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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Improving Child and Parent Mental Health in Primary Care: A Cluster-Randomized Trial of Communication Skills Training
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Improving Child and Parent Mental Health in Primary Care: A Cluster-Randomized Trial of Communication Skills Training

机译:改善初级保健中的儿童和父母心理健康:一项交流技巧培训的随机分组试验

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OBJECTIVE. We examined child and parent outcomes of training providers to engage families efficiently and to reduce common symptoms of a range of mental health problems and disorders.METHODS. Training involved three 1-hour discussions structured around video examples of family/provider communication skills, each followed by practice with standardized patients and self-evaluation. Skills targeted eliciting parent and child concerns, partnering with families, and increasing expectations that treatment would be helpful. We tested the training with providers at 13 sites in rural New York, urban Maryland, and Washington, DC. Children (5–16 years of age) making routine visits were enrolled if they screened “possible” or “probable” for mental disorders with the Strengths and Difficulties Questionnaire or if their provider said they were likely to have an emotional or behavioral problem. Children and their parents were then monitored for 6 months, to assess changes in parent-rated symptoms and impairment and parent symptoms.RESULTS. Fifty-eight providers (31 trained and 27 control) and 418 children (248 patients of trained providers and 170 patients of control providers) participated. Among the children, 72% were in the possible or probable categories. Approximately one half (54%) were white, 30% black, 12% Latino, and 4% other ethnicities. Eighty-eight percent (367 children) completed follow-up monitoring. At 6 months, minority children cared for by trained providers had greater reduction in impairment (?0.91 points) than did those cared for by control providers but no greater reduction in symptoms. Seeing a trained provider did not have an impact on symptoms or impairment among white children. Parents of children cared for by trained providers experienced greater reduction in symptoms (?1.7 points) than did those cared for by control providers.CONCLUSION. Brief provider communication training had a positive impact on parent mental health symptoms and reduced minority children's impairment across a range of problems.
机译:目的。我们检查了培训提供者的孩子和父母的结局,以有效地与家庭互动并减少一系列精神健康问题和障碍的常见症状。培训涉及三个1小时的讨论,围绕家庭/提供者沟通技巧的视频示例进行,每次讨论之后都要进行标准化患者的练习和自我评估。这些技能的目标是引起父母和孩子的关注,与家人结伴,并越来越期望治疗会有所帮助。我们在纽约郊区,马里兰州市区和华盛顿特区的13个地点与提供者一起测试了培训。如果他们通过“强项和困难调查表”筛查了“可能”或“很可能”患有精神障碍,或者他们的提供者说他们可能有情绪或行为问题,则参加例行探访的儿童(5-16岁)。然后对儿童及其父母进行了6个月的监测,以评估父母评定的症状,损伤和父母症状的变化。共有58名提供者(31名受过训练的提供者和27名对照者)和418名儿童(248名受过训练的提供者的患者和170名对照提供者的患者)参加了会议。在儿童中,有72%属于可能或可能类别。大约一半(54%)是白人,30%黑人,12%拉丁裔和4%其他种族。 88%(367名儿童)完成了随访监测。在6个月时,受过训练的提供者照料的少数民族儿童的损伤减少程度(?0.91分)比对照提供者所照护的儿童减小的程度更大,但症状的减轻没有更大。看到受过训练的提供者对白人儿童的症状或损害没有影响。结论由受过训练的提供者照料的儿童父母的症状减轻程度(?1.7分)比由控制提供者照料的儿童减轻得多。简短的提供者沟通培训对父母的心理健康症状有积极的影响,并减少了一系列问题中少数民族儿童的伤害。

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