Đánh giá hệ thống về tác động của việc điều chỉnh các yếu tố trước trong việc điều trị các vấn đề về giấc ngủ ở trẻ em trong phổ tự kỷ

Springer Science and Business Media LLC - Tập 6 - Trang 253-269 - 2021
Kate A. M. Ford1, Laurie K. McLay1, Karyn G. France1, Neville M. Blampied2, Rosina M. Gibbs1
1School of Health Sciences (Te Kura Mātai Hauora), University of Canterbury (Te Whare Wānanga O Waitaha), Christchurch, New Zealand
2School of Psychology Speech & Hearing (Te Kura Mahi ā-Hirikapo), University of Canterbury (Te Whare Wānanga O Waitaha), Christchurch, New Zealand

Tóm tắt

Các vấn đề về giấc ngủ được báo cáo rộng rãi ở trẻ em và thanh thiếu niên trong phổ tự kỷ. Có bằng chứng đang nổi lên về hiệu quả và tính hợp lệ xã hội của các can thiệp hành vi về giấc ngủ do cha mẹ thực hiện cho trẻ em và thanh thiếu niên trong phổ tự kỷ. Tuy nhiên, hầu hết các nghiên cứu tập trung vào các can thiệp đa thành phần bao gồm việc sử dụng phương pháp tiêu diệt, và vẫn còn những câu hỏi về hiệu quả của việc điều chỉnh các biến antecedent (bao gồm việc sắp xếp lại giờ giấc ngủ/thức) một mình. Đánh giá hệ thống này nhằm tóm tắt và đánh giá tài liệu nghiên cứu về hiệu quả của việc điều chỉnh dựa trên các yếu tố antecedent trong việc điều trị các vấn đề về giấc ngủ ở trẻ em trong phổ tự kỷ. Các nghiên cứu đủ điều kiện bao gồm một hoặc nhiều người tham gia từ 2 đến 18 tuổi mắc chứng tự kỷ và đã điều trị các vấn đề về giấc ngủ bằng các điều chỉnh đối với các biến antecedent như một liệu pháp độc lập. Dữ liệu đã được xác định từ các cơ sở dữ liệu PsycINFO, Thư viện Cochrane, Scopus, và MEDLINE và được trích xuất theo các đặc điểm của người tham gia và các vấn đề về giấc ngủ, thiết kế nghiên cứu, đặc điểm của can thiệp, các biến phụ thuộc và các thước đo giấc ngủ, kết quả điều trị, và tính hợp lệ xã hội. Chất lượng nghiên cứu đã được đánh giá bằng cách sử dụng bảng tiêu chuẩn hóa và được phân loại là “mạnh”, “đủ”, hoặc “yếu”. Tổng cộng, 12 nghiên cứu đáp ứng tiêu chí đủ điều kiện. Tất cả các nghiên cứu báo cáo sự cải thiện trong các vấn đề về giấc ngủ của hầu hết hoặc tất cả người tham gia sau khi điều chỉnh dựa trên các yếu tố antecedent. Sự cải thiện được duy trì trong lần theo dõi cho tất cả người tham gia mà dữ liệu này được thu thập. Chỉ có 3 nghiên cứu đáp ứng các tiêu chí phản ánh tính nghiêm ngặt phương pháp mạnh mẽ. Việc điều chỉnh các biến antecedent có thể giảm hoặc loại bỏ các vấn đề về giấc ngủ; tuy nhiên, cần có thêm đánh giá chặt chẽ và mở rộng có hệ thống những phát hiện này. Việc điều chỉnh tối thiểu các biến antecedent có thể được thực hiện như một lựa chọn ít hạn chế hơn so với các can thiệp dựa trên hậu quả. Đăng ký đánh giá hệ thống: PROSPERO CRD42021240539.

Từ khóa

#tự kỷ #vấn đề giấc ngủ #can thiệp hành vi #điều chỉnh antecedent #đánh giá hệ thống

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