHL, CNKI, VIP Database, Wanfang Database, and CBM from inception to January 2025.Literature was screened, summarized, extracted, and analyzed based on inclusion and exclusion criteria. Results Eleven studies were included.Family interventions primarily encompassed nutritional education, behavioral modification techniques, psychological support, and mealtime hygiene practices, with durations ranging from 2 weeks to 12 months.Key outcome measures included growth and development, eating behaviors, feeding practices, psychological well-being, and feasibility assessments.The findings indicated that family interventions improved children's dietary behaviors, promoted growth, optimized parental feeding strategies, enhanced caregivers' self-efficacy, and strengthened parent-child interactions.However, heterogeneity was observed in evaluation tools and intervention durations, highlighting the lack of standardized protocols. Conclusions Family-centered interventions demonstrate feasibility and positive effects in managing non-organic feeding difficulties in children.Future efforts should focus on developing standardized intervention systems through multidisciplinary collaboration, incorporating personalized adjustments, and establishing a culturally adapted three-dimensional evaluation model—"objective measures as the core, subjective feedback as supplementary, and biochemical markers for validation"—to enhance intervention precision and efficacy.
关键词
喂养困难 /
非器质性 /
家庭干预 /
范围综述
Key words
feeding difficulties /
non-organic /
family interventions /
scoping review
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参考文献
[1] Chatoor I.Feeding disorders in infants and toddlers:Diagnosis and treatment[J].Child Adolesc Psychiatr Clin N Am, 2002, 11(2):163-183.
[2] 赵职卫, 徐海青.婴幼儿喂养困难研究进展[J].中国儿童保健杂志, 2012, 20(2):145-148.
Zhao ZW, Xu HQ.Progress in research on infant and young child feeding difficulties[J].Chin J Child Health Care, 2012, 20(2):145-148.(in Chinese)
[3] 赵职卫, 徐海青, 戴琼, 等.喂养人喂养行为对婴幼儿喂养困难影响的研究[J].中国儿童保健杂志, 2013, 21(3):262-265.
Zhao ZW, Xu HQ, Dai Q, et al.Study on the effects of feeding behaviors of caregivers on infants feeding disorder[J].Chin J Child Health Care, 2013, 21(3):262-265.(in Chinese)
[4] Kerzner B, Milano K, MacLean W C, et al.A practical approach to classifying and managing feeding difficulties[J].Pediatrics, 2015, 135(2):344-353.
[5] Krom H, Van Oers H A, Van Der Sluijs Veer L, et al.Health-related quality of life and distress of parents of children with avoidant restrictive food intake disorder[J].J Pediatr Gastroenterol Nutr, 2021, 73(1):115-124.
[6] 苟芸, 李凌燕, 林莹, 等.学龄前儿童厌食致营养不良流行病学调查及对儿童形态和生理机能的影响[J].中国妇幼保健, 2023, 38(21):4227-4230.
Gou Y, Li LY, Lin Y, et al.Epidemiological survey of malnutrition due to anorexia nervosa in preschool children and its effects on children's morphological and physiological functioning[J].Matern and Child Health Care of China, 2023, 38(21):4227-4230.(in Chinese)
[7] 纪文静, 梁爱民.婴幼儿喂养困难的研究现状与展望[J].中国儿童保健杂志, 2019, 27(3):277-280.
Ji WJ, Liang AM.Research progress on feeding difficulty in infants[J].Chin J Child Health Care, 2019, 27(3):277-280.(in Chinese)
[8] Giusto A, Waller BY, Bunn M, et al.The call to increase adoption of family-based interventions in global mental health programming[J].Psychiatr Serv, 2025,76(4):413-416.
[9] 徐德勇, 罗光月, 任清源, 等.儿童非器质性厌食症的影响因素研究[J].中国儿童保健杂志, 2023, 31(10):1142-1146.
Xu DY, Luo GY, Ren QY, et al.Influencing factors of children's non-organic anorexia[J].Chin J Child Health Care, 2023, 31(10):1142-1146.(in Chinese)
[10] Madonna M, Jeffers E, Harding KE.Caregiver training improves child feeding behaviours in children with paediatric feeding disorder and may reduce caregiver stress:A systematic review and meta-analysis[J].Int J Speech Lang Pathol, 2024:1-13.doi:10.1080/17549507.2024.2381459
[11] Peters MDJ, Godfrey C M, Khalil H, et al.Guidance for conducting systematic scoping reviews[J].Int J Evid Based Healthc, 2015, 13(3):141-146.
[12] Segal I, Tirosh A, Sinai T, et al.Role reversal method for treatment of food refusal associated with infantile feeding disorders[J].J Pediatr Gastroenterol Nutr, 2014, 58(6):739-742.
[13] 朱华, 汪丽霞.亲职教育在改善婴幼儿喂养困难中的应用[J].南昌大学学报(医学版), 2015, 55(5):42-44, 47.
Zhu H, Wang LX.Parent education for improving feeding difficulties in infants[J].Journal of Nanchang University (Medical Science), 2015, 55(5):42-44, 47.(in Chinese)
[14] Lock J, Sadeh-Sharvit S, L'Insalata A.Feasibility of conducting a randomized clinical trial using family-based treatment for avoidant/restrictive food intake disorder[J].Int J Eat Disord, 2019, 52(6):746-751.
[15] Dahlsgaard K K, Bodie J.The (extremely) picky eaters clinic:a pilot trial of a seven-session group behavioral intervention for parents of children with avoidant/restrictive food intake disorder[J].Cogn Behav Pract, 2019, 26(3):492-505.
[16] 杨春雪, 姚亦, 陈敏, 等.基于互联网平台的低出生体重儿童喂养困难干预效果研究[J].上海预防医学, 2020, 32(1):54-57.
Yang CX, Yao Y, Chen M, et al.Effects of intervention based on internet platform for feeding disorders of infants with low birth weight[J].Shanghai Journal of Preventive Medicine, 2020, 32(1):54-57.(in Chinese)
[17] Taylor T, Blampied N, Roglic' N.Controlled case series demonstrates how parents can be trained to treat paediatric feeding disorders at home[J].Acta Paediatr, 2021, 110(1):149-157.
[18] Maestro S, Curzio O, Calderoni S, et al.Feeding disorders in preschoolers:A short-term outcome study in an Italian Family Care Program[J].Eat Weight Disord, 2022, 27(4):1467-1479.
[19] Tanner K, Dempster R, Castillo A, et al.Randomized trial of a self-administered parenting intervention for selective eating in young children[J].Eat Behav, 2022, 46:101646.
[20] 尹嫚丽, 王春华.基于微信平台和以家庭为中心的护理模式在厌食症患儿中的应用效果[J].中西医结合护理(中英文), 2024, 10(5):5-8.
Yin ML, Wang CH.Application effect of family-centered care model based on WeChat platform in children with anorexia[J].Chinese Jeurnal of Integrative Nursing, 2024, 10(5):5-8.(in Chinese)
[21] Breiner CE, Miller ML, Hormes JM.ARFID parent training protocol (“ARFID-PTP”):Results of a randomized pilot trial evaluating a brief, parent-training program for avoidant/restrictive food intake disorder[J].Int J Eat Disord, 2024, 57(11):2306-2317.
[22] Matheson B, Datta N, Van Wye E, et al.Pilot case series studying a psychoeducational and motivational treatment for children with low-weight avoidant restrictive food intake disorder[J].Int J Eat Disord 2024, 57(11):2176-2180.
[23] Estrem HH, Pederson JL, Dodrill P, et al.A US-based consensus on diagnostic overlap and distinction for pediatric feeding disorder and avoidant/restrictive food intake disorder[J].Int J Eat Disord, 2025,58(3):489-499.
[24] 岳小静, 杜琳, 贾飞勇.婴幼儿喂养困难的研究进展[J].中国儿童保健杂志, 2021, 29(7):738-741.
Yue XJ, Du L, Jia FY.Research advances in feeding difficulties of infants and toddlers[J].Chin J Child Health Care, 2021, 29(7):738-741.(in Chinese)
[25] Tang MY, Liu XM, Yang F.The prevalence and predictors of feeding difficulties in children at self-feeding transition stage[J].Front Pediatr, 2023, 11:1175927.
[26] 徐东, 林立, 陈玉珍.我国亲职教育发展的困境及其应对[J].高等继续教育学报, 2023, 36(6):20-26.
Xu D, Lin L, Chen YZ.The dilemma of parenting education development in china and its response[J].J Contin High Educ, 2023, 36(6):20-26.(in Chinese)
[27] Lock J, Le Grange D.Family-based treatment:Where are we and where should we be going to improve recovery in child and adolescent eating disorders[J].Int J Eat Disord, 2019, 52(4):481-487.
[28] Bentz M, Pedersen S H, Moslet U.An evaluation of family-based treatment for restrictive-type eating disorders, delivered as standard care in a public mental health service[J].J Eat Disord, 2021, 9(1):141.
[29] 王丹, 徐红贞, 邵雪华, 等.儿童饮食行为评估工具的研究进展[J].中华护理杂志, 2022, 57(14):1783-1787.
Wang D, Xu HZ, Shao XH, et al.Advances in research on assessment tools for children's eating behavior[J].Chin J Nurs, 2022, 57(14):1783-1787.(in Chinese)
[30] 王畅, 童连.国内外家长喂养行为评价研究进展[J].中国儿童保健杂志, 2022, 30(9):989-993, 999.
Wang C, Tong L.Research progress on the evaluation of parental feeding practices in China and abroad[J].Chin J Child Health Care, 2022, 30(9):989-993, 999.(in Chinese)
基金
上海市进一步加快中医药传承创新发展三年行动计划[ZY(2025-2027)-3-2-1-07]
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