先天性甲状腺功能减低症患儿的行为问题及家庭护理对策

目的了解先天性甲状腺功能减低症(congenital hypothyroidism,CH)患儿的行为特点和家庭环境特征,指导家庭进行正确的家庭护理和健康教育。方法 2010年9-12月便利选取确诊的永久性CH患儿53例和正常儿童56例,采用一般情况调查表、Achenbach儿童行为量表及家庭环境量表-中文版进行调查。结果两组男童在忧郁、社会退缩、性问题、分裂样焦虑、违纪等5个方面和总分上差异有统计学意义,而女童则在肥胖、多动、躯体诉述、忧郁等4个方面和总分上差异有统计学意义(P<0.05或P<0.01);病例组儿童行为问题的发生率(41.5%)明显高于对照组(17.8%),差异有统计学意义(P<0.05);两组儿童的家庭在亲密度、情感表达、成功性、知识性等4个方面差异有统计学意义(P<0.05或P<0.01)。结论 CH患儿行为问题的发生率明显高于正常儿童,且其家庭环境还有待改善;因此,在对CH患儿进行常规治疗的同时,应重视CH患儿家庭功能的改善,为CH患儿提供良好的康复环境。

Behavior Problem Analysis and Family Nursing Interventions for Children with Congenital Hypothyroidism

Objective To understand the behavioral characteristics and family environment for children with congenital hypothyroidism（CH）, so as to provide evidence for guiding home care and health educa- tion. Methods A total of 53 children with CH and 56 normal children were recruited by convenience sam- pling from september to December 2010. General questionnaire, Achenbach Children＇s Behavior Scale and the Parent Environment Scale-Chinese Version（FES-CV） were used for evaluation. Results Total score and 5 aspects including withdrawal, depression, social issues, schizoid anxiety, breaking the rules were statistically significant in male children with CH, while the total score and 4 aspects including obesity, hyperactivity, physical complaints, and depression were statistically significant in female children with CH （P〈0.05 or P〈0.01）. Incidence of behavior problem for children with CH （41.5 %）was higher than normal children（17.8 %） （P〈0.05） ; Significant differences about intimacy, emotion expression, achievement and knowledge were also found between the two groups （P 〈 0. 05 or P〈 0. 01）. Conclusion Incidence of behavior problem for children with CH was higher than normal children, and their family environment needed to be improved. Emphasize should be attached on the improvement of family environment while implemen- ting conventional therapy, so as to provide a good rehabilitation environment for children with CH.