烧伤瘢痕整复手术前后患儿及家属心理状况及影响因素分析:一项预实验

Analysis of psychological status and influencing factors of children and their families before and after burn scar reconstructive surgery

目的初步评估烧伤瘢痕整复手术前后患儿心理、行为状况及家属的心理健康状况,探讨相关影响因素。方法采用调查问卷的方式,记录患儿烧伤及治疗经过、瘢痕部位、家属的基本情况。在术前及术后6个月分别根据Achenbach儿童行为量表(CBCL)对患儿心理、行为状况进行测评,同时采用医院焦虑抑郁量表(HADS)对患儿家长心理状况进行评定。结果23.10%(3/13)的患儿家长认为烧伤瘢痕对患儿的情绪和行为存在不良影响,但根据CBCL评分未发现患儿存在抑郁、焦虑情绪及行为的异常。术前有30.80%(4/13)的患儿家长存在焦虑、抑郁问题,15.40%(2/13)的患儿家属存在可疑的不良情绪,53.80%(7/13)的患儿家属无焦虑、抑郁症状。术后6个月患儿家属焦虑、抑郁状况同术前无明显变化(P>0.05)。而患儿年龄、烧伤时间、患儿被烧伤时家属是否在场、烧伤面积、烧伤是否行手术治疗、防治瘢痕情况、瘢痕部位、对瘢痕治疗满意情况、家长文化程度、家庭婚姻状况、家庭年收入、家属与患儿的关系、家长主观对患儿情绪及行为异常的评价等因素都与患儿家属焦虑、抑郁状况无明显相关性(P>0.05)。结论本预实验提示烧伤瘢痕患儿家属存在一定程度的抑郁和焦虑情绪,患儿接受手术后其家属的不良情绪并不能得到明显改善。后续计划纳入更多病例,侧重研究患儿家属的心理状况及相关影响因素,并进一步纳入其家庭社会支持、自身心理应对方式等因素进行分析。

Objective To Preliminary evaluate the psychological and behavioral status of children and their families before and after burn scar surgery,and to explore the relevant influencing factors.Methods A questionnaire was used to record the children's burn and treatment process,scar location,and general information of family members.The psychological and behavioral status of the children were evaluated according to the Achenbach Child Behavior Scale(CBCL)before and 6 months after the operation,and the psychological status of the parents of the children was evaluated by the Hospital Anxiety and Depression Scale(HADS).Results 23.10%(3/13)of the children's parents thought that burn scar had a negative impact on the children's mood and behavior,but no depression,anxiety and behavior abnormalities were found according to CBCL score.Before surgery,30.80%(4/13)of the children's parents had anxiety and depression problems,15.40%(2/13)of the children's family members had suspected bad emotions,and 53.80%(7/13)of the children's family members had no anxiety and depression symptoms.There were no significant changes in anxiety and depression of the family members 6 months after operation(P>0.05).And age,burn time,whether family members present while burns,the area of the burns,whether the burn was treated with surgery,prevention and treatment of scar and satisfaction with scar treatment,parents educational level,family marital status,family income,the relationship between families and children,parents'subjective evaluation of children's emotional and behavioral abnormalities have no obvious correlation with the anxiety and depression of children's family members(P>0.05).Conclusion This preliminary experiment suggests that the family members of children with burn scars have a certain degree of depression and anxiety,and the family members'bad moods cannot be significantly improved after the children have undergone surgery.In the follow-up plan,more cases will be included,focusing on the study of the psychological status and influencing factors of the family members of the children,and further factors such as family social support and their own psychological coping styles will be included for analysis.