以家庭为中心的教育干预对孤独症儿童养育者育儿自我效能感及情绪的影响

发布时间：2018-03-05 08:23

本文选题：孤独症谱系障碍　切入点：照顾者　出处：《重庆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的调查孤独症谱系障碍(ASD)儿童养育者育儿自我效能感(PSE)和焦虑抑郁情绪现状,为进一步实施心理干预提供依据;评价以家庭为中心的心理教育干预(FFPT)对孤独症谱系障碍儿童父母育儿自我效能感及焦虑抑郁情绪的效果,为ASD家庭管理提供参考依据。方法1 ASD儿童养育者育儿自我效能感及焦虑抑郁情绪现况1.1研究对象通过方便抽样、连续入组的方式选取2015年7月至12月在重庆医科大学附属儿童医院儿保科及心理科确诊的ASD儿童的养育者为研究对象。1.2研究方法本部分属于描述性研究。采用一般人口学资料调查表收集ASD儿童及养育者的基本信息;采用汉化后的育儿自我效能感测评工具(TOPSE),WW Zung版焦虑自评量表(SAS)、抑郁自评量表(SDS)调查养育者的育儿自我效能感和焦虑抑郁情绪现况。2 FFPT对ASD儿童养育者育儿自我效能感及焦虑抑郁情绪的影响2.1研究对象选取2015年10月至2016年3月在重庆医科大学附属儿童医院孤独症康复训练中心首次参与康复训练的ASD儿童的父亲或母亲作为研究对象。2.2研究方法本部分属于自身前后比较的类实验研究。干预前课题组通过回顾文献、调查家长心理健康服务需求及咨询专家构建了包括ASD疾病知识简介、康复训练、家庭问题处理、情绪管理为主题的以家庭为中心的心理教育干预方案,并进行了预实验。干预期间采用团体干预的方式,由心理医生、护师、康复训练师等为主导对纳入的研究对象实施为期4周的干预,每周一次,90~120分钟/次,同时,患儿及家长每日上午到训练中心接受康复训练。纳入的研究对象均接受干预前、后及一个月后随访三次测评,测评内容同前一部分,以评价干预效果。结果1 ASD儿童养育者育儿自我效能感及焦虑抑郁情绪现况1.1 165例ASD儿童养育者接受调查,其育儿自我效能感总均分为(6.61+1.00),处于中等水平,各维度得分由高至低依次为:学习、自我接纳、共情、情感、玩耍、压力、控制力、自律/规则制定。共情(?R2=0.708,P0.05)和自律/规则制定(?R2=0.153,P0.05)自我效能感对PSE影响最大。女性养育者的PSE水平显著高于男性(p0.05)。城镇患儿养育者的PSE显著高于农村(p0.05)。养育者的PSE因学历不同存在差异,学历越高,PSE越高(p0.05)。1.2 165例ASD儿童养育者焦虑总得分为(44.02±10.24)分、抑郁总得分为(50.07±9.66)分分别显著高于国内常模(29.78±10.01)、(33.46±8.55)分,差异具有统计学意义(P0.01),其中焦虑、抑郁阳性检出率分别为23.0%、39.4%。2以家庭为中心的心理教育干预实施效果2.1 64例ASD儿童父(母)参与了本次干预,结果显示其育儿自效能感各维度得分及总均分在干预前、后及一个月后随访差异有统计学意义(P0.05)。2.2干预后和一个月后随访64例患儿父(母)焦虑、抑郁症状阳性检出率显著低于干预前,差异有统计学意义(P0.05)。结论1 ASD儿童养育者育儿自我效能感处于中等水平,表明养育者对自己所具有的促进儿童健康的能力评价不高,且焦虑、抑郁症状较明显。2以家庭为中心的心理教育干预可有效提高ASD儿童父母育儿自我效能感水平,减轻患儿父母焦虑、抑郁情绪。
[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.

【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.2

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