本文選題：孤獨(dú)癥譜系障礙　切入點(diǎn)：照顧者　出處：《重慶醫(yī)科大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的調(diào)查孤獨(dú)癥譜系障礙(ASD)兒童養(yǎng)育者育兒自我效能感(PSE)和焦慮抑郁情緒現(xiàn)狀,為進(jìn)一步實(shí)施心理干預(yù)提供依據(jù);評(píng)價(jià)以家庭為中心的心理教育干預(yù)(FFPT)對(duì)孤獨(dú)癥譜系障礙兒童父母育兒自我效能感及焦慮抑郁情緒的效果,為ASD家庭管理提供參考依據(jù)。方法1 ASD兒童養(yǎng)育者育兒自我效能感及焦慮抑郁情緒現(xiàn)況1.1研究對(duì)象通過(guò)方便抽樣、連續(xù)入組的方式選取2015年7月至12月在重慶醫(yī)科大學(xué)附屬兒童醫(yī)院兒�？萍靶睦砜拼_診的ASD兒童的養(yǎng)育者為研究對(duì)象。1.2研究方法本部分屬于描述性研究。采用一般人口學(xué)資料調(diào)查表收集ASD兒童及養(yǎng)育者的基本信息;采用漢化后的育兒自我效能感測(cè)評(píng)工具(TOPSE),WW Zung版焦慮自評(píng)量表(SAS)、抑郁自評(píng)量表(SDS)調(diào)查養(yǎng)育者的育兒自我效能感和焦慮抑郁情緒現(xiàn)況。2 FFPT對(duì)ASD兒童養(yǎng)育者育兒自我效能感及焦慮抑郁情緒的影響2.1研究對(duì)象選取2015年10月至2016年3月在重慶醫(yī)科大學(xué)附屬兒童醫(yī)院孤獨(dú)癥康復(fù)訓(xùn)練中心首次參與康復(fù)訓(xùn)練的ASD兒童的父親或母親作為研究對(duì)象。2.2研究方法本部分屬于自身前后比較的類(lèi)實(shí)驗(yàn)研究。干預(yù)前課題組通過(guò)回顧文獻(xiàn)、調(diào)查家長(zhǎng)心理健康服務(wù)需求及咨詢(xún)專(zhuān)家構(gòu)建了包括ASD疾病知識(shí)簡(jiǎn)介、康復(fù)訓(xùn)練、家庭問(wèn)題處理、情緒管理為主題的以家庭為中心的心理教育干預(yù)方案,并進(jìn)行了預(yù)實(shí)驗(yàn)。干預(yù)期間采用團(tuán)體干預(yù)的方式,由心理醫(yī)生、護(hù)師、康復(fù)訓(xùn)練師等為主導(dǎo)對(duì)納入的研究對(duì)象實(shí)施為期4周的干預(yù),每周一次,90~120分鐘/次,同時(shí),患兒及家長(zhǎng)每日上午到訓(xùn)練中心接受康復(fù)訓(xùn)練。納入的研究對(duì)象均接受干預(yù)前、后及一個(gè)月后隨訪三次測(cè)評(píng),測(cè)評(píng)內(nèi)容同前一部分,以評(píng)價(jià)干預(yù)效果。結(jié)果1 ASD兒童養(yǎng)育者育兒自我效能感及焦慮抑郁情緒現(xiàn)況1.1 165例ASD兒童養(yǎng)育者接受調(diào)查,其育兒自我效能感總均分為(6.61+1.00),處于中等水平,各維度得分由高至低依次為:學(xué)習(xí)、自我接納、共情、情感、玩耍、壓力、控制力、自律/規(guī)則制定。共情(?R2=0.708,P0.05)和自律/規(guī)則制定(?R2=0.153,P0.05)自我效能感對(duì)PSE影響最大。女性養(yǎng)育者的PSE水平顯著高于男性(p0.05)。城鎮(zhèn)患兒養(yǎng)育者的PSE顯著高于農(nóng)村(p0.05)。養(yǎng)育者的PSE因?qū)W歷不同存在差異,學(xué)歷越高,PSE越高(p0.05)。1.2 165例ASD兒童養(yǎng)育者焦慮總得分為(44.02±10.24)分、抑郁總得分為(50.07±9.66)分分別顯著高于國(guó)內(nèi)常模(29.78±10.01)、(33.46±8.55)分,差異具有統(tǒng)計(jì)學(xué)意義(P0.01),其中焦慮、抑郁陽(yáng)性檢出率分別為23.0%、39.4%。2以家庭為中心的心理教育干預(yù)實(shí)施效果2.1 64例ASD兒童父(母)參與了本次干預(yù),結(jié)果顯示其育兒自效能感各維度得分及總均分在干預(yù)前、后及一個(gè)月后隨訪差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2.2干預(yù)后和一個(gè)月后隨訪64例患兒父(母)焦慮、抑郁癥狀陽(yáng)性檢出率顯著低于干預(yù)前,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論1 ASD兒童養(yǎng)育者育兒自我效能感處于中等水平,表明養(yǎng)育者對(duì)自己所具有的促進(jìn)兒童健康的能力評(píng)價(jià)不高,且焦慮、抑郁癥狀較明顯。2以家庭為中心的心理教育干預(yù)可有效提高ASD兒童父母育兒自我效能感水平,減輕患兒父母焦慮、抑郁情緒。
[Abstract]:Objective to investigate the autism spectrum disorder (ASD) children foster parenting self-efficacy (PSE) and the anxiety and depression status, provide the basis for the further implementation of psychological intervention; evaluation of psychological education of family centered intervention (FFPT) for parents of children with autism spectrum disorder parenting self-efficacy and anxiety depression effect, provide a reference for the ASD family management. Methods 1 ASD children in foster parenting self-efficacy and anxiety and depression in 1.1 subjects by convenient sampling, continuous way into the group from July 2015 to December in children's Hospital Affiliated to Medical University Of Chongqing of child care and psychological department confirmed the rearing of ASD children is descriptive study methods in this part of.1.2 basic information. Using the general demographic data questionnaire to collect ASD children and caregivers; the Chinese parenting self efficacy The sense evaluation tool (TOPSE), WW Zung version of the self rating Anxiety Scale (SAS), self rating Depression Scale (SDS) and the influence of anxiety and depression in.2 FFPT of ASD children foster parenting self-efficacy and anxiety depression survey nurturer parenting self-efficacy research object from October 2015 to 2.1 for the first time in March 2016 to participate in the rehabilitation training of autism Rehabilitation Center for the children's Hospital Affiliated to Medical University Of Chongqing ASD children's father or mother as the experimental class of comparison research object.2.2 methods in this part. Before the intervention group subjects through the review of literature, survey the parents' mental health service needs and consultation of experts established including the introduction of ASD, knowledge of disease rehabilitation training, family problems, psychological education and family centered intervention for emotion management as the theme, and the experimental group. The pre intervention period Body the way of intervention by psychological doctor, nurse, rehabilitation trainer for leading the implementation of a 4 week intervention on the subject, once a week, 90~120 minutes / time, at the same time, the children and their parents to the daily morning training center for rehabilitation training. All subjects underwent intervention before and after a after three month follow-up evaluation, evaluation of the content of the previous part, to evaluate the effect of intervention. Investigation results of 1 ASD children foster parenting self-efficacy and anxiety and depression status of 1.1165 cases of ASD children rearing, the parenting self-efficacy score is (6.61+1.00), in the middle level, the score of each dimension is as follows high to low: learning, self acceptance, empathy, emotion, play, pressure control, self-discipline / rules. Empathy (? R2=0.708, P0.05) and self-discipline rules / (R2=0.153? P0.05) the self-efficacy of the greatest impact on women raising PSE. The level of PSE was significantly higher than that of male (P0.05). The PSE town children rearing were significantly higher than in rural areas (P0.05). The breeder's PSE because the degree of different differences, the higher the degree is, the higher the PSE (P0.05).1.2 in 165 cases of ASD children's anxiety score was (44.02 + 10.24), depression score (50.07 + 9.66) was significantly higher than the national norm (29.78 + 10.01), (33.46 + 8.55), the difference was statistically significant (P0.01), including anxiety, depression and the positive rate was 23%, the 39.4%.2 family centered psychological education intervention implementation effect of 2.164 children with ASD (the father mother) participated in the intervention, the results showed that the parental self efficacy scores and total scores before intervention, the difference was statistically significant after follow-up and one month after the intervention of.2.2 (P0.05) and one month after the follow-up of 64 cases of children with the father (mother) anxiety, depressive symptoms were significantly lower than the positive rate dry Before, the difference was statistically significant (P0.05). Conclusion: 1 ASD children foster parenting self-efficacy in the middle level, that raise myself on with the promotion of children's health evaluation ability is not high, and anxiety, depression significantly.2 family centered education psychological intervention can effectively improve the ASD children's parents parenting self-efficacy level, reduce anxiety in children with depression. Parents.

【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R473.2

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