家庭环境对脑瘫患儿家长心理稳态影响的病例对照研究

关键词：家庭环境  脑性瘫痪  心理健康

Keywords:family enviroment  cerebral palsy  mental health

摘要：

      摘要 目的：比较脑瘫患儿及正常儿童家庭环境和家长心理稳态情况，分析家庭环境对家长心理稳态的影响。 方法：采用一般情况调查表、家庭亲密度适应性量表、心理弹性量表、焦虑自评量表、抑郁自评量表、幸福指数量表对138例脑性瘫痪儿童家长和119例非脑性瘫痪对照组儿童家长进行问卷调查。 结果：①CP患儿家庭独生子女比例、城市居住率、父母高学历比例、父母职业为知识分子或商人比例、家庭月收入水平、父亲年龄低于对照组（P<0.05），家庭年平均住院费用高于对照组（P<0.05）。②CP组家庭理想和现实亲密度及适应性、心理弹性和幸福指数得分均低于对照组（P<0.05），CP组亲密度和适应性不满程度、焦虑、抑郁评分均高于对照组（P<0.05）。③多元线性回归发现，年住院平均费用、父亲职业、家庭亲密度和适应性是家长心理稳态的主要影响因素；主要照顾者影响幸福指数和焦虑。 结论：脑性瘫痪儿童家庭环境不良，影响主要照顾者心理状况。医务人员及社会有关部门需采取措施改善脑性瘫痪儿童家庭环境，提升家庭功能。

Abstract:

      Abstract Objective: To assess the family enviroment and psychologic status of caregivers of developed children and cerebral palsy children,and to investigate the relationship between family enviroment and psychologic status of caregivers of children . Method: Self -designed questionnaire, FACESⅡ-CV, CD-RISC, Index of Well-being, SAS, SDS were used to survey the caregivers with cerebral palsy children from Cerebral Palsy Rehabilitation Center and the caregivers with healthy children from Child Health Care Outpatient in the hospital from August 2013 to August 2014，after rejecting invalid questionnaires，138 caregivers with cerebral palsy children and 110 caregivers with healthy children were included in the study. Result: Univariate analysis showed that CP family had lower ratio on single- child ,living in the city,high education experience of parents, parents's occupation with business and intellect, family income, younger father, but had higher ratio on the average medical cost, compared to control group(P<0.05), CP group had low score on real cohesion [Median,Rang(64,57 )vs.(71,45)],ideal cohesion [Median, Rang (73,56) vs. (78,39)], and real adaption [Median, Rang (43,51) vs. (49,41)] , ideal adaptation [Median, Rang (53,43) vs. (56,41)], the psychological resilience [(58.83±17.45) vs. (68.84±14.31) and the subjective well-being [(9.35±3.36) vs. (11.06±3.25)],but had higher score on cohesion dissatisfaction degree [Median ,Rang (10,55) vs. (7,46)], adaptability dissatisfaction degree[Median,Rang(10,50)vs.(7,34)], anxiety [(51.52±11.63)vs. (42.18±9.88)] and depression [(53.27±11.89) vs. (47.25±9.99)], compared to control group (P<0.05). Multiple liner regression analyses showed that the influencing factors of psychologic status of caregivers of children included father’s occupation, primary caregiver, the average medical cost and family cohesion and adaptation (P<0.05). Conclusion: Family enviroment of children with cerebral palsy needs to be improved. At the same time of treating the children with cerebral palsy, the environmental states of caregivers and the families with cerebral palsy children should be paid more attention to，the mutual assistance and self -help among the family members should be encouraged, relevant support and help should be provided to the families with cerebral palsy children