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首页> 外文期刊>Pediatric blood & cancer >Token economy to improve adherence to activities of daily living
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Token economy to improve adherence to activities of daily living

机译：令牌经济，改善遵守日常生活活动

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Abstract Background Participation in key activities of daily living (ADL), including daily bathing, physical activity, and oral hygiene, can decrease the risk of bloodstream infections, oral complications, and deconditioning in pediatric patients undergoing hematopoietic stem cell transplant (HSCT). However, many patients fail to perform ADL during their inpatient stay. To improve inpatient adherence to ADL, we tested a token economy to engage patients, families, and the clinical team in improving adherence to these important health behaviors during this critical time. Methods We used a controlled before‐after study design to test our hypothesis. All patients were prescribed three ADL. We used an “all or none” measurement for each component of the ADL 1‐2‐3 initiative to measure adherence. HSCT patients with poor ADL adherence (20%) were eligible to receive the intervention, which consisted of rewarding patients through an ADL via a token economy. Results Twenty‐one patients participated in the study. ADL adherence for the 14 days prior to intervention in study subjects ( n ?=?294 inpatient days) averaged 0.51 ADL per day (95% CI 0.45–0.57). In the 14?days postinitiation of the token economy intervention ( n ?=?294 inpatient days), the average adherence was 2.5 ADL per day (95% CI 2.4–2.5; P ?= 0.001). Discussion Positive reinforcement through a token economy system is associated with improved adherence to ADL in hospitalized pediatric patients who demonstrated poor ADL adherence at baseline. We believe this intervention can positively impact adherence to targeted health behaviors with the ability to correlate with improved health outcomes.
机译：摘要背景参与日常生活（ADL）的关键活动，包括每日沐浴，身体活动和口腔卫生，可以降低血液感染，口服并发症和接受造血干细胞移植（HSCT）的儿科患者的背信。然而，许多患者在入住住院期间未能进行ADL。为了提高入住Adl的住院遵守，我们测试了一个令牌经济，从事患者，家庭和临床团队在这次关键时刻期间改善对这些重要的健康行为的依从性。方法我们使用受控前进的研究设计来测试我们的假设。所有患者均被规定三个ADL。我们为ADL 1-2-3主动权的每个组件使用了“全部或无”测量以测量遵守。 ADL遵守的HSCT患者（＆ 20％）有资格获得干预，该患者包括通过令牌经济通过ADL奖励患者。结果二十一名患者参加了该研究。 ADL遵守在研究主题之前的14天（N？= 294天的304天）平均每天0.51AdL（95％CI 0.45-0.57）。在14个？天后的令牌经济干预（n？= 294天），平均依从每天2.5 adl（95％ci 2.4-2.5;p≤x＆ 0.001）。通过令牌经济体系讨论积极加强与住院儿科患者的粘附性有关，他们在基线上表现出贫困的ADL粘附性。我们认为，这种干预可以积极影响依赖于有针对性的健康行为的能力，以与改善的健康结果相关。

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