Evaluation & the Health Professions最新文献

This study aimed to examine the measurement invariance of the Basic Psychological Need Satisfaction Subscale (BPNSS) and compare the latent factor means of basic psychological needs between individuals with psychiatric and non-psychiatric disabilities. This cross-sectional study included 97 individuals with psychiatric and 102 individuals with non-psychiatric disabilities. Prior to comparing scores on basic psychological needs across these groups, we evaluated the measure invariance of the BPNSS and confirmed scalar invariance. Individuals with psychiatric disabilities had significantly lower autonomy scores than those with non-psychiatric disabilities. There were no significant mean differences in competence and relatedness between the groups. These findings suggest wide applicability of the BPNSS across individuals with psychiatric and non-psychiatric disabilities. Practitioners should support individuals with psychiatric disabilities to improve their autonomy. Replication with large, diverse samples is crucial to validate the findings and investigate intragroup variances.

Single-Case Experimental Designs (SCEDs), or N-of-1 trials, are commonly used to estimate intervention effects in many disciplines including in the treatment of youth mental health problems. SCEDs consist of repeated measurements of an outcome over time for a single case (e.g., student or patient) throughout one or more baseline phases and throughout one or more intervention phases. The manipulation of the baseline and intervention phase make the SCED a type of interrupted time series design, which is considered one of the most effective experimental designs for causal inference. An important step towards understanding why interventions are effective at producing a change in the outcome is through the investigation of mediating mechanisms. Hypotheses of mediating mechanisms involve an intervention variable which is hypothesized to affect an outcome through its effect on a mediating variable. Little work has attempted to combine mediation analysis and ABAB reversal designs. Therefore, the goals of this paper are to define, estimate, and interpret mediation effects for ABAB reversal designs. An empirical example is used to demonstrate how to estimate and interpret the mediation effects. R code is provided for researchers interested in estimating mediation effects in single-case reversal designs.

This study evaluated LLInC (Leerkracht-Leerling Interactie Coaching in Dutch, or Teacher Student Interaction Coaching), an intervention targeted at teachers' mental representations to improve dyadic teacher-child relationship quality. Four teachers and eight children from Dutch elementary schools participated in this single case study. Teachers themselves selected two children with whom they experienced a difficult relationship. The results indicated that teachers' global judgments of relationship quality improved from pretest to posttest for almost all teacher-child dyads. Day-to-day perceptions of conflict, closeness, and self-efficacy improved for a few teacher-child dyads, and especially for teacher-child dyads of the second targeted child. This implies that LLInC is especially helpful when carried out for at least two teacher-child dyads. The results of this study suggest that LLInC is promising, especially with regard to teachers' global relationship perceptions. However, LLInC should be further evaluated using a larger, representative sample, especially with regard to day-to-day perceptions of relationship quality.

Although the prevalence of symptoms of post-traumatic stress disorder (PTSD) in infants and young children is similar as in older age groups, and PTSD intervention is as important in this age group, research on PTSD-treatment in infants is very scarce. Eye Movement Desensitization and Reprocessing (EMDR) Storytelling is a trauma-focused treatment that is being used by clinicians for infants with PTSD-symptoms. The aim was to assess the feasibility, acceptability and initial indications of effectiveness of EMDR Storytelling for infants aged 3-24 months with PTSD-symptoms after medical procedures. We included 6 infants and administered personalized items to assess PTSD-symptoms during the baseline, intervention and follow-up phase on a day-to-day basis. Furthermore, we measured PTSD-classification and symptoms at three and four measurement points, respectively. The data was analysed visually and quantitatively. EMDR Storytelling was shown to be feasible and acceptable for all participating families. Parent- and therapist-report showed that four out of the six infants included in the current study showed a clear reduction over time in PTSD-classification, -symptoms, and daily measured PTSD-symptoms. The results concerning the other two infants were mixed. Attention should be paid to cognitive (language) as well as interactional (infant-parent) mechanisms potentially underlying the benefits of EMDR Storytelling.

Existing research has shown that parental behavior can influence the onset and persistence of adolescent depression; however, the initial treatment guidelines do not include parental involvement, and there is no established protocol for engaging parents. For this study, the Doepressie parent training protocol was designed to teach parents ways to help their child cope with depression, and this study sought to evaluate the feasibility and changes in parenting of combining individual cognitive behavioral therapy (CBT) for adolescents with parent training. Because of the heterogeneity observed in adolescents with depression, a single-case design study with daily diaries for parents was conducted. Adolescents (N = 9; mean age = 15.9, SD = 1.05) with major depressive disorder and their parents participated in this study. Parents reported that the parent training was feasible. After treatment, two-thirds of the adolescents no longer met the criteria for major depressive disorder. Most of the parents reported positive effects on their child's mood and activity level, problem-solving skills with their child, and parental responsiveness and competence. Four parents demonstrated medium positive change. Involving parents in the treatment of adolescent depression has significant clinical benefits. Because of the heterogeneity of adolescent depression, the impact of parental involvement varies.

In the United States, only approximately one-third of students read at or above proficiency level. Moreover, the difference in reading proficiency of students is severely disproportionate for students with disabilities compared to students without disabilities. Reading fluency is a precursor for academic success and one of the six aspects of reading that contributes to effective reading skills. Many studies have examined the effectiveness of repeated reading to improve reading fluency. However, existing literature has mixed evaluations of whether repeated reading can be considered evidence-based reading intervention practice for students with disabilities. The current study examined the effects of a repeated reading intervention on reading fluency for three middle school students with learning disabilities. To address limitations of traditional single-case experimental design analytical methods such as visual analysis and nonoverlap indices, our study provided empirical researchers with a step-by-step procedure of using an advanced statistical method for single-case experimental designs, namely, generalized linear mixed models (GLMM) to analyze data. The results presented by GLMMs showed that repeated reading intervention can significantly improve reading fluency for some students with learning disabilities. Implications, limitations, and future directions from both empirical and methodological perspectives were also discussed.

Transitioning to motherhood comes with new and intensive tasks that may cause parental stress, low parental self-efficacy, and internalizing problems. This can in turn negatively affect the mother-child relationship. Mindful with your Baby/Toddler (MwyB/T) is a mindfulness-based intervention for parents of young children experiencing parental stress and internalizing problems. Previous evaluative studies showed promising results, but methodology of these studies was limited. The current study used a single case design, including a baseline, intervention, posttest, and follow-up phase, to evaluate the effectiveness of MwyB/T. Ten participants were included and completed daily administered personalized items and validated questionnaires measuring mindfulness, mindful parenting, parental self-efficacy, internalizing problems, and parental stress, for 10 participants. Personalized items were first coded into themes and then assessed using visual analysis and descriptive effect size measures. Reliable change indices were computed for the questionnaires. All mothers improved on personalized items, with most improving on most (or all) of their items. On the questionnaires the majority of mothers improved. Results indicate that MwyB/T could benefit mothers with various intervention goals. More research is needed on the role of personalized items, both as a research measure and an as a possible additional element of interventions.

Secure residential care (SRC) is criticized for several reasons. Therefore, in many countries, the general policy is to limit the length of stay of adolescents in SRC. However, research on length of stay and treatment effects of SRC on adolescents' behavioral problems is sparse. Using single case experimental designs with time-series, forty adolescents referred to SRC completed a questionnaire on behavioral and attention problems every two weeks during a baseline (A) and treatment period (B). Two-level regression analyses were used to investigate the effects of SRC on behavioral and attention problems. In addition, we tested whether length of stay moderated effectiveness. On the individual level, the treatment showed a positive statistically significant effect on the behavioral problems of 0%-8% of the adolescents and a statistically significant negative effect on behavioral problems was found in 3%-10% of the adolescents. On the group level, adolescents showed no significant decrease in problem behavior or attention problems from baseline to discharge. Length of stay did not moderate the results. Based on the results we conclude that most adolescents fail to improve. In addition, length of stay was not associated with effectiveness, nor could it be explained by adolescents' characteristics.

Generalized linear mixed models (GLMMs) have great potential to deal with count and rate data in single-case experimental designs (SCEDs). However, applied researchers face challenges to apply such an advanced approach in their own studies. Hence, our study aimed to provide a tutorial and demonstrate a step-by-step procedure of using GLMMs to handle SCED count and rate outcomes. We utilized an empirical examplewith a purpose to examine the effect of prelinguistic milieu teaching (PMT) on prelinguistic intentional communication for six school-age children with autism. The outcomes were sustained intentional communication (frequency count) and initiated intentional communication (rate). A step-by-step analytical approach with GLMMs was illustrated and associated R and SAS code was provided. The results overall supported the original conclusions of the effectiveness of PMT, whereas additional evidence regarding the precise estimate of the individual treatment effect and between-case variation of the treatment effect were also interpreted. The implications of the similarities and differences between the findings based on GLMMs and from the original study were discussed.

Parents with borderline personality disorder (BPD) experience deficiencies in parenting skills leading to increased family burden, stress, mental health problems in children and even family violence. The present study evaluated a Dutch version of the parenting training based on Dialectical Behavior Therapy (DBT) for mothers with BPD. A multiple baseline single-case experimental design study was conducted with standardized and idiosyncratic assessments of parenting behavior and parental stress before, biweekly during, and after training. Participants (N = 10) were mothers with a BPD diagnosis with a child under the age of 6. Four participants discontinued the training. Among six training completers, clinically reliable improvements in parenting skills were most pronounced for inconsistent discipline, involvement, positive parenting and corporal punishment. Frequent, idiosyncratic assessments showed that for six mothers training had a positive effect on parenting skills, while for five mothers this effect was large. Overall, less improvement was found for parenting stress. DBT parenting training seems to have clinical value for mothers with BPD struggling with raising their children. Most prominent improvement was found in relation to mothers disciplining their child in a more consistent manner. The complexity and heterogeneity of mothers with BPD requires a more idiosyncratic, patient-centered approach. This study was registered (retrospectively) in ISRCTN (ID ISRCTN74447767). https://www.isrctn.com/ISRCTN74447767, March 2022.