特殊儿童家庭医学应对方式调查及其影响因素分析
|
摘要
背景脑瘫、自闭症、智力障碍等特殊儿童在其成长过程中需要持续的康复训练,而家庭在此过程中起着至关重要的作用,家庭医学应对方式会影响孩子的康复过程和疗效。目的调查了解特殊儿童家庭医学应对方式,分析其影响因素,为相关人员进行健康宣教和康复指导提供参考。方法 2017年6—8月,采用三阶段抽样法抽取调查对象,即第一阶段采用单纯随机抽样法抽取四川省8个市/州,第二阶段在抽取的8个市/州中采用单纯随机抽样法各抽取2家有脑瘫、自闭症和智力障碍等特殊儿童就读的学校和/或进行康复的机构,第三阶段采用整群抽样法抽取第二阶段抽取的学校或机构的特殊儿童的家长为调查对象。采用特殊儿童及其家庭基本情况问卷和医学应对方式问卷对其进行调查。共发放问卷320份,回收有效问卷292份,有效回收率为91.3%。将特殊儿童家庭医学应对方式得分与常模比较,分析特殊儿童家庭医学应对方式现状,医学应对方式的影响因素分析采用多元线性逐步回归分析。结果特殊儿童家庭医学应对方式倾向面对者142名(48.6%),回避者30名(10.3%),屈服者120名(41.1%)。特殊儿童家庭面对、回避维度得分低于常模,屈服维度得分高于常模(P<0.05)。多元线性逐步回归分析结果显示:疾病诊断、残疾等级、自理能力、康复救助情况、母亲文化程度和父母婚姻状况是面对维度得分的影响因素(P<0.05),父亲文化程度和家庭年收入是回避维度得分的影响因素(P<0.05),残疾等级、康复救助情况、父亲文化程度、父母婚姻状况和家庭年收入是屈服维度得分的影响因素(P<0.05)。结论特殊儿童家庭医学应对方式有待改善;疾病诊断、残疾等级、自理能力、康复救助情况、父/母亲文化程度、父母婚姻状况和家庭年收入为影响家庭应对方式的主要因素,应针对上述影响因素对家长实施有针对性的心理健康教育,改变家庭消极应对的现状,提高特殊儿童康复效果。
Background Children with cerebral palsy,autism and intellectual disability need constant rehabilitation training throughout their growth,in which family plays a vital role.Family medical coping mode can influence the rehabilitation process and efficacy for these children.Objective To understand family medical coping mode for children with special needs and its influencing factors,so as to provide references in health education and rehabilitation guidance for people concerned.Methods Respondents were selected by taking three-stage sampling method from June to August,2017:in the first stage,8 cities/prefectures were selected from Sichuan Province by simple stochastic sampling method;in the second stage,two schools and/or rehabilitation institutions for children with cerebral palsy,autism and intellectual disability were selected within each of the 8 cities/prefectures by simple stochastic sampling method;in the third stage,those children's parents from these schools or rehabilitation institutions were selected as respondents by cluster sampling method.The survey was conducted through questionnaires for basic information of children with special needs and their families and questionnaires for medical coping modes.A total of 320 questionnaires were distributed,and 292 valid questionnaires were recollected,with 91.3% of recovery rate.The scores of family medical coping modes for children with special needs and norms were compared to analyze the status quo of family medical coping mode for children with special needs.The influencing factors of medical coping modes were studied by multiple linear stepwise regressions.Results Among all respondents,142 tended to be confronting(48.6%),30 tended to be avoiding(10.3%),and 120 tended to be yielding(41.1%).Families with children of special needs scored lower than families with norms in the dimensions of confrontation and avoidance,and higher in the dimension of yielding(P<0.05).The results of multiple linear stepwise regressions showed that the diagnosis,disability grading,self-care ability,rehabilitation assistance,educational level of mother and parents' marital status were factors influencing the score of confrontation mode dimension(P<0.05);educational level of father and annual household income were influencing factors of the score of avoidance mode dimension(P<0.05);and disability grading,rehabilitation assistance,educational level of father,parents' marital status and annual household income were factors influencing the score of yielding dimension(P<0.05).Conclusion Family medical coping modes for children with special needs is still to be improved.The diagnosis,disability grading,self-care ability,rehabilitation assistance,parents educational level and their marital status,and annual household income are main influencing factors for family coping mode.Targeted psychological health assistance based on fore mentioned influencing factors should be implemented among parents to change the passive family coping mode and improve the rehabilitation efficacy of children with special needs.
Background Children with cerebral palsy,autism and intellectual disability need constant rehabilitation training throughout their growth,in which family plays a vital role.Family medical coping mode can influence the rehabilitation process and efficacy for these children.Objective To understand family medical coping mode for children with special needs and its influencing factors,so as to provide references in health education and rehabilitation guidance for people concerned.Methods Respondents were selected by taking three-stage sampling method from June to August,2017:in the first stage,8 cities/prefectures were selected from Sichuan Province by simple stochastic sampling method;in the second stage,two schools and/or rehabilitation institutions for children with cerebral palsy,autism and intellectual disability were selected within each of the 8 cities/prefectures by simple stochastic sampling method;in the third stage,those children's parents from these schools or rehabilitation institutions were selected as respondents by cluster sampling method.The survey was conducted through questionnaires for basic information of children with special needs and their families and questionnaires for medical coping modes.A total of 320 questionnaires were distributed,and 292 valid questionnaires were recollected,with 91.3% of recovery rate.The scores of family medical coping modes for children with special needs and norms were compared to analyze the status quo of family medical coping mode for children with special needs.The influencing factors of medical coping modes were studied by multiple linear stepwise regressions.Results Among all respondents,142 tended to be confronting(48.6%),30 tended to be avoiding(10.3%),and 120 tended to be yielding(41.1%).Families with children of special needs scored lower than families with norms in the dimensions of confrontation and avoidance,and higher in the dimension of yielding(P<0.05).The results of multiple linear stepwise regressions showed that the diagnosis,disability grading,self-care ability,rehabilitation assistance,educational level of mother and parents' marital status were factors influencing the score of confrontation mode dimension(P<0.05);educational level of father and annual household income were influencing factors of the score of avoidance mode dimension(P<0.05);and disability grading,rehabilitation assistance,educational level of father,parents' marital status and annual household income were factors influencing the score of yielding dimension(P<0.05).Conclusion Family medical coping modes for children with special needs is still to be improved.The diagnosis,disability grading,self-care ability,rehabilitation assistance,parents educational level and their marital status,and annual household income are main influencing factors for family coping mode.Targeted psychological health assistance based on fore mentioned influencing factors should be implemented among parents to change the passive family coping mode and improve the rehabilitation efficacy of children with special needs.
引文
[1]黄琼,周慧玲,梁玲毓.工伤康复患者医学应对方式和心理状况的相关性[J].中国康复医学杂志,2012,27(5):458-461.DOI:10.3969/j.issn.1001-1242.2012.05.016.HUANG Q,ZHOU H L,LIANG L Y.Correlation analysis on medical coping styles and psychological status in work-injury rehabilitation patients[J].Chinese Journal of Rehabilitation Medicine,2012,27(5):458-461.DOI:10.3969/j.issn.1001-1242.2012.05.016.
[2]唐月红,王新.脑瘫患儿父母的亲职压力现状调查[J].全科护理,2015,13(20):1991-1992.DOI:10.3969/j.issn.1674-4748.2015.20.039.TANG Y H,WANG X.Investigation on parenting stress of parents of children with cerebral palsy[J].Chinese General Practice Nursing,2015,13(20):1991-1992.DOI:10.3969/j.issn.1674-4748.2015.20.039.
[3]陈夏尧,李丹,刘荣莲,等.智力障碍、孤独症儿童家长心理压力及相关因素对比研究[J].中国康复理论与实践,2013,19(6):572-574.DOI:10.3969/j.issn.1006-9771.2013.06.020.CHEN X Y,LI D,LIU R L,et al.Related factors of stress of parents of children with intellectual disabilities and autism:a comparative study[J].Chinese Journal of Rehabilitation Theory and Practice,2013,19(6):572-574.DOI:10.3969/j.issn.1006-9771.2013.06.020.
[4]贺莉娜,周长虹,李海燕.孤独症儿童家长的应对方式与心理健康的相关性研究[J].中国儿童保健杂志,2015,23(9):937-939.DOI:10.11852/zgetbjzz2015-23-09-13.HE L N,ZHOU C H,LI H Y.Correlation between coping style and mental health of the autism children's parents[J].Chinese Journal Child Health Care,2015,23(9):937-939.DOI:10.11852/zgetbjzz2015-23-09-13.
[5]张向葵,郭新志,孙阳.中轻度脑瘫患儿父母应对方式的心理干预研究[J].大庆师范学院学报,2015,35(5):132-137.DOI:10.13356/j.cnki.jdnu.2095-0063.2015.05.030.ZHANG X K,GUO X Z,SUN Y.A psychologecal intervening research on parental coping styles of children with mild to moderate cerebral palsy[J].Journal of Daqing Normal University,2015,35(5):132-137.DOI:10.13356/j.cnki.jdnu.2095-0063.2015.05.030.
[6]FEIFEL H,STRACK S,NAGY V T.Coping strategies and associated features of medically ill patients[J].Psychosom Med,1987,49(6):616-625.
[7]沈晓红,姜乾金.医学应对方式问卷中文版701例测试报告[J].中国行为医学科学,2000,9(1):18-20.DOI:10.3760/cma.j.issn.1674-6554.2000.01.008.SHEN X H,JIANG Q J.Report on application of Chinese version of MCMQ in 701 patients[J].Chinese Journal of Behavioral Medical Science,2000,9(1):18-20.DOI:10.3760/cma.j.issn.1674-6554.2000.01.008.
[8]周贵,苏超敏,宋列席,等.某地住院空巢老人医学应对方式调查[J].现代临床医学,2016,42(6):429-431.DOI:10.11851/j.issn.1673-1557.2016.06.009.ZHOU G,SU C M,SONG L X,et al.Investigation of medical coping style in hospitalized empty-nest elderly in certain area[J].Journal of Modern Clinical Medicine,2016,42(6):429-431.DOI:10.11851/j.issn.1673-1557.2016.06.009.
[9]常艳玲,李巧秀.脑瘫患儿父母希望水平与应对方式的关系[J].中华临床医师杂志:电子版,2016,10(7):32-33.CHANG Y L,LI Q X.The relationship between hope level and coping styles of cerebral palsy children's parents[J].Chinese Journal Clinicians:Electronic Edition,2016,10(7):32-33.
[10]何春秀,郝桂荣,张会君,等.老年2型糖尿病患者医学应对方式及影响因素研究[J].中国全科医学,2015,18(5):525-529.DOI:10.3969/j.issn.1007-9572.2015.05.010.HE C X,HAO G R,ZHANG H J,et al.Medical coping in elderly T2DM patients and its influencing factors[J].Chinese General Practice,2015,18(5):525-529.DOI:10.3969/j.issn.1007-9572.2015.05.010.
[11]原志芳,柴倩文,金奕,等.首发脑卒中患者医学应对方式及其影响因素调查研究[J].中国全科医学,2016,19(2):210-215.DOI:10.3969/j.issn.1007-9572.2016.02.018.YUAN Z F,CHAI Q W,JIN Y,et al.Investigation on medical coping modes of first stroke patients and its influencing factors[J].Chinese General Practice,2016,19(2):210-215.DOI:10.3969/j.issn.1007-9572.2016.02.018.
[12]关珊珊,赵雅宁,郝正玮,等.智障儿童父母应对方式及影响因素研究[J].护理研究,2015,29(4B):1300-1303.DOI:10.3969/j.issn.1009-6493.2015.11.007.GUAN S S,ZHAO Y N,HAO Z W,et al.Study on coping styles of parents of mentally retarded children and its influencing factors[J].Chinese Nursing Research,2015,29(4B):1300-1303.DOI:10.3969/j.issn.1009-6493.2015.11.007.
[13]丁彦华.父母婚姻质量与儿童心理发展的关系[J].中小学心理健康教育,2014(22):4-6,10.DOI:10.3969/j.issn.1671-2684.2014.22.002.DING Y H.The relationship between the quality of parents'marriage and the psychological development of children[J].Mental Health Education in Primary and Secondary School,2014(22):4-6,10.DOI:10.3969/j.issn.1671-2684.2014.22.002.
[14]吉彬彬,陈三妹,易容芳,等.孤独症儿童父母社会支持和应对方式及家庭功能的研究[J].广东医学,2013,34(10):1594-1596.DOI:10.3969/j.issn.1001-9448.2013.10.045.JI B B,CHEN S M,YI R F,et al.Study on social support,coping styles and family functioning in parents of children with autism[J].Guangdong Medical Journal,2013,34(10):1594-1596.DOI:10.3969/j.issn.1001-9448.2013.10.045.
[15]毕宏生,潘华伟,刘力,等.糖尿病及其合并视网膜病变者特质应对方式分析[J].山东大学学报(医学版),2011,49(10):146-149.BI H S,PAN H W,LIU L,et al.Coping style and the related factors in patients with diabetes and diabetic retinopathy[J].Journal of Shandong University(Health Sciences),2011,49(10):146-149.
[2]唐月红,王新.脑瘫患儿父母的亲职压力现状调查[J].全科护理,2015,13(20):1991-1992.DOI:10.3969/j.issn.1674-4748.2015.20.039.TANG Y H,WANG X.Investigation on parenting stress of parents of children with cerebral palsy[J].Chinese General Practice Nursing,2015,13(20):1991-1992.DOI:10.3969/j.issn.1674-4748.2015.20.039.
[3]陈夏尧,李丹,刘荣莲,等.智力障碍、孤独症儿童家长心理压力及相关因素对比研究[J].中国康复理论与实践,2013,19(6):572-574.DOI:10.3969/j.issn.1006-9771.2013.06.020.CHEN X Y,LI D,LIU R L,et al.Related factors of stress of parents of children with intellectual disabilities and autism:a comparative study[J].Chinese Journal of Rehabilitation Theory and Practice,2013,19(6):572-574.DOI:10.3969/j.issn.1006-9771.2013.06.020.
[4]贺莉娜,周长虹,李海燕.孤独症儿童家长的应对方式与心理健康的相关性研究[J].中国儿童保健杂志,2015,23(9):937-939.DOI:10.11852/zgetbjzz2015-23-09-13.HE L N,ZHOU C H,LI H Y.Correlation between coping style and mental health of the autism children's parents[J].Chinese Journal Child Health Care,2015,23(9):937-939.DOI:10.11852/zgetbjzz2015-23-09-13.
[5]张向葵,郭新志,孙阳.中轻度脑瘫患儿父母应对方式的心理干预研究[J].大庆师范学院学报,2015,35(5):132-137.DOI:10.13356/j.cnki.jdnu.2095-0063.2015.05.030.ZHANG X K,GUO X Z,SUN Y.A psychologecal intervening research on parental coping styles of children with mild to moderate cerebral palsy[J].Journal of Daqing Normal University,2015,35(5):132-137.DOI:10.13356/j.cnki.jdnu.2095-0063.2015.05.030.
[6]FEIFEL H,STRACK S,NAGY V T.Coping strategies and associated features of medically ill patients[J].Psychosom Med,1987,49(6):616-625.
[7]沈晓红,姜乾金.医学应对方式问卷中文版701例测试报告[J].中国行为医学科学,2000,9(1):18-20.DOI:10.3760/cma.j.issn.1674-6554.2000.01.008.SHEN X H,JIANG Q J.Report on application of Chinese version of MCMQ in 701 patients[J].Chinese Journal of Behavioral Medical Science,2000,9(1):18-20.DOI:10.3760/cma.j.issn.1674-6554.2000.01.008.
[8]周贵,苏超敏,宋列席,等.某地住院空巢老人医学应对方式调查[J].现代临床医学,2016,42(6):429-431.DOI:10.11851/j.issn.1673-1557.2016.06.009.ZHOU G,SU C M,SONG L X,et al.Investigation of medical coping style in hospitalized empty-nest elderly in certain area[J].Journal of Modern Clinical Medicine,2016,42(6):429-431.DOI:10.11851/j.issn.1673-1557.2016.06.009.
[9]常艳玲,李巧秀.脑瘫患儿父母希望水平与应对方式的关系[J].中华临床医师杂志:电子版,2016,10(7):32-33.CHANG Y L,LI Q X.The relationship between hope level and coping styles of cerebral palsy children's parents[J].Chinese Journal Clinicians:Electronic Edition,2016,10(7):32-33.
[10]何春秀,郝桂荣,张会君,等.老年2型糖尿病患者医学应对方式及影响因素研究[J].中国全科医学,2015,18(5):525-529.DOI:10.3969/j.issn.1007-9572.2015.05.010.HE C X,HAO G R,ZHANG H J,et al.Medical coping in elderly T2DM patients and its influencing factors[J].Chinese General Practice,2015,18(5):525-529.DOI:10.3969/j.issn.1007-9572.2015.05.010.
[11]原志芳,柴倩文,金奕,等.首发脑卒中患者医学应对方式及其影响因素调查研究[J].中国全科医学,2016,19(2):210-215.DOI:10.3969/j.issn.1007-9572.2016.02.018.YUAN Z F,CHAI Q W,JIN Y,et al.Investigation on medical coping modes of first stroke patients and its influencing factors[J].Chinese General Practice,2016,19(2):210-215.DOI:10.3969/j.issn.1007-9572.2016.02.018.
[12]关珊珊,赵雅宁,郝正玮,等.智障儿童父母应对方式及影响因素研究[J].护理研究,2015,29(4B):1300-1303.DOI:10.3969/j.issn.1009-6493.2015.11.007.GUAN S S,ZHAO Y N,HAO Z W,et al.Study on coping styles of parents of mentally retarded children and its influencing factors[J].Chinese Nursing Research,2015,29(4B):1300-1303.DOI:10.3969/j.issn.1009-6493.2015.11.007.
[13]丁彦华.父母婚姻质量与儿童心理发展的关系[J].中小学心理健康教育,2014(22):4-6,10.DOI:10.3969/j.issn.1671-2684.2014.22.002.DING Y H.The relationship between the quality of parents'marriage and the psychological development of children[J].Mental Health Education in Primary and Secondary School,2014(22):4-6,10.DOI:10.3969/j.issn.1671-2684.2014.22.002.
[14]吉彬彬,陈三妹,易容芳,等.孤独症儿童父母社会支持和应对方式及家庭功能的研究[J].广东医学,2013,34(10):1594-1596.DOI:10.3969/j.issn.1001-9448.2013.10.045.JI B B,CHEN S M,YI R F,et al.Study on social support,coping styles and family functioning in parents of children with autism[J].Guangdong Medical Journal,2013,34(10):1594-1596.DOI:10.3969/j.issn.1001-9448.2013.10.045.
[15]毕宏生,潘华伟,刘力,等.糖尿病及其合并视网膜病变者特质应对方式分析[J].山东大学学报(医学版),2011,49(10):146-149.BI H S,PAN H W,LIU L,et al.Coping style and the related factors in patients with diabetes and diabetic retinopathy[J].Journal of Shandong University(Health Sciences),2011,49(10):146-149.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |