创伤聚焦的认知行为管理在癫痫患儿中的应用

Application of Trauma-Focused Cognitive-Behavioral Management in Children with Epilepsy

目的:探讨创伤聚焦的认知行为管理(TF-CBT)在癫痫患儿中的应用效果。方法:选择2020年1月1日~7月31日收治的癫痫患儿81例作为研究对象,根据入院顺序编号,按照抽取到纸条上的单双数分为观察组41例和对照组40例。对照组采用常规护理,观察组在常规护理基础上采用TF-CBT。干预前、干预后6个月分别采用Piers-Harris儿童自我概念量表、Addenbrooke评估量表(ACE-Ⅲ)、儿童适应行为量表(SAB)、癫痫患儿生活质量问卷(QOLCE)比较两组自我概念、认知能力、适应行为能力和生活质量。结果:干预后,观察组Piers-Harris儿童自我概念量表各分量表评分和总分高于对照组(P<0.01,P<0.05),ACE-Ⅲ中注意和定向、记忆力、语词流利性、语言、视空间能力得分及总分高于对照组(P<0.01,P<0.05),适应能力商数(ADQ)高于对照组(P<0.01),QOLCE中身体情况、认知、自评健康、情绪、社会活动、行为、自评生活质量得分高于对照组(P<0.05,P<0.01)。结论:采用TF-CBT能有效改善癫痫患儿的自我概念和认知能力,提高其适应行为能力和生活质量。

Objective:To explore the application effect of trauma-focused cognitive-behavioral therapy(TF-CBT)on children with epilepsy.Methods:A total of 81 children with epilepsy admitted during January 1 to July 31,2020 were selected as the rerseach subjects,and they were divided into observation group with 40 cases and the control group with 41 cases according to the random number table method.The control group was given routine nursing,while the observation group applied trauma-focused cognitive-behavioral management on the basis of the control group.Before intervention and after 6 months of intervention,Piers-Harris Child Self-Concept Scale,Addenbrooke Cognitive ExaminationⅢ(ACE-Ⅲ),Scale of Adaptive Behavior(SAB)and Quality of Life in Children with Epilepsy(QOLCE)were adopted to compare the self-concept,cognitive ability,adaptive behavior ability and quality of life in children.Results:After intervention,the dimensional and total scores of Piers-Harrisin in the observation group were higher than those in the control group(P<0.01,P<0.05).The dimensional and total scores of attention and orientation,memory,verbal fluency,language and visual spatial ability of ACE-Ⅲin the observation group after intervention were higher than those in the control group(P<0.01,P<0.05).The adaptive capacity quotient(ADQ)in the observation group was higher than that in the control group(P<0.01).The scores of physical condition,cognition,self-rated health,emotions,social activities,behaviors and self-rated quality of life were higher in the observation group than those in the control group(P<0.01,P<0.05).Conclusion:Trauma-focused cognitive-behavioral management can effectively improve the self-concept and cognitive ability,and enhance the adaptive behavior ability and quality of life in children with epilepsy.