基于儿童游戏的隐喻对脑外伤恢复期患儿心理及行为的影响

Influence of play-based metaphors on negative emotion and behavior in children recovering from brain injury

目的探讨基于儿童游戏的隐喻对脑外伤恢复期患儿心理及行为的影响,为制定针对此类患儿的基于儿儿童游戏的隐喻干预提供依据。方法选取2021年5月—2022年10月在温州医科大学附属第二医院育英儿童医院康复中心进行康复的6~12岁脑外伤恢复期患儿60名,随机分为试验组和对照组,每组30例。对照组给予常规护理方法,试验组给予基于儿童游戏的隐喻干预治疗方法。对比两组患儿社会生活能力评分、行为异常检出率、抑郁评分、焦虑评分、认知功能评分。结果干预前,两组患儿各项量表评分差异均无统计学意义(P>0.05)。干预后试验组婴儿-初中生社会生活能力评分(t=3.175),简易精神状态检查评分(t=5.265)和洛文斯顿作业疗法认知评定量表评分(t=7.835)均高于对照组(P<0.001)。试验组患儿儿童行为量表(CBCL)评分(Z=7.823),抑郁-问卷总分(t=6.398)和儿童焦虑性情绪障碍筛查表总分(t=6.248)均低于对照组(P<0.001)。结论基于儿童游戏的隐喻干预了减轻脑外伤恢复期患儿的焦虑抑郁的负性情绪,提高患儿社会生活能力,降低CBCL评分,并改善患儿的认知功能。

Objective To explore the effect of metaphors based on children′s games on the negative emotion and behavior of children during the recovery period of traumatic brain injury,in order to provide reference for making intervention strategy for these children.Methods From May 2021to October 2022,a total of 60children aged 6-12years who underwent rehabilitation in the rehabilitation center of the Second Affiliated Hospital of Wenzhou Medical University were selected into this study,and were randomly divided into experimental group and control group,with 30cases in each group.The control group was given routine nursing,while the experimental group was given metaphorical intervention based on children′s games.The scores of social living ability,abnormal behavior detection rate,depression score,anxiety score and cognitive function were compared between the two groups.Results The scale score of the two groups was not significantly different before intervention(P>0.05).After intervention,the infant-junior high school students′social living ability score,Mini-Mental State Examination and the Loewenstein Occupational Therapy Cognitive Assessment score in the experimental group were higher than those in the control group(t=3.175,5.265,7.835,P<0.001).The scores of Child Behavior Checklist(CBCL),the children′s depression inventory and the screen for child anxiety related emotional disorders in the experimental group were lower than those in the control group(Z=7.823,t=6.398,6.248,P<0.001).Conclusions Metaphorical intervention based on children′s games can reduce the negative emotions of anxiety and depression in children with traumatic brain injury,improve their social life ability,reduce the CBCL score,and improve the cognitive function.