Perkasa干预:马来西亚白血病儿童父母的心理治疗干预

Muhammad Syamsul Mat Zin, A. Azman, Z. Abdul Latiff, L. C-Khai
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摘要

这项研究被称为PERKASA干预,是一项针对白血病儿童父母的心理治疗干预,在吉隆坡的一家大学教学医院(UTH)实施,由一名医务社会工作者进行。本随机对照试验(RCT)是一项后续研究,改编自先前已完成的一项试点研究。这种干预包括四个阶段,每个阶段60分钟,强调情感、理性思考、认知和行为。采用有目的抽样法共选取60个样本,随机阶段采用1:1的抽样比例。实验组(EG) 30人,对照组(CG) 30人。在儿科肿瘤科/血液科的严格监控下,在两名护士长的配合下,研究人员与所有参与者进行了接触。EG的参与者进行了三次评估;干预前(T1)、干预中期(T2)和干预后(T3),同时仅在干预后(T2a)对CG参与者进行评估,并与EG进行比较。本研究采用卡方、多变量方差分析重复测量和独立样本t检验分析干预的相互作用。意向治疗分析显示,剩余参与者和退出研究的参与者之间没有显著相关性,也没有显著差异。干预前后,除情绪焦点外,EG无显著变化;干预前和干预后的评估显示焦虑、问题焦点和情绪焦点的显著变化。两组干预后评估比较显示,除抑郁水平外,其他变量均有显著性差异。这种PERKASA干预成功地克服了情绪和心理困扰,并增强了白血病儿童父母在干预后使用的应对策略。对未来研究的建议应该在更大范围的参与者中进行并且应该在更长的时间内进行。
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PERKASA INTERVENTION: A PSYCHOTHERAPY INTERVENTION AMONG PARENTS OF CHILDREN WITH LEUKEMIA IN MALAYSIA
This study, known as PERKASA Intervention, is a psychotherapy intervention towards parents of children with leukemia, implemented in one of the University Teaching Hospital (UTH) in Kuala Lumpur, and has been conducted by a Medical Social Worker. This Randomized Controlled Trial (RCT) is a sequel study adapted from a pilot study that has been done previously. This intervention consists of four sessions with 60 minutes per session emphasizing emotional, rational thinking, cognitive, and behavior. A total of 60 samples are selected using purposive sampling, and a 1:1 ratio has been used at randomized stages. A total of 30 participants were placed in the Experimental Group (EG), while the remaining 30 participants were placed in the Control Group (CG). All the participants were approached by the researcher with rigorous monitoring by Pediatric Oncology/Hematology and cooperation from two Chief Nurses. Participants from EG have been assessed three times; pre-intervention (T1), mid-intervention (T2), and post-intervention (T3), meanwhile CG participants were assessed just at the post-intervention (T2a) and compared with EG. This study used chi-square, multivariate ANOVA repeated measures, and independent samples t-test to analyze the intervention interactions. Intent-to-treat analysis shows no significant correlation and no significant differences between remaining participants and participants who withdrew from the study. At pre- to mid-intervention in EG shows no significant changes, except in emotional-focus; the pre- to post-intervention assessment shows significant changes in anxiety, problem-focus, and emotional-focus. Comparison between two groups tested at post-intervention assessment reveal that all variables show significant differences, except in depression level. This PERKASA Intervention successfully overcame the emotional and psychological distress and enhanced coping strategies used among parents of children with leukemia at post-intervention. Recommendations for a future study to be performed in a larger scale of participants and should be done over a long period of time.
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