Acceptance and Commitment Therapy Eczema Management Program for Children With Eczema: A Pilot Randomised Controlled Trial.

IF 6.3 2区医学 Q1 ALLERGY

Clinical and Experimental Allergy Pub Date : 2025-02-03 DOI:10.1111/cea.70003

Yuen Yu Chong, Wai Tong Chien, Huan Yu Mou, Sui Ping Leung, Oi Yin Wong, Shu Yan Lam

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引用次数: 0

Abstract

Introduction: Eczema significantly affects the quality of life of affected children and their families, with psychological stress often overlooked. Acceptance and Commitment Therapy (ACT) provides a supplementary approach to address these psychological challenges and enhance overall care.

Objective: This pilot randomised controlled trial aimed to examine the feasibility, acceptability and preliminary effectiveness of the Family ACT-based Eczema Management Program (FACT-EMP).

Methods: Parents and children aged 6-12 diagnosed with eczema from three outpatient clinics in Hong Kong were randomly assigned to either the FACT-EMP group, receiving four weekly ACT-based sessions plus eczema management education, or a waitlist control group receiving routine care. Feasibility and acceptability were assessed through recruitment, retention and completion rates, supplemented by focus group feedback on parental experiences. Primary clinical outcomes were children's eczema Severity Scoring of Atopic Dermatitis (SCORAD) and parental self-efficacy. Secondary outcomes included parental distress, quality of life, psychological flexibility and self-compassion of both parents and children.

Results: From July 2021 to June 2023, 181 of 944 screened parent-child dyads met the inclusion criteria, and 78 were randomised and analysed (parents' mean [SD] age, 41.3 [11.0] years; 70 mothers [89.7%]; children's mean [SD] age, 8.3 [1.9] years; 53 boys [67.9%]). Recruitment, retention and completion rates were 43.1%, 87.2% and 76.9%, respectively. No significant between-group differences in SCORAD scores were observed immediately post-intervention. At 3-month post-intervention, SCORAD scores decreased significantly more in the FACT-EMP group than in the waitlist control group (adjusted mean difference, aMD, -7.73; 95% CI, -13.92 to -1.54). Parental self-efficacy scores also improved significantly more in the FACT-EMP group than the control, with an aMD of 18.69 (95% CI, 13.80 to 33.58) immediately post-intervention and 28.90 (95% CI, 13.93 to 43.84) at 3 months.

Conclusion: FACT-EMP is potentially feasible, acceptable and effective in improving children's eczema symptoms and enhancing parents' self-efficacy in disease management over 3 months.

Trial registration: NCT04919330.

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接受和承诺治疗湿疹管理计划的儿童湿疹：一项试点随机对照试验。

简介：湿疹显著影响患病儿童及其家庭的生活质量，而心理压力往往被忽视。接受和承诺治疗（ACT）提供了一种补充的方法来解决这些心理挑战并加强整体护理。目的：本随机对照试验旨在探讨基于家庭act的湿疹管理计划（FACT-EMP）的可行性、可接受性和初步有效性。方法：来自香港三家门诊诊所的6-12岁诊断为湿疹的父母和儿童被随机分配到FACT-EMP组，接受每周一次基于act的课程和湿疹管理教育，或接受常规护理的候补对照组。可行性和可接受性通过招募率、留任率和完成率进行评估，并辅以焦点小组对家长经历的反馈。主要临床结果为儿童湿疹特应性皮炎严重程度评分（SCORAD）和父母自我效能感。次要结果包括父母的痛苦、生活质量、心理灵活性和父母和孩子的自我同情。结果：从2021年7月至2023年6月，944对筛选的亲子对中有181对符合纳入标准，78对被随机化并进行分析(父母平均[SD]年龄41.3[11.0]岁；70例（89.7%）；儿童平均[SD]年龄8.3[1.9]岁；53个男孩[67.9%])。录取率、留任率和结业率分别为43.1%、87.2%和76.9%。干预后立即观察到组间SCORAD评分无显著差异。干预后3个月，FACT-EMP组的SCORAD评分明显低于等候名单对照组(调整平均差，aMD, -7.73；95% CI, -13.92至-1.54)。与对照组相比，FACT-EMP组的父母自我效能得分也有显著提高，干预后立即的aMD为18.69 (95% CI， 13.80至33.58)，3个月时的aMD为28.90 （95% CI， 13.93至43.84）。结论：FACT-EMP在改善患儿湿疹症状、提高家长疾病管理自我效能3个月以上具有潜在的可行性、可接受性和有效性。试验注册：NCT04919330。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Experimental Allergy 医学-过敏

CiteScore

10.40

自引率

9.80%

发文量

189

审稿时长

3-8 weeks

期刊介绍： Clinical & Experimental Allergy strikes an excellent balance between clinical and scientific articles and carries regular reviews and editorials written by leading authorities in their field. In response to the increasing number of quality submissions, since 1996 the journals size has increased by over 30%. Clinical & Experimental Allergy is essential reading for allergy practitioners and research scientists with an interest in allergic diseases and mechanisms. Truly international in appeal, Clinical & Experimental Allergy publishes clinical and experimental observations in disease in all fields of medicine in which allergic hypersensitivity plays a part.