脑性瘫痪儿童父母焦虑及抑郁心理健康状况的临床研究

Clinical study on mental health status of anxiety and depression in parents of children with cerebral palsy

目的:分析比较痉挛型和不随意运动型脑瘫儿童父母焦虑及抑郁心理健康状况的特点,探讨父母焦虑及抑郁状况对脑瘫儿童康复治疗效果的影响。方法:采用Zung氏焦虑自评量表(SAS)、Zung氏抑郁自评量表(SDS)和自拟父母行为量表,对2019年1月—2019年10月在佳木斯大学附属第三医院确诊的100例痉挛型和不随意运动型脑瘫儿童父母(主要照料者)进行问卷调查。根据SAS和SDS结果,在父母焦虑抑郁组抽取痉挛型和不随意运动型脑瘫儿童各10例(共20例)为观察组,父母无焦虑抑郁组抽取痉挛型和不随意运动型脑瘫儿童各10例(共20例)为对照组。两组均接受常规康复治疗。于治疗前、治疗8周后采用粗大运动功能测试88项(GMFM-88)、儿童功能独立性测量(WeeFIM)、儿童生活质量量表3.0脑瘫模块简体中文版(PedsQL^(TM)3.0)评估。结果:痉挛型和不随意运动型脑瘫儿童父母焦虑及抑郁的心理健康状况特点有所不同。治疗8周后,两组GMFM-88评分、WeeFIM评分及PedsQLTM3.0评分较治疗前均明显提高(P<0.01)。治疗后两组GMFM-88评分无显著性差异(P>0.05),但对照组WeeFIM评分及PedsQLTM3.0评分均优于观察组(P<0.05)。结论:两种类型脑瘫儿童父母焦虑及抑郁状况存在差别,父母焦虑抑郁状况对脑瘫儿童的功能独立性和生活质量产生消极影响,可能影响脑瘫儿童身心全面康复进程。

Objective:To analyze and compare the characteristics of anxiety and depression in parents of children with spastic and dyskinetic cerebral palsy,and to explore the effect of parental anxiety and depression on the rehabilitation of children with cerebral palsy.Method:Using self-rating anxiety scale(SAS),self-rating depression scale(SDS) and self-designed parents’ behaviour scale, a questionnaire survey was conducted on 100 parents(the main caregivers) of children diagnosed as spastic or dyskinetic cerebral palsy in the Third Affiliated Hospital of Jiamusi University from January to October,2019. According to the results of SAS and SDS, 10 children with spastic cerebral palsy and 10 children with dyskinetic cerebral palsy(a total of 20) were selected in the group of parents with anxiety and depression as the observation group,and 10 children with spastic cerebral palsy and 10 children with dyskinetic cerebral palsy(a total of 20) were selected in the group of parents without anxiety and depression as the control group. Both groups received conventional rehabilitation,and were assessed by GMFM-88,Wee FIM and PedsQL^(TM)3.0 before and after therapy for 8 weeks.Result:The characteristics of anxiety and depression in parents of children with spastic and dyskinetic cerebral palsy were different. All the indexes improved after 8 weeks of treatment in both groups(P<0.01). After 8 weeks of treatment,there was no significant difference in GMFM-88 score between the two groups(P>0.05),but the WeeFIM score and PedsQLTM3.0 score of the children in the control group were both better than those in the observation group(P<0.05).Conclusion:The mental health status of parents with anxiety and depression is different in children with spastic and dyskinetic cerebral palsy. This mental health status of parents have a negative impact on the functional independence and quality of life of children with cerebral palsy,and may affect the overall recovery process of children physically and mentally.