脑性瘫痪儿童运动功能恢复过程中家长的心理状况

Mental health status of guardians of children with cerebral palsy during the recovery of motor function

目的:调查康复训练过程中脑性瘫痪儿童家长的心理健康状况。方法:选择2004-02/03在复旦大学附属儿科医院康复中心进行3个月以上康复训练的53例脑性瘫痪患儿的父母或同其共同生活的其他监护人(祖父母,外祖父母)。在获得知情同意后,共调查80人,男26人,女54人,年龄22～66岁。采用症状自评量表(包含90个项目,包括躯体化,强迫症状,人际关系,抑郁,焦虑,敌对,恐怖,偏执,精神病性9个因子。按照5级评分,1分为从无,2分为轻度,3分为中度,4分为相当重,5分为严重。参照全国成人常模标准:因子分<1.8分为正常;1.8～2.0分为轻度异常;2.1～3.0分为中度异常;>3.0分为重度异常评定其最近一周内的心理健康状况。在安静环境下,由受试者自行填写,测试前采用统一指导语,父母、祖父母或外祖父母同时参加测评者,家长之间分开测评。对于受试文化程度较低或年龄较大者,由调查人员逐条解释问卷内容。最后使用“惠诚心理测试系统”对测评结果进行得分计算。并于全国常模比较。组间比较采用t检验方法分析。结果:发放问卷80份,收回合格问卷80份,有效率100%。①脑性瘫痪儿童家长的症状自评量表的评分与全国常模的比较无显著差异(P>0.05);不同性别的脑性瘫痪儿童家长的症状自评量表的评分比较无显著差异(P>0.05)。②脑性瘫痪患儿家长其文化程度高低不同,表现在症状自评量表评分上存在差异。初中以下组症状自评量表总分及阳性项目数显著高于高中以上组(P<0.05),在人际关系,抑郁,焦虑,敌对,恐怖因子评分显著高于高中以上组(P<0.05或<0.01)。结论:脑性瘫痪患儿康复训练过程中其家长的心理状况与正常成年人之间无显著差异,亦不存在性别差异,但文化程度的高低对脑性瘫痪患儿家长的心理健康状况存在影响。

AIM： To investigate the mental health status of the guardians of children with cerebral palsy undertaking rehabilitation training. METHODS： Parents or other synchronously living guardians（grandparents, adoptive grandparents） of 53 children with cerebral palsy undertaking rehabilitation training for more than 3 months were selected from Center for Rehabilitation Medicine, Children＇s Hospital of Fudan University between February and March 2004. Having known the fact, totally 80 guardians consented to receive the survey including male 26 and female 54, aged from 22 to 66 years. The symptom checklist 90（SCL-90） questionnaire consisted of 90 items such as somatization, obsession, interpersonal relationship, depression, anxiety, hostility, fear, crankiness, psychotic diseases. The symptoms were graded from 1 to 5： be symptomless, mild, moderate, mildly severe and severe symptoms in the sequence. The SCL-90 was based on the standard for national adult norm： factor score less than 1.8 points as normality, between 1.8 and 2.0 points as mild abnormity, between 2.1 and 3.0 points as moderate abnormity, and more than 3.0 points as severe abnormity. SCL-90 was used to investigate the mental health status of them within 1 week.The guardians filled the questionnaires by themselves by the uniform instruction quietly. All the parents, grandparents or adoptive grandparents attended the test simultaneously and separately. To those with loweducational level or the elderly ones, the investigators explained the questionnaires one by one. Finally, the test results were scored by Huicheng psychometry system, which were then compared with the national norm. Inter-group comparison was analyzed by t test. RESULTS： Totally 80 questionnaires were delivered, and all of them were reclaimed with the effective rate of 100%. ①The scores of SCL-90 in the guardians of children with cerebral palsy were insignificantly different from the national norm（P 〉 0.05）, and those in the guardians in different genders were also insignificantly different（P 〉 0.05）. ②The scores of SCL-90 were significantly different in the guardians due to their different educational level. The total score and the number of positive items of SCL-90 were significantly higher and more than in the guardians below those at or above junior education level than in the senior educational level（P 〈 0.05 ）, and the scores of interpersonal relationship, depression, anxiety, hostility and fear were also significantly higher in the former than in the latter（P 〈 0.05 or P 〈 0.01）. CONCLUSION： There is unremarkable difference in the mental health status between guardians of children with cerebral palsy undergoing rehabilitation training and normal adults , also unremarkable in their gender. But the educational level has influence on the mental health status in the guardians of children with cerebral palsy.