本文選題：白血病　切入點：學齡期兒童　出處：《福建醫(yī)科大學》2011年碩士論文　論文類型：學位論文

【摘要】：目的:(1)通過調(diào)查了解學齡期白血病兒童及家長在疾病心理健康狀況及疾病的應對方式,探討其可能的影響因素,為臨床實施心理干預提供理論依據(jù)。(2)通過調(diào)查心理干預后白血病兒童及家長心理轉(zhuǎn)變情況,探討有效的心理干預策略,以期為指導白血病兒童及家長的身心康復提供有價值的理論依據(jù)和決策咨詢。 方法:采用前瞻性病例-對照研究方法,對60例白血病患兒(白血病初治與強化治療兒童各30例)、39例非惡性血液病患兒(病例對照組)及52例正常對照組兒童和其家長心理衛(wèi)生狀況進行調(diào)查。分別采用兒童焦慮性情緒障礙篩查表(SCARED)、兒童抑郁障礙自評量表(DSRSC)、患病行為問卷調(diào)查患兒心理行為狀況,SCL-90癥狀自評量表調(diào)查家長的心理衛(wèi)生狀況,醫(yī)學應對方式量表調(diào)查患兒的應對方式,應對方式問卷調(diào)查患兒家長的應對方式情況,并搜集患兒及家庭基本信息進行分析,探討可能的影響因素。通過笑臉卡評價干預組與非干預組白血病兒童入院第1個月的心情變化情況。 結(jié)果:(1)心理狀況量表測評:①SCARED、DSRSC及SCL-90量表測評:白血病初治組白血病強化組病例對照組正常對照組(F=10.317,P0.001;F=11.674,P0.001;F=11.025,P0.001)。②白血病初治組兒童在軀體化/驚恐、廣泛性焦慮、分離性焦慮分量表評分均高于病例對照組和正常對照組(P0.05),白血病強化組在分離性焦慮、社交恐懼分量表高于正常對照組(P0.05)。③白血病組患兒在一般疑病、疾病信念、情感壓抑、情緒紊亂、易激惹性、情緒狀態(tài)、疾病確信和Whiteley疑病指數(shù)方面得分均高于病例對照組兒童(P0.05)。④白血病組患兒家長有較多的心理問題,在SCL-90量表中,軀體化、抑郁、焦慮三個分量表評分顯著高于健康對照組(P0.05),白血病初治組的家長表現(xiàn)出更顯著的強迫、抑郁、焦慮癥狀(P0.05)。(2)應對方式量表測評:①白血病組兒童較病例對照組兒童更多采用回避(P0.05)和放棄(P0.001)方式來應對疾病;與白血病強化組比較,白血病初治組兒童更不愿意面對疾病(P0.05)。②白血病組患兒家長在自責、求助、幻想的消極應對方面高于病例對照組(P0.05)。(3)相關(guān)分析顯示:白血病組患兒的負性情緒與其面對方式存在負相關(guān)關(guān)系(P0.05),與放棄方式存在正相關(guān)關(guān)系(P0.05)。家長的解決問題方式影響家長的心理健康,與其心理問題呈負相關(guān)關(guān)系(P0.05);自責、幻想和退避消極應對方式與家長的心理問題存在正相關(guān)關(guān)系(P0.05)。平均住院天數(shù)較長和與同伴的交往關(guān)系不良的患兒焦慮性情緒障礙表現(xiàn)更為突出,治療費用拮據(jù)和家長對患兒治愈信心不足以及患兒家長的工作不穩(wěn)定等,可影響家長的社會適應能力,使得其出現(xiàn)更多的負性心理,并影響患兒表現(xiàn)出更明顯的抑郁癥狀。(4)隨著時間的推移,兩組白血病兒童入院第1個月的心情都有逐漸變好的趨勢,但干預組在心理干預的幫助下,較非干預組比較,心情明顯改善,且能夠面對疾病,而非干預組改善不明顯,提示積極心理干預可有效改善白血病兒童及家長心理衛(wèi)生狀況,提高治療依從性。 結(jié)論:(1)白血病兒童及家長存在較多的心理問題及消極應對方式,尤其是在最初診斷和治療階段。(2)消極應對方式、對治療的錯誤認知及治療費用拮據(jù)是影響白血病患兒及家長心理健康的重要因素。(3)有效的心理干預有助于提高患兒的生活質(zhì)量和改善家長的心身健康。
[Abstract]:Objective: (1) understand the school-age children with leukemia and their parents in coping style mental health status and disease disease through investigation, to explore the influencing factors, and provide a theoretical basis for clinical psychological intervention. (2) through the investigation of psychological intervention after the transformation of leukemia children and family psychology, to explore the psychological intervention strategies for effective, in order to provide valuable theoretical basis and decision-making consultation for physical and mental rehabilitation leukemia children and their parents.
Methods: a prospective case-control study method, 60 cases of children with leukemia (leukemia and strengthening treatment of children 30 cases), 39 cases of non malignant hematological disease patients (case group) and 52 normal children and their parents mental health status were investigated respectively. The anxiety of children barriers to screening table (SCARED), depression self rating scale for children (DSRSC), the prevalence of psychological behavior of children with behavior questionnaire survey, SCL-90 SCL-90 mental health survey of parents, the coping style of Medical Coping Style Questionnaire of children, coping strategies and Coping Style Questionnaire of parents of children, and collect analyze the basic information of children and their families, to explore the possible influencing factors. The face card evaluation of intervention group and non intervention group of leukemia children hospitalized for first months the mood changes.
Results: (1) mental status scale: SCARED, DSRSC and SCL-90 scale: leukemia Leukemia Group intensive group case control group and normal control group (F=10.317, P0.001; F=11.674, P0.001; F=11.025, P0.001). The group of children leukemia / panic in the body, generalized anxiety. Separation anxiety subscale scores were higher than those of case control group and normal control group (P0.05), leukemia group in strengthening separation anxiety, social phobia subscale is higher than the normal control group (P0.05). The group of children with leukemia in general hypochondria, illness beliefs, emotional depression, mood disorders, irritability, mood state, disease sure and Whiteley index scores were higher than the case of hypochondriasis of children in the control group (P0.05). The group of parents of children with leukemia have more psychological problems, the body in the scale of SCL-90, anxiety, depression, three subscales scores were significantly higher than that of the control group (P 0.05), leukemia group of parents showed significantly greater compulsion, depression, anxiety symptoms (P0.05). (2) coping style scale: the children leukemia group than in case control group of children with more avoidance (P0.05) and (P0.001) give way to deal with the disease; compared with leukemia enhancement. Leukemia children were more reluctant to face the disease (P0.05). The group of parents of children with leukemia in self blame, for help, was higher than the control group negative coping style of fantasy (P0.05). (3) the correlation analysis showed that the negative emotion of patients and the leukemia group face has a negative correlation (P0.05), there is a way the relationship and give way (P0.05). The influence of parents' parents to resolve the problem of mental health was negatively correlated with mental problems (P0.05); self blame, fantasy and withdrawal should be negative and there is a positive correlation between the psychological problems of other type and parents (P0.05). Performance anxiety emotional disorders adverse average hospitalization days longer and with peer relationship were more prominent, treatment cost constraints and parents of the children were cured and lack of confidence in parents of children with unstable, can affect the parents' ability to adapt to society, making it appear more negative psychological, and influence the children show the more obvious depressive symptoms. (4) with the passage of time, the two groups of children with leukemia were first months of mood has gradually become a good trend, but the intervention group in psychological intervention help, compared with the non intervention group, the mood is obviously improved, and able to face the disease, and no obvious improvement in the non intervention group that suggests that positive psychological intervention can effectively improve the mental health status of parents and children with leukemia, improve treatment compliance.
Conclusion: (1) leukemia children and their parents have many psychological problems and negative coping style, especially in the initial diagnosis and treatment stage. (2) negative coping style, wrong cognition and treatment costs of treatment of the constraints factors that influence the mental health of parents of children with leukemia and the weight. (3) effective psychological intervention help to improve the mental health of children and improve the quality of life for parents.

【學位授予單位】：福建醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2011
【分類號】：R395.6;R733.7

【引證文獻】

相關(guān)碩士學位論文 前2條

1 孟喜軍;心理干預在小兒骨科圍手術(shù)期的應用[D];山西醫(yī)科大學;2012年

2 吉盼盼;社會化理論視角下白血病兒童服務模式探索[D];中國社會科學院研究生院;2013年

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本文編號：1558846