父亲带养时间对孤独症谱系障碍患儿母亲育儿压力的影响

Reducing maternal parenting stress of children with autism spectrum disorder： father＇s involvement

目的 探讨父亲参与带养时间对孤独症谱系障碍（简称孤独症）患儿母亲压力值的影响.方法 前瞻性病例对照研究.将2015年6月至2016年1月在复旦大学附属儿科医院儿保科首次诊断为孤独症的98例患儿作为孤独症组,并纳入上海闵行区某妇幼保健院体检及某幼儿园的92名正常儿童作为对照组,进行横断面调查研究.采用家长育儿压力简表（PSI-SF）对母亲压力值进行评定,并通过收集一般情况及育儿信息,调查父母带养时间以及母亲的相关育儿压力因素.对相关育儿压力因素以及父母带养时间进行多元线性回归分析及秩和检验.结果 孤独症组母亲压力总分、亲子互动失调、育儿愁苦分量表得分与父亲带养时间显著相关（t=-2.76、-2.98、-2.79,P=0.007、0.004、0.006）;多元线性回归模型发现影响孤独症患儿母亲压力总分以及亲子互动失调分量表的相关因素仅有父亲带养时间,育儿愁苦量表相关因素还包括家庭年收入及母亲带养时间（R2=0.22、0.24、0.25）.对照组母亲育儿压力因素与父亲带养时间无关（P=0.22、0.42、0.06）.对62个（63.3％）双薪家庭的孤独症组患儿父母和72个（78.3％）双薪家庭的对照组儿童父母进行的Wilcoxon秩和检验分析显示,孤独症组患儿父亲带养时间与孤独症组患儿母亲及对照组儿童父亲带养时间差异有统计学意义[2.0（0.5,2.1）比3.5（2.4,6.0）比3.0（2.0,4.7）h,t=-86.32、-49.65,P均＜0.01].结论 在孤独症患儿的带养中,父亲的参与程度低.增加父亲的带养时间,提高父亲参与孤独症患儿家庭干预的积极性与主动性,将对缓解孤独症患儿母亲的育儿压力以及改善家庭干预模式产生积极影响.

Objective To explore the relationship between fathers＇ nursing time and maternal parenting stress of children with autism spectrum disorder （ASD）.Method Mothers of 98 ASD children who were first diagnosed in the department of Child Health Care,Children＇s Hospital of Fudan University during June 2015 to January 2016 were included in the ASD group,with mothers of 92 typical children from a Community Maternal and Child Health Hospital and a kindergarten in the control group.The evaluation of parenting stress,parents＇ nursing time and other related factors were cross-sectionally analyzed.Interview was conducted with the following tools：Parental Stress Index-Short Form （PSI-SF） for maternal parenting stress,and self-made General Parenting Information Questionnaire for nursing time of both parents and other related factors.The relationships were analyzed by Multiple Linear Regression analysis and Wilcoxon RankSum test.Result Maternal parenting stress of ASD children had a significant negative correlation with father＇s nursing time in total score of parenting stress,PCDI domain and PD domain （t =-2.76,-2.98,-2.79;P =0.007,0.004,0.006）,within which PD domain also included family annual income and mothers＇ nursing time （R2 =0.22,0.24,0.25）;while no such correlation was found in control group in terms of father＇s nursing time （P =0.22,0.42,0.06）.Wilcoxon Rank-Sum test showed that in 62 （63.3%） double-income ASD families and 72 （78.3%） double-income typical families,there were significant differences between ASD fathers＇ and ASD mothers＇ and typical fathers＇ nursing time （2.0 （0.5,2.1）vs.3.5（2.4,6.0）vs.3.0（2.0,4.7）h,t=-86.32、-49.65,allP〈0.01）.Conclusion Lack of fathers＇ involvements was common in ASD children＇s families.Increasing these fathers＇ nursing time,as well as their enthusiasm and initiative in the family intervention could relieve maternal parenting stress and improve the intervention pattern of ASD children.