2～3岁脑瘫患儿行为问题影响因素及差异性研究

Influential Factors for Behavioral Problems of Cerebral Palsy Children Aged 2-3 and Its Difference

目的 探讨2～3岁脑瘫患儿行为问题发生的影响因素及其差异性,为脑瘫患儿实施早期心理行为干预提供依据.方法 选取2010年1-12月重庆医科大学附属儿童医院康复中心确诊的2～3岁脑瘫患儿138例,采用2～3岁Achenbach儿童行为评定量表及自拟基本情况调查表进行调查,用多元逐步回归法分析行为问题影响因素,并对最终进入回归方程的影响因素进行差异性分析.结果 脑瘫患儿除躯体诉述外,其余各行为因子（社交退缩、抑郁、睡眠问题、攻击行为、破坏行为）得分及总分与常模比较,差异有统计学意义（P＜0.05）.多元逐步回归结果显示,住院时间、家庭经济状况、父母期望值、社会活动次数4个因素最终进入回归方程,有统计学意义（P＜0.05）.在住院时间上,住院1～3个月的患儿社交退缩、抑郁、攻击行为、破坏行为及行为总分均高于住院时间＜1个月的患儿,差异有统计学意义（P＜0.05）;住院＞3个月的患儿睡眠问题、躯体诉述、社交退缩、抑郁、攻击行为、破坏行为及行为总分均高于住院＜1个月的患儿,差异有统计学意义（P＜0.05）.在家庭经济状况上,家庭人均月收入≤3000元的患儿除躯体诉述外,其余各行为因子得分及总分均高于家庭人均月收入3 001 ～5 000元的患儿,差异有统计学意义（P＜0.05）;家庭人均月收入≤3000元的患儿除躯体诉述外,其余各个行为因子得分及总分均高于家庭人均月收入＞5 000元的患儿,差异有统计学意义（P＜0.05）.在父母期望值上,父母对患儿的康复效果期望值过高的患儿,除躯体述诉外,行为问题总分及其他各因子得分均高于父母期望值合理的患儿,差异有统计学意义（P＜0.05）.在参加社会活动上,经常参加社会活动的脑瘫患儿除躯体诉述、睡眠问题、破坏行为外,行为总分及其他各因子得分均低于偶尔参加或不参加社会活动的脑瘫患儿,差异有统计学意义（P＜0.05）.结论 住院时间、家庭经济状况、父母期望值、社会活动次数是影响脑瘫患儿行为问题发生的4个因素,且住院时间越长、家庭收入越低、父母期望值过高以及不参加社会活动的脑瘫患儿行为问题越严重.

Objective To explore the influential factors of behavioral problems in cerebral palsy children （CP） and analyze its differences so as to provide evidence for early psychological intervention. Methods Totally 138 children with cerebral palsy determined by the Recovery Center, Children＇s Hospital of Chongqing Medical University from January to December 2010 were investigated by 2 - 3 Achenbach child behavior checklist and self - made basic information questionnaire. Their behavioral problems were analyzed by multiple regression analysis and the factors which finally entered the regression equation were undergone difference analysis. Results Except body complaints, the scores of each other behavior factor （ social withdrawal, depressive anxiety, sleeping problems, aggressive behavior and destruction behavior ） as well as the total of cerebral palsy children compared to those of the norms and the differences were significant （ P 〈 0.05 ） . Multiple regression analysis showed that four factors including length of hospitalization, family income, expectation of parents and social activities entered the regression equation, with significance （ P 〈0.05 ） . In length of hospitalization, the scores of each behavior factor and the total of children whose length of hospitalization was 1 -3 months were higher than those of children who hospitalized for less than one month, with significance （ P 〈 0. 05 ） . In family income, except body complaints, the scores of others and the total were higherin children whose family income was ≤ 3 000 yuan/ per month than those of 3 001 ～ 5 000, with significance （ P 〈 O. 05 ） ; except body complaints, the scores of others and the total scores were higher in children whose family income was ≤3 000 than those of 〉 5 000, with significance （P 〈 0. 05） . In parents＇ expectation, children whose parents had high expectation had higher scores in total and each behavior except body complaint than those with rational one, with significance （ P 〈0. 05 ） . In social activities, cerebral palsy children who often took part in the activities had higher scores in the total and each factor except body complaint, sleeping problem and destruction behavior than those who occasionally or never did, with significance （ P 〈 0. 05） . Conclusion Length of hospitalization, family income, expectation of parents and social activities are significant factors influencing the behavior of cerebral palsy children. With longer hospitalization, lower family income, higher expectation and inactivity in social activities, cerebral palsy children will display more serious behavioral problems.