学龄前恶性肿瘤患儿意志控制在家庭环境与情绪行为间的中介效应

Mediating effect of children's effortful control between home environment and emotional behavioral problems among preschool children with malignant tumors

目的:探讨学龄前恶性肿瘤患儿意志控制在家庭环境与儿童情绪行为间的中介作用,为有情绪行为问题儿童及家庭干预提供参考。方法:采用家庭亲密度和适应性量表(family adaptation and cohesion evaluation scalesⅡ,FACESⅡ)、简化版儿童气质量表(child behavior questionnaire-very short form,CBQ-VSF)、长处与困难问卷(strengths and difficulties questionnaire,SDQ)对353名学龄前恶性肿瘤患儿进行问卷调查后,应用AMOS 22.0统计软件构建路径分析模型,Bootstrap法进行中介效应检验。结果:学龄前恶性肿瘤患儿家庭亲密度和适应性得分为(51.63±12.41)分、(55.43±10.16)分,意志控制得分为(3.23±0.80)分,长处与困难问卷困难总分及情绪症状、品行问题、过度活跃、同伴问题、亲社会行为维度得分分别为(13.75±3.66)分、(2.83±0.90)分、(2.73±0.99)分、(2.67±0.93)分、(2.76±0.85)分、(2.67±0.85)分。学龄前恶性肿瘤患儿家庭亲密度和适应性得分与意志控制得分呈正相关(r=0.244、0.289,P<0.01);意志控制得分与情绪行为得分呈负相关(r=-0.365^-0.302,均P<0.05);家庭亲密度和适应性得分与情绪行为得分呈负相关(r=-0.323^-0.124;r=-0.342^-0.181,均P<0.05);且通过意志控制间接影响情绪行为(直接效应值为-0.469,间接效应值为-0.102,间接效应占总效应的17.86%)。结论:学龄前恶性肿瘤患儿意志控制在家庭环境与儿童情绪行为间产生显著中介效应,医护人员需要密切关注其意志控制水平,指导家属采取精准干预措施减少学龄前恶性肿瘤患儿情绪行为问题,增强其社会适应能力。

Objective:To explore the mediating effect of children's effortful control on the relationship between home environment and children's behavioral emotional problems in preschool children with malignant tumors and to provide evidences for family intervention on behavioral emotional problems in children.Methods:Totally 353 preschool children with malignant tumors were investigated with family adaptation and cohesion evaluation scales II(FACES II),child behavior questionnaire-very short form(CBQ-VSF)and strengths and difficulties questionnaire(SDQ),AMOS 22.0 software was used to construct a structural equation model in data analysis and the Bootstrap method was used to test the mediation effect.Results:The scores of family adaptation and cohesion,children's effortful control,difficulty questionnaire were(51.63±12.41),(55.43±10.16),(3.23±0.80)and(13.75±3.66).The scores of dimensions including emotion,conduct,hyperactivity,peer problems,prosocial of difficulty questionnaire were(2.83±0.90),(2.73±0.96),(2.67±0.93),(2.76±0.85),(2.67±0.85),respectively.Family adaptation and cohesion were positively correlated with children's effortful control(r=0.244,0.289,P<0.01).Children's effortful control was negatively correlated with children's behavioral emotional problems(r=-0.365--0.302,all P<0.05).Family adaptation and cohesion were negatively correlated with children's behavioral/emotional problems(r=-0.323--0.124,r=-0.342--0.181,all P<0.05).The direct effect value was-0.469,indirect effect value was-0.102,accounting for 17.86%of the total effect.Conclusion:Children's effortful control exert a significant mediating effect on the relationship between home environment and children's behavioral/emotional problems in preschool children with malignant tumors,suggesting that medical staff should pay attention to the level of effortful control of preschool children with malignant tumors in order to take effective actions to reduce children's behavioral/emotional problems and improve social applicability.