青少年关节炎患者的依从性:一项系统综述。

IF 1.2 Q3 PSYCHOLOGY, CLINICAL Clinical Practice in Pediatric Psychology Pub Date : 2024-09-01 Epub Date: 2023-04-13 DOI:10.1037/cpp0000483
Cecelia I Nelson, Destiny Noel, Line Caes, Klanci M McCabe, Christina L Duncan
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引用次数: 0

摘要

目的:幼年特发性关节炎(JIA)是导致儿童患者慢性疼痛的主要原因之一。治疗方案对症状控制至关重要,但也可能是一种负担,其中包括可能产生厌恶副作用的药物和可能导致关节疼痛的运动。因此,研究 JIA 患者坚持治疗的障碍和促进因素非常重要。虽然目前已有针对成人风湿性疾病的系统综述,但还没有针对 JIA 患者坚持治疗的文献综述:方法:系统检索了 PsychINFO、PubMed 和 MEDLINE 数据库,以确定调查 JIA 患者依从性的定性和定量实证研究。关键词包括:患者依从性或依从性或持续性;青少年或儿童或少年或儿科或青少年或儿童或青少年;类风湿性关节炎或特发性关节炎或关节炎。如果文章涉及非人类或成人样本、非实验性(如实践建议)、未经同行评议或不是用英语撰写,则排除在综述之外。经过摘要筛选,32 篇文章被纳入分析:结果:运动疗法的依从性始终低于药物疗法。研究人员在很大程度上依赖于自我报告的依从性,这表明需要对依从性进行更客观的测量,以开展更多的研究。在所有研究中,心理治疗未被包括在内,因此对JIA治疗的依从性研究仍然不足:结论:研究结果表明,未来的研究应以设计和评估干预措施为目标,以提高运动和心理治疗的依从性:为促进JIA患者坚持治疗,行为健康提供者应注重在提供者和患儿之间建立牢固的治疗联盟,培养家长和患儿的积极应对技能,并监测亲子关系。
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Adherence in young people living with juvenile arthritis: A systematic review.

Objective: Juvenile idiopathic arthritis (JIA) is one of the leading causes of chronic pain in pediatric patients. Treatment regimens, which are critical to symptom management, can be burdensome, involving medication with potentially aversive side effects and exercise that can cause joint pain. Thus, it is important to examine the barriers and facilitators to adherence in JIA. While systematic reviews exist for rheumatic disease in adults, there has not yet been a synthesis of the literature examining adherence in JIA.

Methods: PsychINFO, PubMed and MEDLINE databases were systematically searched to identify qualitative and quantitative empirical studies that investigate adherence for JIA. Keywords included: patient compliance OR adherence OR persistence; youth OR children OR juvenile OR pediatric OR teen OR child OR adolescent; and rheumatoid arthritis OR idiopathic arthritis OR arthritis. Articles were excluded from the review if they involved non-human or adult samples, were non-experimental (e.g., practice recommendations), were not peer-reviewed, or were not written in English. After abstract selection, 32 articles were included in the analyses.

Results: Adherence to exercise regimens was consistently lower than adherence to medication. Researchers relied heavily on self-report of adherence, which suggests a need for additional research with more objective measures of adherence. Across studies, psychological treatment was not included, so adherence to this treatment component in JIA remains understudied.

Conclusions: Results suggest that future research should target devising and evaluating interventions to improve adherence to exercise and perhaps psychological treatment.

Implications for impact: To facilitate adherence in JIA, behavioral health providers should focus on building a strong therapeutic alliance between provider and child, fostering positive coping skills in parents and children, and monitoring the parent-child relationship.

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来源期刊
Clinical Practice in Pediatric Psychology
Clinical Practice in Pediatric Psychology Psychology-Clinical Psychology
CiteScore
2.30
自引率
18.20%
发文量
50
期刊介绍: Clinical Practice in Pediatric Psychology® publishes articles representing the professional and applied activities of pediatric psychology. The journal comprehensively describes the breadth and richness of the field in its diverse activities;complements the scientific development of the field with information on the applied/clinical side;provides modeling that addresses the ways practicing pediatric psychologists incorporate empirical literature into day-to-day activities;emphasizes work that incorporates and cites evidence from the science base; andprovides a forum for those engaged in primarily clinical activities to report on their activities and inform future research activities. Articles include a range of formats such as commentaries, reviews, and clinical case reports in addition to more traditional empirical clinical studies. Articles address issues such as: professional and training activities in pediatric psychology and interprofessional functioning;funding/reimbursement patterns and the evaluation of the cost-effectiveness of clinical services;program development;organization of clinical services and workforce analyses;applications of evidence based interventions in "real world" settings with particular attention to potential barriers and solutions and considerations of diverse populations;critical analyses of professional practice issues;clinical innovations, e.g., emerging use of technology in clinical practice;case studies, particularly case studies that have enough detail to be replicated and that provide a basis for larger scale intervention studies; andorganizational, state and federal policies as they impact the practice of pediatric psychology, with a particular emphasis on changes due to health care reform.
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