Discontinuation of enterostomy tube feeding by behavioral treatment in early childhood: A randomized controlled trial

被引:64
作者
Benoit, D
Wang, EEL
Zlotkin, SH
机构
[1] Hosp Sick Children, Dept Psychiat, Div Clin Epidemiol, Toronto, ON M5G 1X8, Canada
[2] Hosp Sick Children, Dept Psychiat, Div Gastroenterol & Clin Nutr, Toronto, ON M5G 1X8, Canada
[3] Hosp Sick Children, Dept Pediat, Div Gastroenterol & Clin Nutr, Toronto, ON M5G 1X8, Canada
[4] Hosp Sick Children, Dept Pediat, Div Clin Epidemiol, Toronto, ON M5G 1X8, Canada
[5] Hosp Sick Children, Res Inst, Toronto, ON M5G 1X8, Canada
[6] Univ Toronto, Toronto, ON M5G 1X8, Canada
基金
英国医学研究理事会;
关键词
D O I
10.1067/mpd.2000.108397
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective: To determine whether behavior therapy was more effective than nutritional therapy in obviating the need for. enteral feeding in infants with resistance to feeding. Study design: Sixty-four children aged 4 to 36 months who were tube fed for at least 1 month and had resistance to feeding were randomly assigned to either behavioral or nutritional interventions (32 per group). For 7 consecutive weeks subjects and their primary feeders attended a weekly clinic with 1 of 2 dietitians followed by 4 follow-up visits. The nutritional intervention provided structured schedules and routines to stimulate the hunger/satiety cycle. The behavioral intervention provided the same schedules and routines plus behavioral therapy (extinction). The primary outcome measure was the proportion of successes, defined as infants no longer requiring tube feeding at the third follow-up visit in each group (4 1/2 months after start of trial). The decision to discontinue tube feeding was made by an independent olsen er who used criteria defined before the study commencement. Results: Fifteen (47%) of 32 subjects in the behavioral group versus none in the nutritional group were successes (P < .001). Conclusion: Behavior therapy is more efficacious in eliminating the need for tube feeding than nutritional counseling alone.
引用
收藏
页码:498 / 503
页数:6
相关论文
共 29 条
[1]   ASSESSMENT AND TREATMENT OF FOOD AVERSION IN A 4-YEAR-OLD BOY - A MULTIDIMENSIONAL APPROACH [J].
ARCHER, LA ;
SZATMARI, P .
CANADIAN JOURNAL OF PSYCHIATRY-REVUE CANADIENNE DE PSYCHIATRIE, 1990, 35 (06) :501-505
[2]  
ARTSRODAS D, 1998, J PAEDIATR CHILD H, V3, P21
[3]  
BABBITT RL, 1994, J DEV BEHAV PEDIATR, V15, P278
[4]   FACTORS ASSOCIATED WITH THE TRANSITION TO ORAL-FEEDING IN INFANTS FED BY NASOGASTRIC TUBES [J].
BAZYK, S .
AMERICAN JOURNAL OF OCCUPATIONAL THERAPY, 1990, 44 (12) :1070-1078
[5]   Posttraumatic feeding disorders [J].
Benoit, D ;
Green, D ;
ArtsRodas, D .
JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY, 1997, 36 (05) :577-578
[6]  
Benoit D, 1998, INFANT MENT HEALTH J, V19, P409, DOI 10.1002/(SICI)1097-0355(199824)19:4<409::AID-IMHJ4>3.0.CO
[7]  
2-W
[8]  
Benoit D., 2000, HDB INFANT MENTAL HL, V2nd, P339
[9]  
BENOIT D, 1995, 42 ANN M AM AC CHILD
[10]  
BENOIT D, 1993, HDB INFANT MENTAL HL, P317