先天性小耳畸形410例患者心理状况调查研究

Psychological status of congenital microtia patients and relative influential factors:analysis of 410 cases

目的了解先天性小耳畸形患者的心理状况并探讨其相关的影响因素。方法对410例先天性小耳畸形患者进行横断面调查。以 Achenbach 儿童行为量表(CBCL)和症状自评量表(SCL-90)为标准,筛选存在心理障碍的患者,并对相关因素进行单因素 x^2检验及多因素的 Logistic回归分析。结果 83例患者(20.2%)存在"抑郁"心理;150例(36.6%)患者存在"人际关系敏感或社交困难";108例患者(26.3%)存在"敌对或攻击性"心理。患者年龄的增长(OR=1.75)、畸形程度严重(OR=2.77)、母亲受教育程度低(OR=2.49)、受到过他人讥笑(OR=2.58)、家属心理压力过重(OR=1.96)、家属对患者的态度不正确(OR=2.45)及家庭长期不和睦(OR=2.57)与患者"抑郁"心理的形成有关;年龄增长(OR=1.62)、受到过他人讥笑(OR=3.34)及家属心理压力过重(OR=1.89)与其"人际关系敏感或社交困难"心理的形成有关;受到过他人的讥笑(OR=2.47)及家属心理压力过重(OR=1.80)与"敌对或攻击性"心理的形成有关。结论应该有效地控制和避免与小耳畸形患者心理问题形成有关的危险因素,对患者进行早期教育。尽早成功地实施外耳再造手术对于防止其心理问题的产生是极为必要的。

Objective To investigate the psychologic status of congenital microtia patients and related influential factors. Methods In a cross-sectional survey for congenital microtia, 410 patients, 314 males and 96 females, aged 12 ± 6 （5-37） , underwent psychological survey with the symptom checklist-90 （SCL-90） or Achenbach child behavior checklist （ CBCL）, centering on the 3 main psychological problems ： depression, interpersonal sensitivity or social difficulties, and hostility or aggression. A questionnaire was designed to investigate the influencing factors, such as the patients＇own factors, and psychological factors of the patients＇ families Chi square test and logistic regression analysis were performed to find the factors contributing to those psychological problems. Results Psychological status of congenital microtia patients were depression existed in 83 patients （20.2%）, interpersonal sensitivity or social difficulties existed in 150 patients （36.6%）, and hostility or aggression existed in 108 patients （26.3%）. The factors, such as age （ OR = 1.75 ）, microtia grade （ OR = 2.77 ）, mother＇s education （ OR = 2.49 ）, having been subjected to ridicule（ OR = 2.58）, pressure of family affection （ OR = 1.96 ）, family attitude to patient （ OR = 2.45 ）, and deficiency of family harmony （ OR = 2.57 ） were risk factors contributing to depression of patients. The factors, such as age （ OR = 1.62）, having been subjected to ridicule（ OR = 3.34）, and pressure of family affection（ OR = 1.89） Were risk factors contributing to interpersonal sensitivity or social difficulties of the patient. The factors, such as having been subjected to ridicule （ OR = 2.47）, and pressure of family affection （OR = 1.80）were risk factors contributing to hostility or aggression of the patient. Conclusion Having been subjected to ridicule, deficiency of family harmony, and pressure of family affection are mainly risk factors of psychological problems of congenital microtia patients. Early education and early operation for the patients are necessary.