儿童困难问卷在注意缺陷多动障碍儿童中的应用价值

Application value of the questionnaire-children with difficulties in attention deficit hyperactivity disorder

目的了解儿童困难问卷在儿童注意缺陷多动障碍中的应用价值。方法选取昆明市儿童医院儿保科2019年4月—2021年8月期间符合DSM-Ⅴ诊断标准诊断为注意缺陷多动障碍(attention deficit/hyperactivity disorder,ADHD)并且规律治疗的45例儿童,治疗前后分别填写儿童困难问卷(QCD)、中国儿童气质量表(CSTS)、SNAP-Ⅳ评定量表父母/教师用(26项)测查。结果儿童困难问卷的总分在ADHD儿童治疗前、治疗半年后不同,差异有统计学意义(P<0.05),同时SNAP-Ⅳ评定量表父母/教师用(26项)中教师及家长在注意缺陷方面分数、多动-冲动分数、混合总分、对立违抗分数各项在治疗前、治疗半年后均不同,差异具有统计学意义(P<0.05)。QCD问卷总分与SNAP-Ⅳ评定量表家长用(26项)在注意力分数、多动/冲动分数、总分数和对立违抗分数呈轻到中度负相关(相关系数为-0.384~-0.518,P<0.05),与SNAP-Ⅳ评定量表教师用(26项)在注意缺陷呈负相关(相关系数为-0.293,P<0.05),与气质量表中活动水平、坚持性、情绪本质、反应强度、适应性维度呈轻到中度负相关(相关系数为-0.496~-0.378,P<0.05),与气质中的注意分散度、反应阈值、趋避性、节律性无相关性(P>0.05)。结论注意缺陷多动障碍儿童QCD问卷在规律治疗前后有明显变化,对ADHD儿童症状、疗效评估有辅助作用,对其进行研究可更好地辅助诊断以及干预ADHD。

Objective To explore the Questionnaire-Children with Difficulties of children in attention deficit hyperactivity disorder(ADHD).Methods From April 2019 to August 2021,45 children who met DSM-Ⅴdiagnostic criteria and were diagnosed as attention deficit/hyperactivity disorder(ADHD)and treated regularly were selected from the child protection department of Kunming children's hospital.Before and after treatment,they were measured by filling out the child difficulty questionnaire(QCD),China children's air quality scale(CSTS),SNAP-ⅣRating Scale(26 items)for parents/teachers.Results The total scores of the Questionnaire-Children with Difficulties were different before and after treatment,and the difference was statistically significant(t=-2.156,P<0.05).At the same time,the scores of attention deficit,hyperactivity impulse,mixed total scores and opposition and disobedience of teachers and parents in the parents/teachers(26 items)questionnaire of SNAP-Ⅳrating scale were different before and after treatment,and the difference was statistically significant(P<0.05).The total score of QCD questionnaire was slightly to moderately negatively correlated with the attention score,hyperactivity/impulsivity score,total score and oppositional defiance score of SNAP-ⅣRating Scale(26 items),and negatively correlated with the attention deficit score of SNAP-ⅣRating Scale(26items)(correlation coefficient-0.293,P<0.05),and with the activity level in Qi quality scale Persistence,emotional essence,reaction intensity and adaptability showed light to moderate negative correlation(correlation coefficient was-0.496~-0.378,P<0.05),but there was no correlation with attention dispersion,reaction threshold,avoidance and rhythm in temperament(P>0.05).Conclusion The QCD questionnaire of children with attention deficit hyperactivity disorder has obvious changes before and after regular treatment.It plays an auxiliary role in the evaluation of symptoms and curative effect of ADHD children.Its research can better assist in the diagnosis and intervention of ADHD.