摘要
目的探讨建立医疗服务和学校卫生系统相结合(以下简称医教结合)的干预模式,以促进注意缺陷多动障碍(attention-deficit/hyperactivity disorder,ADHD)儿童的心理行为健康。方法选取医教结合项目学校的ADHD儿童作为干预组同时设立对照组,对干预组患儿进行综合评估并制定个性化干预方案。干预包括团体游戏治疗、行为治疗和药物治疗,并对干预组学校教师、家长进行培训;对照组仅做门诊常规治疗及随访。治疗时间为期8周,干预前后用SNAP-Ⅳ评定量表、长处与困难问卷、自尊量表、学业成绩表现教师评估问卷进行评估。通过各组自身治疗前后对照和组间对照,对结果进行统计分析。结果干预后,干预组和对照组ADHD儿童的多动/冲动、注意力缺陷、行为问题自身前后对比均有明显改善,两者相比干预组改善效果更明显(P<0.05)。干预组ADHD儿童的对立违抗、总的心理行为问题、自尊感、学业成绩表现自身前后对比有显著改善(P<0.05),对照组无明显差异(P>0.05)。结论医教结合模式对于促进ADHD儿童的心理行为健康是可行的、有效的。
Objective To study the intervention model of cooperation in medical services and school health systems to care for attention-deficit/hyperactivity disorder(ADHD)Children's mental health.Methods Schools with medical-educational combination were selected as the intervention group.Besides medication,they got individualized interventions,such as group play therapy,behavior therapy,language therapy,and trainings about ADHD knowledge for school teachers and parents with ADHD children.The control group was ADHD patients from our clinic.Children with ADHD in the control group only got routine treatment and follow-up in our clinic.Treatment time was 8 weeks.The Chinese version of the Swanson,Nolan,and Pelham,versionⅣ(SNAP-Ⅳ)scale,strengths and difficulties questionnaire,self-esteem scale,and school achievement questionnaire(teacher version)were reassessed at the end of the intervention.Through self-control and comparing to the control group,the statistical analysis of the results was condcucted.Results After the intervention,the hyperactivity/impulsivity,attention deficit,and behavioral problems of the ADHD children in the intervention group and the control group before and after treatment were significantly improved.Compared with the control group,these symptoms as mentioned above were improved more significantly in the intervention group(P<0.05).In the intervention group,the oppositional defiance,total psychological behavior problems,self-esteem,and academic performance of ADHD children were significantly improved(P<0.05),while in the control group no improvement was observed(P>0.05).Conclusion The model of cooperation in medical services and school health systems to care for ADHD Children's mental health in Shanghai is feasible and effective.
作者
张小林
章依文
马骏
吴增强
马珍珍
王慧
张琪娜
ZHANG Xiaolin;ZHANG Yiwen;MA Jun;WU Zengqiang;MA Zhenzhen;WANG Hui;ZHANG Qina(Shanghai Children's Medical Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Shanghai Academy of Educational Sciences,Shanghai 200032,China;The First Central Primary School of Jing an District of Shanghai,Shanghai 200040,China;Shanghai Huagao Primary School,Pudong New Area,Shanghai 200120,China)
出处
《教育生物学杂志》
2019年第3期149-155,共7页
Journal of Bio-education
基金
上海市学生心理健康教育发展中心项目(A201475002)
上海交通大学医学院紧缺专业硕士研究生临床研究能力提升计划
关键词
注意缺陷多动障碍
医教结合
干预
心理行为问题
儿童
attention-deficit/hyperactivity disorder
medical-educational combination
intervention
mental and behavior problems
children
