慢性病儿童应激源应对方式及心理状态的研究

Stressors,coping strategies and psychosocial state of children with chronic illness

目的在治疗慢性病儿童的同时,了解患儿的应激源、应对方式及心理状态,对于帮助他(她)们更好地应对慢性病的挑战、适应慢性病的状态是非常有帮助的。该研究旨在了解我国慢性病儿童的应激源、应对方式、心理状态及其影响因素,为儿科工作者提供信息,为临床干预提供依据。方法对203名8～16岁慢性病儿童进行调查,采用半结构访谈方式了解其应激源,采用CODI自评应对方式量表、儿童焦虑性情绪障碍筛查表(SCARED)、儿童抑郁障碍自评量表(DSRSC)了解其应对方式及焦虑、抑郁状态。结果①患儿应激源主要包括学习、疾病治疗、日常生活、与同学/伙伴关系4个方面。②患儿最常采用的应对方式是"幻想",其次是"接受","负性情绪反应"使用率最少。③慢性病儿童焦虑、抑郁量表得分均高于常模。被调查者中,43.8%患儿存在焦虑障碍,30.0%存在抑郁障碍,26.1%同时存在焦虑和抑郁障碍。结论慢性病儿童应激源较多,虽然相对较多采用积极应对方式,但其焦虑障碍和抑郁障碍仍比较普遍而且严重,应引起关注。

Objective Identifying the stressors, coping strategies, and psychosocial state of children with chronic illness would be very useful to help them to adapt to chronic medical conditions. This study aimed to investigate the stressors, coping strategies, and psychosocial state of Chinese children with chronic illness. Methods Two hundred and three children with chronic illness and aged 8-16 years were administered a semi-structured interview for the identification of stressors. Children＇s coping strategies and psychosocial state were investigated by the Coping with a Disease （CODI） scale, the Screen for Child Anxiety Related Emotional Disorders （SCARED） scale, and the Depression Self-rating Scale for Children （DSRSC）. Results The stressors in children with chronic illness mainly included four aspects： school performance, medication and treatment, daily life, and peer relationships. ＂Wishful thinking＂ was the most common coping strategy, followed by ＂acceptance＂. ＂Negative emotional reaction＂ was rarely seen in children with chronic illness. The scores of anxiety and depression scales of children with chronic illness were higher than those of the norm. The prevalence of anxiety disorders was 43. 8% , the prevalence of depression disorders was 30. 0% , and 26. 1% of the children had both anxiety and depression disorders. Conclusions Children with chronic illness have many stressors. Though they usually use active coping strategies, the prevalence of anxiety disorders and the prevalence of depression disorders were high.