基于行为转变理论的孤独症谱系障碍儿童家庭赋能干预方案构建

Construction of a family empowerment intervention program for children with autism spectrum disorder based on the TTM theory

  • 摘要:
    目的 构建基于行为转变理论(TTM)的孤独症谱系障碍(ASD)儿童家庭赋能干预方案,从神经多样性视角出发,聚焦家庭赋能的核心理念,强调发掘儿童优势与培养家庭自主性。
    方法 于2025年2月至8月在珠海市妇幼保健院以TTM为基础,整合循证与质性访谈方法,形成ASD儿童家庭赋能方案初稿。采用德尔菲法,遴选15名ASD医疗、康复和护理等领域专家,通过电子邮件、腾讯会议等方式进行3轮问卷函询。最后形成ASD儿童家庭赋能方案。
    结果 3轮专家函询问卷和有效回收率均为100.00%;专家权威性Cr值为0.966。Kendall’ s W 值为0.788。第3轮函询结果中,一级条目的重要性赋值为4.58~ 5.00分,二级条目的重要性赋值为4.51 ~ 4.88分,三级条目的重要性赋值为 4.50 ~ 4.88分,变异系数(CV)值 < 0.25。最终构建的ASD儿童家庭赋能方案包括前意向阶段、意向阶段、准备阶段、行动阶段、维持阶段,5项一级条目,20项二级条目,49项三级条目。
    结论 本方案的构建过程方法严谨,具有较高的科学性和可靠性,从神经多样性视角出发,聚焦家庭赋能的核心理念,强调发掘儿童优势与培养家庭自主性,形成了针对不同阶段、不同维度的支持服务条目,内容详尽且具有较广的适用性,可为临床医护人员及照顾者提供参考。

     

    Abstract:
    Objective To construct a family empowerment intervention program for children with autism spectrum disorder (ASD) based on the transtheoretical model (TTM) of behavior change, focusing on the core concept of family empowerment and emphasizing the discovery of children's strengths and the cultivation of family autonomy from the perspective of neurodiversity.
    Methods From February to August 2025, the initial draft of the family empowerment program for children with ASD was formulated based on the theory of behavior change by integrating evidence-based and qualitative interview methods in Zhuhai Center for Maternal and Child Health Care. Using the Delphi method, 15 experts in the fields of medical treatment, rehabilitation and nursing care for ASD were selected. Three rounds of questionnaire inquiries were conducted via email and Tencent Meeting. Finally, the ASD children's family empowerment plan was formulated.
    Results The effective recovery rate of the three rounds of expert questionnaire was 100.00%. The Cr value was 0.966. The Kendall's W value was 0.788. The results of the third round of inquiry were as follows: the importance score for the first-level items ranged from 4.58 to 5.00, from 4.51 to 4.88 for the second-level items, and from 4.50 to 4.88 for the third-level items, CV < 0.25. The final constructed ASD children's family empowerment program includes: the pre-intention stage, intention stage, preparation stage, action stage, and maintenance stage, consisting of 5 first-level items, 20 second-level items, and 49 third-level items.
    Conclusions The construction process of this plan is rigorous and highly scientific and reliable. From the perspective of neurodiversity, it focuses on the core concept of family empowerment, emphasizing the discovery of children's strengths and the cultivation of family autonomy. It has formed support service items for different stages and different dimensions, with detailed content and widespread applicability. It can provide references for clinical medical staff and caregivers.

     

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