新生儿缺氧缺血性脑病恢复期患儿家长焦虑抑郁状况及影响因素分析

发布时间：2018-09-19 19:30

【摘要】：背景新生儿缺氧缺血性脑病(Hypoxic-ischemic encephalopathy,HIE)是造成婴幼儿神经功能障碍的主要原因之一,患儿往往需要较长时间的治疗和康复,家长是患儿的主要照顾者,其自身因素在患儿的治疗、康复过程中起到至关重要的作用。HIE患儿作为家长的心理应激事件,应对不当可能会出现焦虑、抑郁等心理问题,严重者可造成心理疾患,影响患儿的治疗与照顾质量。目的探讨HIE恢复期患儿家长焦虑、抑郁状况并分析其影响因素,以期为进一步制定护理干预措施、消除患儿家长负性情绪、改善心理状况、提高患儿及家长的生活质量提供参考。方法选取2014年10月~2015年10月河南省四所三级综合医院小儿康复科的196名HIE恢复期患儿家长作为研究对象,利用一般资料调查表、医院焦虑抑郁量表、中文版家庭亲密度与适应性量表、社会支持评定量表对其焦虑抑郁情绪、家庭功能、社会支持状况进行调查,并利用SPSS19.0软件对数据进行描述性统计分析、t检验、方差分析、Pearson相关分析和多元线性回归分析。结果1.HIE恢复期患儿家长焦虑情绪得分为9.43±3.62,抑郁情绪得分为9.19±3.83,约70%存在不同程度的焦虑、抑郁倾向,其中约40%肯定存在焦虑、抑郁情绪。2.单因素分析显示,不同学历、职业、与家人关系、性格特征、居住地、对疾病了解程度、自我感觉压力以及照顾不同月龄、HIE程度、康复疗程患儿的家长在焦虑情绪得分上差异有统计学意义(P0.05);不同学历、居住地、自我感觉压力、费用支付方式以及照顾不同月龄、HIE程度、康复疗程患儿的家长在抑郁情绪得分上差异有统计学意义(P0.05)。3.在家庭功能方面,家庭实际亲密度与国内常模相比差异无统计学意义(P0.05),理想亲密度、亲密度不满意度、适应性不满意度高于常模,实际适应性、理想适应性低于常模(P0.05)。焦虑、抑郁情绪得分均与家庭实际亲密度、实际适应性呈负相关,均与亲密度不满意度、适应性不满意度呈正相关(P0.05)。4.在社会支持方面,社会支持总分及各维度得分均高于国内常模(P0.05)。社会支持水平为中等或高等水平,其中中等水平者占79.1%,高水平者占20.9%。焦虑、抑郁情绪得分均与社会支持总分、客观支持得分、主观支持得分、社会支持利用度呈负相关(P0.05)。5.回归分析显示,自我感觉压力、客观支持得分、HIE程度、社会支持利用度、性格特征、居住地、亲密度不满意度均进入了以焦虑情绪得分为因变量的回归方程,共同有效解释39.5%的变异量(P0.05);自我感觉压力、客观支持得分、社会支持利用度、康复疗程均进入了以抑郁情绪得分为因变量的回归方程,共同有效解释36.1%的变异量(P0.05)。其中,客观支持得分、社会支持利用度均为患儿家长焦虑、抑郁情绪得分的负性影响因素。结论1.HIE恢复期患儿家长的情绪状态不容乐观,焦虑、抑郁情绪得分处于较高水平。一般人口社会学资料中,自我感觉压力、性格特征、居住地、HIE程度、康复疗程是患儿家长焦虑、抑郁情绪的主要影响因素。2.HIE恢复期患儿家长家庭功能状况有待改善。家庭功能状况越好,越不容易出现焦虑、抑郁情绪。家庭亲密度不满意度是影响焦虑水平的重要因素。3.HIE恢复期患儿家长社会支持呈中等水平。得到的社会支持越多,焦虑、抑郁水平就越低。客观支持、社会支持利用度是患儿家长重要的保护性因素。
[Abstract]:Background Hypoxic-ischemic encephalopathy (HIE) is one of the main causes of neurological impairment in infants and young children. Children often need long-term treatment and rehabilitation. Parents are the main caregivers of children. Their own factors play an important role in the treatment and rehabilitation of children with HIE. Children as parents of psychological stress events, coping improperly may appear anxiety, depression and other psychological problems, serious can cause psychological disorders, affecting the quality of treatment and care of children. Methods 196 parents of HIE convalescent children in the Department of pediatric rehabilitation in four tertiary general hospitals of Henan Province from October 2014 to October 2015 were selected as the subjects. General data questionnaire, Hospital Anxiety and depression scale and Chinese version of family intimacy were used. The scores of anxiety and depression, family function and social support were investigated with the Adaptability Scale, Social Support Rating Scale and SPSS19.0 software. The data were analyzed by descriptive statistical analysis, t test, variance analysis, Pearson correlation analysis and multiple linear regression analysis. Results 1. The scores of anxiety and depression of parents of HIE convalescent children were 9.43 (+). 3.62, the score of depression was 9.19 + 3.83, about 70% had different degrees of anxiety and depression tendency, of which about 40% certainly had anxiety and depression. 2. Univariate analysis showed that different educational background, occupation, family relationship, personality characteristics, residence, understanding of the disease, self-perceived stress and care for different months, HIE level, rehabilitation course of treatment. Parents of children with anxiety scores were statistically significant (P 0.05); different educational background, residence, self-perceived pressure, payment methods and care for different months, HIE degree, rehabilitation course of parents of children with depression scores were statistically significant (P 0.05). 3. Family function, family actual cohesion and There was no significant difference between the domestic norms (P 0.05). Ideal intimacy, intimacy dissatisfaction, adaptability dissatisfaction were higher than the norm, actual adaptability and ideal adaptability were lower than the norm (P 0.05). The scores of anxiety and depression were negatively correlated with family actual intimacy, actual adaptability, and both were negatively correlated with intimacy dissatisfaction and adaptability dissatisfaction. The scores of social support were higher than those of domestic norm (P 0.05). The social support level was moderate or higher, of which 79.1% was moderate and 20.9% was high. The scores of anxiety and depression were all higher than those of social support, objective support and subjective support. Social support utilization was negatively correlated (P 0.05). Regression analysis showed that self-perceived stress, objective support score, HIE level, social support utilization, personality characteristics, residence, intimacy dissatisfaction entered the regression equation with anxiety score as dependent variable, and together effectively explained 39.5% of the variance (P 0.05); self-perceived stress, and intimacy dissatisfaction. Objective support score, social support utilization and rehabilitation course all entered regression equation with depression score as dependent variable, which explained 36.1% of variance (P 0.05). Among them, objective support score and social support utilization were all negative influencing factors of parents'anxiety and depression scores. Conclusion 1. Long emotional state is not optimistic, anxiety, depression scores are at a higher level. General demographic sociological data, self-perceived stress, personality characteristics, residence, HIE degree, rehabilitation course are the main factors affecting parents'anxiety and depression. 2. HIE recovery period of children's parents' family function status needs to be improved. Family cohesion dissatisfaction is an important factor affecting the level of anxiety. 3. The parents of HIE convalescent children have moderate social support. The more social support they receive, the lower the level of anxiety and depression.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R473.74

【相似文献】