Evaluation of a Home-Based Behavioral Treatment Model for Children With Tube Dependency
| Autor: | Javier Virués-Ortega, Sarah Ann Taylor, Bianca Jackson, Katrina J. Phillips, Suzanne C. Purdy |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Cost effectiveness medicine.medical_treatment Child Behavior Disorders Weight Gain Feeding and Eating Disorders 03 medical and health sciences 0302 clinical medicine Enteral Nutrition Swallowing Behavior Therapy 030225 pediatrics Intervention (counseling) Developmental and Educational Psychology Medicine Humans 0501 psychology and cognitive sciences Applied behavior analysis Child Intubation Gastrointestinal Gastrostomy Intention-to-treat analysis Tube dependency business.industry 05 social sciences medicine.disease Home Care Services Intention to Treat Analysis Clinical trial Treatment Outcome Caregivers Child Preschool Pediatrics Perinatology and Child Health Physical therapy Caregiver stress Female business 050104 developmental & child psychology Follow-Up Studies |
| Zdroj: | Journal of pediatric psychology. 44(6) |
| ISSN: | 1465-735X |
| Popis: | Objective To evaluate a home-based behavioral treatment model for children with tube dependency. Methods Nine children (aged 4-14 years) dependent on nasogastric and gastrostomy tubes were consecutively admitted into a home-based behavioral treatment program. A psychologist specializing in applied behavior analysis led the assessment and treatment phases with the support of caregivers and a multidisciplinary team. Caregivers participated in a caregiver training program and continued the intervention once the service was discontinued. We conducted follow-up visits up to 12 months after treatment. The program was evaluated with a multiple-baseline across participants design. We computed on-treatment and intention-to-treat effects according to the Hedges-Pustejovsky-Shadish model. We monitored behavioral (food acceptance and swallowing) and nutritional outcomes (body weight, oral intake, and tube intake), treatment acceptability and satisfaction, caregiver stress, and estimated treatment cost savings. Results Food acceptance, swallowing, oral intake, and tube intake demonstrated large treatment gains relative to pretreatment levels (effect size range of the intention-to-treat analysis = 0.74-2.1). All participants maintained or increased their body weight. Follow-up effect sizes indicated further improvements. By the final follow-up assessment, six out of the nine children had ceased tube feeding, and one had tube feeds reduced. Caregivers and health professionals provided strong ratings of treatment satisfaction. The cost-savings analysis suggested that a home-based treatment may be a cost-effective alternative to prolonged tube feeding as well as to other treatment approaches. Conclusions This study provides evidence supporting home-based multicomponent behavioral interventions in the treatment of pediatric feeding disorders. Clinical trial identifier ACTRN12614001127695, https://goo.gl/XSQ4ZH. |
| Databáze: | OpenAIRE |
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