意外伤害儿童心理学特点及干预对策

Analysis and intervention of psychologic problems in children with accidental injury

目的了解意外伤害儿童心理学特点,为采取心理干预措施提供依据。方法采用艾森克个性问卷(EPQ)和Achenback儿童行为量表(CBCL,父母用表),对7～11岁住院治疗的意外伤害儿童(伤害组)和正常健康儿童(对照组)各81例进行测试。结果 EPQ的P、E、N分量表得分伤害组高于对照组(P均<0.05),对照组L分量表得分则高于伤害组(P<0.001)。伤害组CBCL平均得分(37.62±11.03)高于对照组(17.77±12.12,P<0.001);行为问题检出率(32.09%)亦高于对照组(11.11%,P<0.001),OR值3.78,95%CI为1.66～8.59。行为因子的敏感性(32.1%)较低,特异性(88.9%)和阳性结果价值(74.3%)较高。伤害组男童在多动、攻击性、违纪,女童在多动、攻击性、抑郁、违纪等因子M均高于对照组(P均<0.01)。伤害组男童CBCL平均得分(39.81±10.99)高于女童(34.26±10.43,P<0.05)。伤害的危险因子男童为攻击、多动、违纪,女童为攻击、违纪、抑郁。结论意外伤害儿童心理、行为问题较多,应采取心理干预措施,降低儿童意外伤害的发生。

Objective To study psychologic features of accidentally injured children and provide evidence for application of psychologic intervening measures.Methods Eighty-one accidentally injured children hospitalized in Tengzhou Central People＇s Hospital were enrolled in the study（ages between 7 and 11 years,injury group）,and 81 age-matched healthy children were studied as control（control group）.Eysenck personality questionnaire（EPQ） and Achenback child behavior capacity List（CBCL,list for parents） were used for the study.Results Scores of P,E,and N branch capacity in EPQ were higher,while score of L branch capacity was lower in injury group than those in control group（P〈0.05 or P〈0.001）.Average CBCL score was higher in injury group than that in control group（37.62 ± 11.03 vs.17.77 ± 12.12,respectively,P〈0.001）.Detectable rate of behavior problems was higher in injury group than that in control group（32.09% vs.11.11%,respectively,P〈0.001）.The odd ratio（OR） was 3.78,95% CI was 1.66-8.59（P〈0.01）.The sensitivity of behavior factor in detection of behavior problems was lower（32.1%）,but the positive result and specificity were higher（74.3% and 88.9%,respectively）.In the injury group,mean value of restlessness,aggression,and violation of discipline were higher in boys,while the mean value of restlessness,aggression,depression,and violation of discipline were higher in the girls（P〈0.01）.In injury group,the average score in CBCL was higher in the boys than that in the girls（39.81 ± 10.99 vs.34.26 ± 10.43,P〈0.05）.Logistic multiple factor analysis showed that the risk factors of injury for boys were aggression,restlessness,and violation of discipline,and the risk factors for the girls were aggression,violation of discipline,and depression.Conclusions Accidentally injured children have more psychologic problems in character and behavior.Psychologic intervention should be given and more attention should be paid to reduce the incidence of accidental injury in children.