本文選題：孤獨(dú)癥譜系障礙 + 照料者壓力/育兒壓力��； 參考：《昆明醫(yī)科大學(xué)》2017年碩士論文

【摘要】：[目的]探索孤獨(dú)癥譜系障礙(Autism Spectrum Disorders,ASD)的照料者壓力情況及影響照料者壓力的相關(guān)因素,從而為臨床相關(guān)問題的篩查和干預(yù)供有針對性指導(dǎo)。[方法]納入符合 DSM-5(The Diagnostic and Statistical Manual of Mental Disorders-5)診斷標(biāo)準(zhǔn)的ASD患者168例以及性別、年齡匹配的正常對照143例。兩組均填寫自編的一般情況調(diào)查表,并通過照料者壓力問卷(Caregivers Strain Questionnaire,CGSQ)評估照料者壓力水平。此外,通過孤獨(dú)癥兒童行為量表(Autism Behavior Checklist,ABC1)評估患兒的臨床癥狀、通過異常行為量表(Aberrant Behavior Checklist,ABC2)和 Conners 多動指數(shù)問卷(Conners Index of Hyperactivity,CIH)來評估 ASD 患兒刻板、多動、自傷、易激惹等異常行為情況、通過醫(yī)院焦慮抑郁量表(Hospital Anxiety and Depression Scale,HAD)評估ASD患兒照料者的情緒狀態(tài)。[結(jié)果]1.ASD組CGSQ總分及客觀壓力、主觀外在性壓力、主觀內(nèi)在性壓力得分均高于正常對照組(P值均0.05);2.照料者(包括父親、母親、其他)焦慮陽性檢出率為55例(34.59%)、抑郁陽性檢出率為57例(35.84%),焦慮和抑郁任意一種情緒檢出陽性的為73例(45.91%);照料者(包括父親、母親、其他)填寫HAD量表總分及各分量表得分情況間差異無統(tǒng)計學(xué)意義,P值均0.05;3.根據(jù)自定義的標(biāo)準(zhǔn),近4周各種異常行為的發(fā)生率分別為易激惹67.26%、多動62.5%以及自傷14.29%,存在易激惹、多動、自傷三種行為患兒的父母的照料者壓力高于無相應(yīng)行為患兒的父母,差異有統(tǒng)計學(xué)顯著性(P值均0.05);4.相關(guān)單因素分析提示:與CGSQ總分及客觀壓力、主觀外在性壓力、主觀內(nèi)在性壓力得分均相關(guān)的因素包括:母親文化程度越低以及父母關(guān)系越差則CGSQ總分及各維度得分越高(P值均0.05);ABC1總分以及運(yùn)動、交往、感覺維度分越高CGSQ總分及各則維度得分越高(P值均0.05);患兒多動行為(CIH)總分越高則CGSQ總分及各維度得分越高(P值均0.05);ABC2總分越高CGSQ總分及各維度得分越高(P值0.05);ABC2量表的自傷、多動、刻板行為、及刻板語音或言語得分越高則CGSQ總分及各個維度得分越高(P值均0.05);5.回歸方程分析顯示:多重線性回歸分析顯示HAD總分越高、ABC2總分越高、父母關(guān)系越差、進(jìn)行特殊教育和訓(xùn)練、ABC2自傷得分越高則CGSQ總分及客觀壓力得分越高(R2=0.531,p0.05;R2=0.509,p0.05);HAD 總分越高、ABC2易激惹及多動得分越高則CGSQ主觀外在性壓力得分越高(R2=0.393,p0.05);HAD總分越高、CIH總分越高、存在行走及運(yùn)動發(fā)育遲緩則CGSQ主觀內(nèi)在性壓力得分越高(R2=0.468,p0.05)。[結(jié)論]1.ASD患兒照料者的壓力顯著高于正常對照組兒童的照料者;2.各種異常行為在ASD患兒中普遍存在,除刻板行為外,各種異常行為在過去4周的發(fā)生率分別為易激惹67.26%、多動62.5%以及自傷14.29%。異常行為是加重ASD照料者壓力的重要因素;此外,ASD患兒的父母關(guān)系越差、照料者存焦慮抑郁情緒、患兒目前接受特殊教育和訓(xùn)練、以及患兒存在行走及運(yùn)動發(fā)育遲緩可加重ASD患兒照料者的壓力。
[Abstract]:[Objective] to explore the stress situation of the caregivers of Autism Spectrum Disorders (ASD) and the related factors affecting the stress of the caregivers, so as to provide specific guidance for the screening and intervention of clinical related problems. [Methods] included the diagnostic criteria of DSM-5 (The Diagnostic and Statistical Manual of Mental). 168 patients with ASD and 143 cases of sex, age matched normal control. The two groups filled out the self-made general questionnaire and assessed the stress level of the caregivers through the Caregivers Strain Questionnaire (CGSQ). In addition, the children's clinical data (Autism Behavior Checklist, ABC1) was used to evaluate the clinical value of the children. The symptoms were assessed by the Aberrant Behavior Checklist (ABC2) and the Conners hyperactivity Index questionnaire (Conners Index of Hyperactivity, CIH) to assess the abnormal behaviors of ASD children, such as stereotypes, hyperactivity, self injury, irritability and so on. [results]1.ASD group CGSQ total score and objective pressure, subjective external pressure, subjective internal pressure score were higher than normal control group (P value 0.05); 2. caregivers (including father, mother, other) positive rate of anxiety was 55 cases (34.59%), depression positive rate was 57 cases (35.84%), anxiety and depression of any kind of emotional examination. The positive was 73 cases (45.91%); the caregivers (including father, mother, other) had no statistical difference between the total score of the HAD scale and the scores of each subscale, and the value of P was 0.05. 3. according to the custom standard, the incidence of all kinds of abnormal behavior in the last 4 weeks were irritability 67.26%, hyperactivity 62.5%, and self injury 14.29%, and there was irritability, hyperactivity, self. The stress of the caregivers of the parents who were injured in three kinds of behavior was higher than that of the parents who had no corresponding behavior. The difference was statistically significant (P value was 0.05). The 4. related single factor analysis suggested that the factors related to the total score of CGSQ and the objective pressure, the subjective external pressure and the subjective internal pressure score include the lower the mother's level of culture and the relationship between the parents. The score of CGSQ total score and all dimensions was higher (P 0.05), and the higher the total score of ABC1 and movement, communication, the higher the score of CGSQ and the dimensions of each dimension (P value was 0.05); the higher the total score of the children's hyperdynamic behavior (CIH), the higher the score of CGSQ total score and each dimension (P value was 0.05); the higher the ABC2 total score, the higher the total score of CGSQ and the higher scores of the dimensions of each dimension (the higher score of the ABC2 total score and the dimensions of each dimension). The P value was 0.05); the higher the score of CGSQ total and each dimension (the P value was 0.05), the higher the score of CGSQ and each dimension, the higher the score of the ABC2 and the stereotyped speech or speech score, the 5. regression analysis showed that the higher the total score of HAD, the higher the total ABC2 score, the worse the relationship between the father and mother, the special education and training of the ABC2, the higher the score of the ABC2 self injury. The higher the score of CGSQ and the objective pressure (R2=0.531, P0.05; R2=0.509, P0.05), the higher the total HAD score, the higher the ABC2 irritability and the higher the hyperactivity score, the higher the subjective external pressure score of CGSQ (R2=0.393, P0.05), the higher the total score of the HAD, the higher the total CIH score, the higher the walking and movement development delay, the higher the subjective intrinsic pressure score. [Conclusion] [Conclusion: [Conclusion] the stress of]1.ASD children in]1.ASD is significantly higher than that of children in normal control group; 2. abnormal behaviors are common in children with ASD. In addition to stereotyped behavior, the incidence of various abnormal behaviors in the past 4 weeks is irritability 67.26%, hyperactivity 62.5% and self injured 14.29%. abnormal behavior are important for increasing the pressure of ASD caregivers. In addition, the poorer the parents of ASD children, the caregivers have anxiety and depression, the children are currently receiving special education and training, and the existence of walking and motor retardation in the children can aggravate the stress of the caregivers of the children of ASD.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R749.94

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 陳敏榕;陳燕惠;薛漳;;ASD兒童父母的親職壓力及心理影響因素研究[J];中國婦幼健康研究;2016年12期

2 邵國瓊;田征文;;孤獨(dú)癥兒童主要照顧者親職壓力現(xiàn)狀的調(diào)查分析[J];現(xiàn)代臨床護(hù)理;2016年07期

3 祖燕飛;徐光興;杜亞松;;孤獨(dú)癥患者家庭干預(yù)的研究現(xiàn)狀回顧[J];中國兒童保健雜志;2016年07期

4 周娛菁;劉靖;李雪;楊文;齊軍慧;王慧;劉靜然;;學(xué)齡期孤獨(dú)癥兒童社交技能訓(xùn)練的療效[J];中國心理衛(wèi)生雜志;2016年05期

5 宋麗華;李素水;孫志剛;張紅梅;宋雯;李軍濤;;圍產(chǎn)期的應(yīng)激因素與孤獨(dú)癥譜系障礙關(guān)系研究進(jìn)展[J];臨床精神醫(yī)學(xué)雜志;2016年01期

6 李改智;江文慶;杜亞松;姜凌霄;劉文文;楊曹驊;;注意缺陷多動障礙與孤獨(dú)癥患兒母親養(yǎng)育壓力差異的研究[J];中國兒童保健雜志;2015年06期

7 王吉;胡艷杰;王媛;陳彥平;王涵;孫彩虹;夏薇;武麗杰;;孤獨(dú)癥兒童母親親職壓力的6個月隨訪[J];中國心理衛(wèi)生雜志;2013年09期

8 胡艷杰;王吉;秦秀群;尹曉娜;夏薇;孫彩虹;武麗杰;;孤獨(dú)癥譜系障礙兒童母親親職壓力及影響因素研究[J];中國兒童保健雜志;2013年06期

9 葉瑞繁;耿慶山;陳劍;區(qū)麗明;張美蘭;董春玲;朱春燕;李河;;醫(yī)院焦慮抑郁量表與Beck抑郁問卷在綜合醫(yī)院門診病人中評定抑郁的比較[J];中國臨床心理學(xué)雜志;2013年01期

10 龔云;杜亞松;李惠琳;張喜燕;安宇;吳柏林;;孤獨(dú)癥患兒父母壓力和情緒變化及相關(guān)因素[J];中國兒童保健雜志;2012年04期

，

本文編號：1914743