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Title: Effectiveness of a modified comprehensive behavioral intervention for tics for children and adolescents with tourette's syndrome: A randomized controlled trial.
Author: Chen CW, Wang HS, Chang HJ, Hsueh CW.
Journal: J Adv Nurs; 2020 Mar; 76(3):903-915. PubMed ID: 31782167.
Abstract:
AIM: To evaluate the effectiveness of a modified four-session Comprehensive Behavioral Intervention for Tics programme for decreasing tics in children and adolescents with Tourette's syndrome. BACKGROUND: Comprehensive Behavioral Intervention for Tics programme has been shown to decrease tic severity. However, the lack of behaviour therapists in countries, such as in Taiwan, may preclude application of the standard eight-session, 10-week programme. DESIGN: Randomized controlled study. METHODS: Participants aged 6-18 years diagnosed with Tourette's syndrome or chronic tic disorder were recruited from February 2015 through September 2016. Participants in the control and intervention groups (N = 23 each) received the routine care (daily pyridoxine [50 mg] and psychoeducation). The intervention group received additional four behavioural intervention sessions over a 3-month period that included psychoeducation, habit reversal training, relaxation training, and education on tic relapse prevention. The outcome measures, Yale Global Tic Severity Scale scores, were assessed at before and after the completion of programme for both groups and again at 3 months follow-up for the intervention group. The effect of the intervention on severity scores was assessed using a generalized estimated equation. RESULTS: Comparison of scores before and after intervention showed that the intervention significantly decreased the severity of total motor tics (B = -3.28, p < .01) and total tics (B = -5.86, p < .01) as compared with control treatment. YGTSS scores for the intervention group were lower at 3-month follow-up as compared with before treatment or immediately after treatment completion (total tics, p < .001). CONCLUSION: The modified four-session Comprehensive Behavioral Intervention for Tics programme was more effective than routine care for decreasing tic severity in our cohort of 6- to 18-year olds. This improvement was maintained 3 months after intervention. IMPACT: Healthcare providers, including nurses, in countries currently not adopting Comprehensive Behavioral Intervention for Tics programme should be made aware of the positive effects of this modified intervention for Tourette's syndrome. 目的: 评价经改良的四期综合性行为干预措施(用于抽动治疗方案)对减轻患有图雷特综合征的儿童和青少年的抽动行为的有效性。背景: 有研究表明,综合性行为干预(用于抽动治疗方案)可降低抽动行为的严重程度。然而,在台湾等地区,行为治疗师人手短缺可能会妨碍八期十周方案的实施效果。设计: 随机对照研究。方法: 2015年2月至2016年9月招募6-18岁经诊断患有图雷特综合征或慢性抽动障碍的参与者。对照组和干预组(每组N=23人)的参与者均接受了常规护理(每日服用吡哆醇【50毫克】,进行心理教育)。干预组在3个月内还接受了另外4次行为干预治疗,包括心理教育、习惯逆转训练、放松训练和预防抽动搐复发教育。在治疗方案完成前后分别对两组的结果指标--耶鲁综合抽动严重程度量表评分进行评价,并在3个月随访时再次对干预组的结果指标进行评价。同时采用广义估计方程来评估干预措施对严重程度量表评分的影响。结果: 干预前后评分的比较结果表明,与对照治疗相比,干预措施显著降低了整体运动抽动(B = −3.28,p < .01)和整体抽动(B = −5.86,p < .01)的严重程度。与治疗前或治疗完成后相比,干预组在3个月随访时的耶鲁综合抽动严重程度量表评分较低(整体抽动,p<0.001)。结论: 经改良的四期综合性行为干预措施(用于抽动治疗方案)对降低6-18岁群体的抽动严重程度比常规治疗更有效。这一改善情况可在干预后保持3个月。影响: 针对目前尚未采用综合性行为干预措施(用于抽动治疗方案)的国家,包括护士在内的医疗服务提供者应了解此种改良的干预方案对图雷特综合征的积极治疗效果。.

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