Caregiver training improves child feeding behaviours in children with paediatric feeding disorder and may reduce caregiver stress: A systematic review and meta-analysis

The purpose of this systematic review and meta-analysis was to synthesise the evidence from randomised controlled trials for caregiver training on child and family outcomes for children with paediatric feeding disorder. A systematic review was conducted in accordance with PRISMA guidelines. Searches of Medline, CINAHL, PsychInfo, and EMBASE were conducted using the key concepts of paediatrics, feeding disorders, parents/caregivers, and training. Eligible studies included randomised controlled trials published in peer-reviewed articles, testing the impact of caregiver training on outcomes for children with paediatric feeding disorder. Eight articles met the inclusion criteria, involving 575 participants from three countries. Seven articles were included in the meta-analyses, providing high certainty evidence that caregiver training improves child feeding behaviours and reduces unhelpful caregiver mealtime strategies compared with no intervention. Uncertainty remains in regard to impact on caregiver stress and intervention intensity. Caregiver training is an effective strategy for improving outcomes in children with paediatric feeding disorder. Further research is required to determine the most effective methods of caregiver training, including the intensity of treatment required to attain clinically important benefits for families with different levels of need.

本系统评价与荟萃分析旨在整合针对儿童喂养障碍患儿的照料者培训相关随机对照试验（randomised controlled trial, RCT）证据，以探究该培训对儿童及家庭结局的影响。本研究遵循PRISMA声明开展系统评价。本研究以儿科学、喂养障碍、父母/照料者及培训为核心检索词，对Medline、CINAHL、PsychInfo及EMBASE数据库进行了系统检索。纳入研究为发表于同行评议期刊的随机对照试验，旨在探究照料者培训对儿童喂养障碍患儿结局的干预效果。最终共有8篇文献符合纳入标准，涵盖来自3个国家的575名研究对象。其中7篇文献被纳入荟萃分析，结果显示：与无干预组相比，照料者培训可显著改善患儿喂养行为，并减少照料者在进餐时段采用的无益应对策略，该结论具有高确定性。但该培训对照料者压力的影响以及干预强度的作用仍有待明确。综上，照料者培训是改善儿童喂养障碍患儿结局的有效干预手段。未来仍需开展进一步研究，以明确照料者培训的最优方案，包括针对不同需求程度的家庭实现临床显著获益所需的干预强度。