接纳与承诺疗法干预发育性髋关节脱位患儿父母创伤后应激综合征临床分析

Clinical analysis of acceptance and commitment therapy intervention for post-traumatic stress disorder of parents in children with developmental dislocation of the hip

目的探讨发育性髋关节脱位(DDH)患儿父母经接纳与承诺疗法干预对其创伤后应激的影响,以期为未来该类疾病的干预方案制订提供指导。方法选取2019年5—12月湖南省儿童医院骨科108例DDH患儿父母为研究对象,分别在每名患儿父母中随机抽取1名入组观察,采用数字奇偶法将患儿父母分为观察组(奇数)与对照组(偶数),每组各54例。全部接受常规护理,观察组在此基础上接受接纳与承诺疗法。调查两组患儿父母一般资料并比较;分别于干预前,干预3、6周后,采用相关量表或问卷评估两组患儿父母创伤后应激障碍、应对方式及接纳与行动情况;干预结束时,比较两组患儿父母创伤后应激综合征发生率。结果两组患儿父母创伤后应激障碍情况各指标组间、时间点及交互作用比较,差异有统计学意义(P<0.05)。组内比较:干预3、6周后,两组患儿父母创伤后应激障碍评分均较干预前降低,且干预6周后低于干预3周后,差异有统计学意义(P<0.05);组间比较:观察组患儿父母干预3、6周后创伤后应激障碍评分均低于对照组,差异有统计学意义(P<0.05)。两组患儿父母应对方式及接纳与行动评分组间、时间点及交互作用比较,差异有统计学意义(P<0.05)。进一步两两比较,组内比较:干预3、6周后,两组患儿父母应对方式评分均高于干预前,接纳与行动评分低于干预前,且干预6周后应对方式评分高于干预3周后,接纳与行动评分低于干预3周后,差异有统计学意义(P<0.05);组间比较:观察组患儿父母干预3、6周后应对方式评分均高于对照组,接纳与行动评分均低于对照组,差异有统计学意义(P<0.05)。观察组创伤后应激综合征发生率低于对照组,差异有统计学意义(P<0.05)。结论DDH患儿父母接受接纳与承诺疗法,利于提升其对DDH相关疾病思想及感受接受度,父母能够以积极乐观的方式应对,创伤后应激障碍程度减轻,应激综合征发生减少。

Objective To investigate the effect of acceptance and commitment therapy intervention for post-traumatic stress disorder of parents in children with developmental dislocation of the hip(DDH),and to provide the guidance for the development of future intervention programs of this disease.Methods A total of 108 parents of DDH children who admitted in the Hu'nan Children's Hospital from May to December 2019 were selected as the research subjects.One person was randomly selected from the parents of each child for observation.The number parity method was used to divide the children's parents into observation group(odd numbers)and control group(even numbers),with 54 cases in each group.All selected cases received routine nursing,while observation group was given acceptance and commitment therapy based on routine nursing.The general information of the children's parents in two groups were investigated;the post-traumatic stress disorder,coping style,acceptance and action of the children's parents of two groups were evaluated by relevant scale or questionnaire before intervention,after intervention for three and six weeks;at the end of intervention,the incidence of post-traumatic stress disorder was compared between the two groups.Results There were statistically significant differences in post-traumatic stress disorder of the index group,time point and interaction comparison between the children's parents of the two groups(P<0.05).Intra-group comparison:after three and six weeks of intervention,the scores of post-traumatic stress disorder of the children's parents of the two groups were lower than those before the intervention,while after six weeks of intervention was lower than after three weeks of intervention,and the differences were statistically significant(P<0.05);comparison between groups:parental intervention of the observation group after three and six weeks,the scores of post-traumatic stress disorder were lower than those of the control group,and the differences were statistically significant(P<0.05).There were statistically significant differences in the coping style and acceptance and action scores of children's parents of the two groups between the groups,time points and interactions(P<0.05).Further pairwise comparison,intra-group comparison:after three and six weeks of intervention,the scores of the parents'coping styles of the two groups were higher than those before the intervention,while the scores of acceptance and action were lower than those before the intervention,and the score of coping style after six weeks of intervention was higher than that of three weeks after intervention,while the score of acceptance and action was lower than that of three weeks after intervention,and the differences were statistically significant(P<0.05);comparison between groups:the scores of coping styles of children in the observation group after three and six weeks of intervention were higher than those of the control group,while the scores of acceptance and action were lower than those of the control group,and the differences were statistically significant(P<0.05).The incidence of post-traumatic stress syndrome in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Acceptance and commitment therapy in parents of children with DDH can improve the acceptance of DDH-related disease thought and feeling.Parents can respond in a positive and optimistic manner,reduce the degree of post-traumatic stress disorder,and decrease the occurrence of stress syndrome.