受艾滋病影响儿童关怀需求调查及干预对策研究

发布时间：2018-03-28 05:11

本文选题：受艾滋病影响儿童　切入点：关怀需求　出处：《武汉科技大学》2011年硕士论文

【摘要】：目的:通过定性定量研究了解受艾滋病影响儿童(OVC)基本情况、身心状况及家庭功能情况;通过多因素分析了解影响OVC心理状况及家庭功能的因素,通过相关分析了解OVC心理状况与其家庭功能状况的相关性;组织干预活动并进行活动效果评价,为开展OVC关怀与干预提供科学依据。方法:整群抽取湖北省随州市均川镇OVC68人,非受艾滋病影响儿童(NOVC)136人。采用自行设计的《OVC关怀需求问卷》、《中小学生健康知识问卷》,采用国际通用的《SCL-90心理量表》、MMFF《家庭功能评定量表》对目标人群进行一对一的访谈式调查;对OVC进行小组心理干预和个别心理辅导,并进行过程评价。对资料进行描述性分析、t检验、卡方检验、多因素logistics回归分析及Pearson相关分析。结果:68例OVC中,1例感染HIV,28例为艾滋孤儿,39例与HIV/AIDS父母共同生活。OVC对“经输血、注射等接触艾滋病人血液会感染HIV”的知晓率达80.9%,对“艾滋病不能彻底治愈”、“四免一关怀”知识知晓率分别仅为36.8%和27.9%,与NOVC比较,两组对“艾滋病通过血液、母婴、性传播”、“经输血、注射等接触艾滋病人血液会感染HIV”、“与艾滋病人一起吃饭不会得艾滋病”及“艾滋病不能彻底治愈”4个知识点知晓率有统计学差异(P0.05);艾滋病态度比较,两组对“认为自己有感染HIV的风险”的态度有统计学差异(P0.05)。OVC中有头疼、恶心、腹痛等“经常性症状”的达35.3%,与NOVC相比,两组在“罹患疾病”及“用药”方面存在统计学差异(P0.05)。OVC心理症状定性研究主要表现为“注意力不集中”,“强迫症状”,“寂寞感”,“抑郁”及“抵触情绪”,结果均在30%以上,与NOVC比较,“注意力不集中”、“强迫症状”、“寂寞感”、“抑郁”、“常感到孤独”、“害怕上学”、“抵触情绪”、“因家庭困难感到无助”、“不自然感”等9个方面存在统计学差异(均为P0.05)。OVC与NOVC心理量表测试结果比较,两组“躯体化”、“强迫症状”、“人际关系敏感”、“抑郁”、“焦虑”、“敌对”、“恐怖”、“偏执”、“精神病性”九个因子以及“总均分”得分均有统计学差异(P0.05)。走访调查的16户OVC家庭中,50%的家庭经济收入主要来源于农田;68.8%月收入不足1000元;75%家庭仅能维持日常开支,12.5%基本生活难以保障;81.2%被纳入低保;93.7%的家庭成员间关系和睦。OVC与NOVC家庭功能测试结果比较,两组“沟通”、“情感介入”、“行为控制”、“总的功能”4项因子以及“总体均分”得分均有统计学差异(P0.05)。多因素logistics回归分析显示:影响OVC艾滋病知识知晓率的因素为年龄、儿童和抚养人的关系(P0.05);影响OVC心理状况的因素为儿童性别和自觉受歧视感觉(P0.05);影响家庭功能的因素为OVC类型和家庭成员健康状况(P0.05)。Pearson相关性分析显示,家庭功能量表各因子得分与SCL-90心理量表中除“躯体化”的各因子得分均呈显著的正相关(P0.05)。参加两次干预活动的共68名OVC均认为学到了艾滋病的相关知识,对两次活动活动“总体感觉”、“知识宣传内容”、“游戏内容”、“组织安排”等的满意度均达到90%以上。结论:我国农村地区OVC艾滋病防治知识相对缺乏,防治正性态度偏低;OVC身体健康状况不容乐观,较多处于亚健康状态; OVC心理状况不佳,普遍存在强迫、抑郁、焦虑、敌对等心理问题;OVC较多存在沟通、情感介入、行为控制等家庭功能缺陷;OVC年龄、和抚养人的关系影响其艾滋病知识知晓率,性别和受到歧视影响其心理状况,OVC类型和家庭成员健康状况影响其家庭功能状况。OVC心理状况与家庭功能状况存在相关性。对OVC采用参与式的小组干预和个别心理辅导的心理关怀可有效改善其心理问题。因此,针对OVC的关怀活动应倡导公众减少歧视接纳OVC;关怀干预应着重加强OVC的心理关怀,建议干预活动遵循儿童参与原则,开展效果评估与过程督导,以保证干预工作质量;同时,心理干预应与针对OVC家庭的经济、医疗等救助活动相结合,减少家庭不良因素对OVC心理的影响。
[Abstract]:Objective: through qualitative and quantitative research about children affected by AIDS (OVC) the basic situation, mental state and family function; through the multi factor analysis to study the affecting factors of OVC psychological status and family function, psychological status and its correlation to understand the OVC family function through correlation analysis; organization intervention activities and activities to provide scientific evaluation evidence for OVC care and intervention.
Methods: cluster sampling in Suizhou city in Hubei Province Sichuan town of OVC68, non children affected by AIDS (NOVC) 136. , < > elementary and middle school students' health knowledge questionnaire, using MMFF< family assessmentdevice > to interview a survey on one of the target population; group psychological intervention and individual psychological counseling for OVC, and the process of evaluation. The data were analyzed by descriptive analysis, t test, chi square test, logistics regression analysis and Pearson correlation analysis.
Results: 68 cases of OVC, 1 cases of HIV infection, 28 cases of AIDS orphans, 39 cases of HIV/AIDS and.OVC on the parents live together "by blood transfusion, injection contact the blood of AIDS patients infected with HIV" awareness rate reached 80.9%, the "AIDS can not be completely cured", "four free and one care" knowledge rate only 36.8% and 27.9% respectively, compared with NOVC, two groups of "AIDS through blood, maternal transmission", "the blood transfusion, injection contact the blood of AIDS patients infected with HIV," and "people with AIDS to eat not get AIDS" and "HIV / AIDS can not completely cure 4 knowledge awareness rate there was significant difference (P0.05); AIDS attitudes comparison, two groups of" think they have the risk of HIV infection attitude had significant difference (P0.05) of.OVC are headache, nausea, abdominal pain and other symptoms often "up to 35.3%, compared with the NOVC group in two, suffering from the disease "There was a statistically significant difference between" medication "and (P0.05).OVC psychological symptoms mainly qualitative research for" inattention "," compulsion "," loneliness "," depression "and" resentment ", the results were more than 30%, compared with NOVC," inattention "," obsessive compulsive symptoms "," loneliness "," depression "," often feel lonely "," afraid to go to school "," resentment "," feel helpless because of family difficulties, "there was a significant difference between the 9 aspects of the natural sense" (P0.05).OVC and NOVC psychological test, two group of "body", "compulsion", "interpersonal sensitivity", "depression", "anxiety", "hostile", "terror", "paranoid", "the difference between the nine factors of mental illness" and "statistically the total average score (P0.05) survey of 16 households in OVC. In the family, 50% of the family income mainly comes from the farmland; 68.8% monthly income of less than 1000 yuan; 75% families can only maintain the daily expenses, difficult to guarantee the basic livelihood of 12.5%; 81.2% were incorporated into the low; 93.7% among family members in harmony with the NOVC family.OVC function test results, two groups of "communication", "emotional involvement", "behavior control", "total difference function" 4 factor "and the overall average scores were statistically score (P0.05). Logistics regression analysis showed that: the influence factors of the awareness rate of AIDS knowledge for OVC age, relationship between children and raising people (P0.05); the influence factors of the OVC mental health for children and gender consciously feel discriminated (P0.05); influential factors of family function for the OVC type and the health status of family members (P0.05).Pearson correlation analysis showed that family function scale scores and psychological scale in SCL-90" A significant positive correlation of each factor scores of somatization were (P0.05). A total of 68 OVC in two interventions that learn AIDS related knowledge, the two activities "the general feeling", "propaganda", "game", "organization" satisfaction reached more than 90%.
Conclusion: the relative lack of China's rural areas OVC AIDS prevention knowledge, attitude control is low; OVC health status is not optimistic, more in the sub-health state; OVC psychological conditions, widespread compulsion, depression, anxiety, hostility and other psychological problems; OVC has more communication, emotional involvement, behavior control and family function defect; OVC age, relationship and raise people's awareness of the impact of AIDS knowledge, gender discrimination and affect their psychological status, OVC type and the health status of family members influence the family function of the.OVC psychological status and family function of psychological care. The correlation between OVC with participatory group intervention and individual psychological counseling can be effective in improving their psychological problems. Therefore, for the OVC care activities should be advocated to reduce discrimination public acceptance of OVC; care intervention should focus on strengthening psychological care intervention OVC. Following the principle of child participation, we should carry out the effect evaluation and process supervision to ensure the quality of intervention. Meanwhile, psychological intervention should be combined with the OVC family's economic, medical and other relief activities to reduce the impact of family adverse factors on OVC psychology.

【学位授予单位】：武汉科技大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：C913.5;R193

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