慢性疾病儿童同胞关系的初步研究

A Preliminary study on sibling relationship of children with chronic diseases

目的探讨慢性疾病患儿与健康儿童在同胞关系方面的差异,旨在为指导二孩家庭中的慢性疾病儿童心理健康发展提供理论依据.方法选取2017年1月至2019年1月在中山大学孙逸仙纪念医院儿科住院或儿科门诊就诊的二胎家庭中慢性疾病儿童75例作为研究组,男40例,女35例,年龄9~12岁,平均(9.7±1.3)岁;依据病例对照研究原则,采用1:1配对法,选取同期75名无慢性疾病的儿童作为对照组,男40例,女35例,年龄9~12岁,平均(9.5±1.6)岁;应用同胞关系问卷(SRQ)、儿童抑郁自评量表(DSRSC)、儿童社交焦虑量表(SASC)及一般情况调查表分别对研究组与对照组进行调查.结果研究组与对照组儿童在同胞关系各维度上差异均有统计学意义(P<0.05),两组儿童的抑郁和社交阳性筛查率、抑郁和社交焦虑得分差异均有统计学意义,两组儿童抑郁总分与同胞亲密得分呈负相关(r=-0.03,P<0.001),与同胞冲突得分呈正相关(r=0.30,P<0.001);社交焦虑总分与同胞冲突得分呈正相关(r=0.30,P<0.001),与同胞竞争得分呈正相关(r=0.04,P=0.005).结论慢性疾病儿童的同胞积极维度降低,消极维度增加,其关系与抑郁、社交焦虑具有相关性.建议在进行长期生物医学干预的同时,予以足够的心理关注及预防措施,改善慢性疾病儿童的同胞关系,预防抑郁、社交焦虑,甚至同胞竞争障碍的发生.

Objective This study aims to explore the differences between the sibling relationship of children with chronic diseases and that of healthy ones,and to provide a theoretical basis for guiding the mental health development of children with chronic diseases in the two-children family.Methods Seventy-five children with chronic diseases from families with two children were recruited from the pediatric hospital or pediatric outpatient clinic of Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2017 to January 2019,as the study group.Among them,there were 40 males and 35 females,with an average age of (9.7±1.3) years old (ranging from 9 to 12 years old).A 1:1 paired control group was designed to match with them by sex and age,to conduct a case-control study.Accordingly,we further recruited 75 healthy children (including 40 males and 35 females) with an average age of (9.5 ± 1.6) years old.The samples were investigated using the sibling relationship questionnaire (SRQ),the Child Depression Self-Assessment Scale (DSRSC),the Child Social Anxiety Scale (SASC),and a questionnaire for the general population characteristics.Results There were significant differences between the study groups and their controls,in the terms of sibling relationship,depression,social positive screening rates and social anxiety scores ( P <0.05).The total score of depression was negatively correlated with the intimacy score of the children ( r=-0.30,P <0.001),but positively correlated with sibling conflict scores ( r=0.30,P <0.001).Total social anxiety score was positively correlated with sibling conflict scores ( r=0.30,P <0.001) or sibling competition scores ( r=0.04,P =0.005).Conclusion The comparison between the children with chronic diseases with the healthy ones suggest that the sibling relationship is adversely affected by the chronic diseases.Our findings promote mental health interventions to improve the sibling relationship of children with chronic diseases,particularly in the aspect of preventing depression,social anxiety or sibling rivalry disorders.