聚焦解决模式在1型糖尿病患儿主要照顾者中的应用研究

Clinical values of solution- focused brief therapy for caregivers of children with type 1 diabetes

目的探讨聚焦解决模式对1型糖尿病患儿主要照顾者照顾负担和焦虑抑郁情绪的影响。方法1型糖尿病患儿126例及其主要照顾者126名使用随机数字表法分为对照组（63对）和干预组（63对）。2组均给予延续护理，同时对干预组的主要照顾者应用聚焦解决模式，分析比较干预前后2组主要照顾者照顾者负担量表（CBI）、焦虑自评量表（SAS）及抑郁自评量表（SDS）变化。结果干预前，2组间CBI和SAS、SDS水平比较差异均无统计学意义（P〉0．05）。干预后，干预组CBI总分和5个维度时间依赖性负荷、发展受限性负荷、生理性负荷、社交性负荷、情感性负荷得分分别为（42．78±11．44）、（15．74±3．97）、（10．76±2．14）、（6．85±1．09）、（6．15±0．95）、（3．28±0．56）分，也均低于对照组的（51．87±12．20）、（17．67±4．76）、（12．74±2．58）、（8．73±1．13）、（7．98±1．26）、（4．75±0．75）分，差异有统计学意义（f=2．47～12．47，P〈0．05）；干预后干预组SAS（35．43±9．34）分、SDS（42．54±10．24）分，显著低于对照组的（46．52±11．42）、（50．06±12．07）分，差异有统计学意义（t=5．66、4．01，P〈0．05）。结论聚焦解决模式能够有效降低1型糖尿病患儿主要照顾者的照顾负担，并显著缓解其焦虑抑郁情绪。

Objective To investigate the effect of solution-focused brief therapy on the care burden, depression and anxiety emotions in the primary caregivers of children with type I diabetes. Methods Totally126 children with type 1 diabetes and 126 primary caregivers were randomly divided into two groups, control group （n=63 pairs） and intervention group （n=63 pairs） using random number table method. And the two groups were given conventional nursing care. For the intervention group, the primary caregivers accepted the solution-focused brief therapy. The Caregiver Burden Inventory （CBI）, Self- rating Anxiety Scale （SAS）, and Self- rating Depression Scale （SDS） before and after interventions were compared between the two groups. Results Before intervention, CBI, SAS and SDS were similar between the two groups （P〉 0.05）. After intervention： the CBI total score and five sessions, ie, time-dependent load, development-limited load, physiological load, social load, and emotional load of the intervention group were （42.78 ± 11.44）, （15.74 ± 3.97）, （10.76 ± 2.14）, （6.85 ± 1.09）, （6.15 ± 0.95）, （3.28 ± 0.56） , respectively, which were significantly lower than those of the control group （51.87 ± 12.20）, （17.67 ± 4.76）, （12.74 ± 2.58）, （8.73 ± 1.13）, （7.98 ± 1.26）, （4.75 ± 0.75） （t =2.47-12.47, P 〈 0.05）. After intervention, the SAS （35.43 ± 9.34） and SDS （42.54 ± 10.24） were significantly reduced for the intervention group compared with the control group （46.52 ± 11.42） and （50.06 ± 12.07） （t =5.66, 4.01, P〈0.05）. Conclusions Solution-focused brief therapy can effectively decrease the care burden of primary caregivers of children with type 1 diabetes and alleviate their anxiety and depression emotions.