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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 鄭素芳(Suh-Fang Jeng) | |
dc.contributor.author | Fang-Chi Liu | en |
dc.contributor.author | 劉芳綺 | zh_TW |
dc.date.accessioned | 2021-06-15T11:31:38Z | - |
dc.date.available | 2018-08-26 | |
dc.date.copyright | 2016-08-26 | |
dc.date.issued | 2016 | |
dc.date.submitted | 2016-08-17 | |
dc.identifier.citation | Achenbach, T. M., Howell, C. T., Aoki, M. F., & Rauh, V. A. (1993). Nine-year outcome of the Vermont intervention program for low birth weight infants. Pediatrics, 91(1), 45-55.
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/49499 | - |
dc.description.abstract | 背景與目的:極低出生體重早產兒 (出生體重低於 1,500 公克)相較於足月兒有較高的風險會出現認知、語言、動作和行為方面的問題。先前的研究發現極低出生體重早產兒接受門診介入計畫和居家介入計畫後,其發展預後與母嬰互動療效不同。因此,本研究結合此兩種介入計畫發展以家庭為中心介入計畫,探討相較於常規照顧計畫對於極低出生體重早產兒之發展預後和母嬰互動品質之療效,並瞭解母嬰互動是否中介發展預後之療效。方法:本研究為多院之隨機對照試驗,共有269位極低出生體重之早產兒參加 (129位以家庭為中心之早產兒介入計畫組和140位常規照顧組)。本研究之以家庭為中心介入計畫和常規照顧計畫提供從住院期至矯正年齡12個月的服務,且所有參與本研究之極低出生體重早產兒於矯正年齡6和12個月以第三版貝萊氏嬰幼兒發展量表評估其認知、語言和動作功能和以六分鐘與母親自由玩樂的方式評估其母嬰互動行為。結果:兩組極低出生體重早產兒在發展分數沒有顯著的差異,進一步的分組分析結果顯示接受以家庭為中心介入計畫的第一胎嬰兒在語言發展分數顯著的高於常規照顧組 (6個月:100.1±7.7相對97.5±9.2;12個月:95.1±7.9相對93.0±8.0,p=0.03),而非第一胎的嬰兒在發展上則無組間差異。而在母嬰互動評估,接受以家庭為中心介入計畫的母親較常規照顧組母親顯著地有較多高品質行為(6個月:67.7%±20.4%比上60.0%±24.1%;12個月:73.7%±21.9%比上67.0%±19.7%,p =0.01)和較少不主動行為 (6個月:16.0%±15.7%比上23.7%±20.5%;12個月:14.1%±16.7%比上18.8%±16.8%,p<0.01),而接受以家庭為中心介入計畫的親子有較多的和諧模式(6個月:43.1%±22.1%比上41.3%±22.6%;12個月:49.8%±22.6%比上43.9%±20.1%,p=0.10)、較多的孩子失調之親子模式(6個月:29.5%±19.4%比上22.2%±16.1%;12個月:29.5%±17.5%比上28.4%±15.7%,p =0.03)和較少的母親失調之親子模式(6個月:8.6%±12.3%比上15.4%±18.0%;12個月:6.5%±11.7%比上10.3%±12.6%,p<0.01)。中介因子分析發現當分別納入母親的高品質和不主動行為、母親失調之親子模式及親子的和諧模式後會分別明顯降低以家庭為中心介入計畫對於第一胎早產兒的語言發展療效。結論:以家庭為中心之早產兒介入計畫可改善極低出生體重早產兒於第一年的母親互動行為和親子互動模式,然而卻只改善第一胎極低出生體重早產兒之語言發展。而以家庭為中心介入計畫對於第一胎極低出生體重早產兒的語言療效似乎是藉由改善其母嬰互動的品質。 | zh_TW |
dc.description.abstract | Background and Purposes: Preterm birth with very low birth weight (VLBW, birth weight <1500 g) is associated with high risk of motor, cognitive, language, and behavioral disorder. One prior study showed differential effects of clinic- and home-based intervention programs on developmental outcomes and mother-infant interaction in VLBW preterm infants. Therefore, this study was aimed to investigate the effect of a family-centered intervention program (FCIP) that combined these two intervention services on developmental outcomes and quality of mother-infant interaction in VLBW preterm infants with respect to a usual care program (UCP), and to examine whether mother-infant interaction mediated intervention effect on developmental outcomes. Method: This multi-site randomized controlled study included 269 VLBW preterm infants (129 in the FCIP group and 140 in the UCP group). The FCIP and UCP services lasted from hospitalization to 12 months of corrected age. All preterm infants and mothers were examined for child cognitive, language, and motor development by the Bayley Scales of Infant and Toddler Development- 3rd edition and for quality of interaction during a 6-min free play procedure at 6 and 12 months of corrected age. Results: The FCIP and UCP groups showed comparable developmental scores across ages. However, subgroup analysis revealed significantly higher language score in the FCIP group than in the UCP group among those firstborn (6 months: 100.1±7.7 vs. 97.5±9.2; 12 months: 95.1±7.9 vs. 93.0±8.0, p=0.03) but no group difference in the developmental scores among those not firstborn. The FCIP dyads demonstrated more high-quality (6 months: 67.7±20.4 vs. 60.0±24.1; 12 months: 73.7±21.9 vs. 67.0±19.7, p=0.01) and less inactive maternal interactive behavior (6 months: 16.0%±15.7% vs. 23.7%±20.5%; 12 months: 14.1%±16.7% vs. 18.8%±16.8%, p<0.01) together with more concordant pattern (6 months: 43.1%±22.1% vs. 41.3%±22.6%; 12 months: 49.8%±22.6% vs. 43.9%±20.1%, p=0.10) and child discordant pattern (6 months: 29.5%±19.4% vs. 22.2%±16.1%; 12 months: 29.5%±17.5% vs. 28.4%±15.7%, p=0.03) and less mother discordant pattern (6 months: 8.6%±12.3% vs. 15.4%±18.0%; 12 months: 6.5%±11.7% vs. 10.3%±12.6%, p<0.01), but comparable child interactive behavior than the UCP dyads. Mediator analysis revealed that adding high-quality maternal behavior, inactive maternal behavior, concordant dyadic pattern and mother discordant pattern had each markedly attenuated the intervention effect on language outcome among firstborn preterm infants. Conclusions: The FCIP benefited maternal interactive behavior and dyadic interactive pattern in VLBW preterm infants at 6 and 12 months of corrected age. However, the intervention improved the language development at 6 and 12 months of corrected age in firstborn preterm infants only. Furthermore, the language effect appeared to be mediated via enhanced mother-infant interaction among firstborn preterm infants. | en |
dc.description.provenance | Made available in DSpace on 2021-06-15T11:31:38Z (GMT). No. of bitstreams: 1 ntu-105-R03428009-1.pdf: 3715143 bytes, checksum: 55558a52a5d7bbff5d28b872aeabf201 (MD5) Previous issue date: 2016 | en |
dc.description.tableofcontents | Contents I
English Abstract IV Chinese Abstract VII Chapter 1. Introduction 1 Chapter 2. Method 6 2.1 Participants 6 2.2 Interventions 7 2.3 Outcome measurements 10 2.3.1 Bayley scales of infant and toddler development-3rd edition 10 2.3.2 Free-play procedure and coding measures 11 2.3.3 Home Activity Diary 15 2.4 Statistical analysis 15 Chapter 3. Results 16 3.1 Participants 16 3.2 Intervention effect on developmental outcomes 17 3.3 Intervention effect on mother-infant interaction 18 3.4 Moderating role of firstborn on intervention effect 21 3.5 Mediating role of quality of mother-infant interaction 22 Chapter 4. Discussion 23 Chapter 5. Conclusion 30 Chapter 6. Acknowledgements 31 Chapter7. References 32 Tables and Figure 46 Figure 1 Flow chart 46 Table 1 Description of the programs content 47 Table 2 Description of coding systems for mother-infant interaction 48 Table 3 Perinatal and demographic data of participants 49 Table 4 Intervention effect on developmental outcomes in preterm infants with very low birth weight 50 Table 5 Intervention effect on mother-infant interaction in preterm infants with very low birth weight 51 Table 6 Exploration of firstborn as a moderator of intervention effect in preterm infants with very low birth weight 52 Table 7 Intervention effect on developmental outcomes in preterm infants with very low birth weight who were firstborn and not firstborn 53 Table 8 Illustration of perinatal and demographic characteristics in firstborn and not firstborn participants 54 Table 9 Illustration of adherence of home activities in the family of firstborns and not firstborns in the family-centered intervention program group 55 Table 10 Analysis of mother-infant interaction as potential mediator for the intervention effect on language outcome in firstborn preterm infants in the first year 56 Supplemental table 1 Comparison of perinatal and demographic data of preterm infants with very low birth weight who returned and not returned for evaluation 57 Supplemental table 2 Intervention effect on mother-infant interaction with detailed variables in preterm infants with very low birth weight 58 Supplemental table 3 Illustration of mother-infant interaction at 6 months of corrected age for the FCIP and UCP group among firstborn preterm dyads 59 Appendix 60 Appendix 1 Free-play Coding Sheet 60 Appendix 2 Home activity diary 61 | |
dc.language.iso | en | |
dc.title | 極低出生體重早產兒以家庭為中心之介入計畫的母嬰互動與發展預後療效 | zh_TW |
dc.title | Effects of Family-Centered Intervention Program on Mother-Infant Interaction and Developmental Outcomes in Preterm Infants with Very Low Birth Weight | en |
dc.type | Thesis | |
dc.date.schoolyear | 104-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 吳晏慈(Yen-Tzu Wu),許惠瑾(Hui-Chin Hsu),張瑞幸(Jui-Hsing Chang) | |
dc.subject.keyword | 兒童發展,早期介入,療效,以家庭為中心照顧,母嬰互動, | zh_TW |
dc.subject.keyword | Developmental outcome,early intervention,effectiveness,family-centered care,mother-infant interaction, | en |
dc.relation.page | 70 | |
dc.identifier.doi | 10.6342/NTU201603092 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2016-08-17 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 物理治療學研究所 | zh_TW |
顯示於系所單位: | 物理治療學系所 |
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