注意缺陷多动障碍儿童母亲的亲职压力影响因素分析

【目的】探讨注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童母亲的亲职压力及影响因素。【方法】采用亲职压力指标简表(包括职愁苦、亲子互动失调及困难儿童3个子量表)、社会支持评定量表、简易应对方式问卷和中国韦氏儿童智力量表对61名ADHD儿童母亲进行调查,同时对57名正常儿童母亲施测亲职压力指标简表。【结果】ADHD儿童母亲的亲职压力总分及各维度得分均高于正常儿童母亲(P0.05);单因素分析显示:儿童年龄、母亲年龄均与困难儿童维度呈正相关(r=0.343、r=0.429,P0.01);消极应对方式与亲职压力总分呈正相关(r=0.321,P0.05);而社会支持和积极应对方式与亲职压力总分呈负相关(r=0.573、r=0.340,P0.01);多元回归分析结果显示:社会支持和母亲年龄进入了亲职压力的回归方程,解释了总变异的41.3%。【结论】ADHD儿童母亲普遍存在较高水平的亲职压力,其亲职压力受多种因素影响。     

孤独症谱系障碍儿童母亲亲职压力及影响因素研究

目的 探讨孤独症谱系障碍(autism spectrum disorders,ASD)儿童母亲亲职压力及其影响因素。 方法 采用亲职压力指标简表(PSI-SF),焦虑自评量(SAS),流调用抑郁自评量表(CES-D),简易应对方式量表(SCSQ),领悟社会支持量表(PSSS),孤独症行为量表(ABC),以及自拟的儿童和家庭基本情况调查表对150例ASD儿童的母亲进行调查。 结果 不同抑郁和焦虑水平的儿童母亲在亲职总压力及三个维度得分差异均有统计学意义(P<0.05);除亲职愁苦维度外,不同ABC得分组间母亲亲职总压力得分及另外两个维度有差异(P<0.05);除困难儿童维度外,其他各维度及总压力得分均与积极应对呈负相关(P<0.05);除亲子互动失调维度外,其他各维度及总压力得分均与消极应对呈正相关(P<0.05);朋友支持、其他人支持与亲子互动失调呈负相关;社会总支持与亲职愁苦呈负相关(P<0.05);多元线性回归显示:亲职总压力与患儿严重程度、母亲的焦虑和抑郁状态以及政府资助显著相关。 结论 母亲的亲职压力受多种因素影响,提高ASD康复服务水平,改善患儿症状及家长心理状态并给予更多的政府和社会支持是缓解母亲亲职压力的重要途径。     

特发性中枢性性早熟患儿母亲亲职压力评估及影响因素探讨

目的：对特发性中枢性性早熟(ICPP)患儿母亲亲职压力进行评估,并探讨其影响因素。方法：选取2020年5～2021年5月确诊为特发性中枢性性早熟儿童母亲56名,另选取30名正常儿童母亲,使用短职型亲职压力量表进行调查,分析ICPP患儿母亲亲职压力现状及其影响因素。结果：ICPP儿童母亲亲子愁苦、亲子互动失调、困难儿童以及亲职压力总分均高于正常儿童母亲(P<0.05)。不同儿童性别、家庭结构及家庭月收入,ICPP儿童母亲亲职压力总分具有统计学差异(P<0.05)。结论：ICPP儿童母亲亲职压力处于一个较高的水平,儿童性别、家庭结构及其家庭月收入均为母亲亲职压力的影响因素。     

Asperger综合征儿童行为调节与其智力的相关分析

【目的】探讨Asperger综合征(AS)儿童的行为调节与智力的关系并对相关因素进行分析,为AS的评估和干预提供临床指导。【方法】对33名确诊为AS(采用DSM-IV标准)的儿童进行韦氏智力评估,同时由家长完成BASICS行为调节量表中文版,对评估结果进行相关分析。【结果】AS组在5个维度以及总量表的得分均较对照组儿童高,差异有显著性(P均0.001);AS组平均VIQ、PIQ、FIQ、VIQ-PIQ差值分别为106.45±18.33、95.88±15.98、101.76±16.21,16.82±13.04,VIQ和PIQ间差异有统计学意义(P0.05);AS组在所有5个维度及总量表得分与VIQ、PIQ、FIQ以及VIQ-PIQ无显著相关(r为0.004~0.251,P均0.10)。【结论】AS儿童存在行为调节问题和智力发展不平衡,其行为调节问题与智力无明显相关,在临床实践中应重视其非智力因素的干预。     

Asperger综合征早期干预结果分析

[目的]研究学龄前Asperger综合征患儿早期干预内容及结果,为进一步临床干预指导提供依据.[方法]对在四所幼儿园诊断出的4名Asperger综合征患儿,制定个别化计划干预训练.每周五次,每次半天训练,共6个月.[结果]4例患儿临床症状得到不同程度改善.在幼儿园的规范性及适应能力得到明显提高.[结论]早期发现、早期干预能够促进Asperger综合征患儿的早期发展.     

Asperger综合征儿童智力特点分析

【目的】 探讨Asperger综合征(Asperger syndrome ,AS)儿童的智力结构和认知特点,为相关研究及诊疗提供依据。 【方法】 采用韦氏儿童智力测验第4版(Wechsler Intelligence Scale for Children-Fourth Edition,WISC-IV)对26名符合美国《精神障碍诊断和统计手册》第4版(DSM-IV)标准诊断的AS儿童[平均(9.53±2.42)岁]进行测试。 【结果】 入组AS儿童的总智商(95.69±12.11)在正常范围,知觉推理指数(100.08±13.70)的得分最高,加工速度指数(91.58±11.31)的得分最低。此外,在各分测验中,类同(11.04±3.69)的得分最高,背数(7.88±1.88)的得分最低。 【结论】 入组AS儿童具有正常范围的认知水平,但存在明显的执行功能障碍,表现为认知灵活性、工作记忆以及短时记忆等能力相对偏低。     

学龄Asperger综合征儿童智力特征分析

【目的】探讨Asperger综合征(Asperger syndrome,AS)儿童的智力特征。【方法】选取AS儿童62例(AS组),正常儿童63例(对照组),应用中国修订韦氏儿童智力量表(C-WISC)分别进行测试。【结果】AS组中8.07%智力低下(FIQ<70)。AS组FIQ、VIQ、PIQ及11个分测验得分均低于对照组,除知识、分类及填图外,余差异均有显著性(P均<0.05)。AS组V-P差值有显著性的比例高于对照组(P<0.05),且VIQ高于PIQ者较多(P<0.01)。AS组儿童在Dean因子分析理论中抽象思维、视觉记忆、听觉记忆、社会理解和视觉-运动速度明显低于对照组,而远记忆仅低于对照组,但差异无显著性。【结论】Asperger综合征儿童在多个认知功能方面存在缺陷。     

改善母亲亲职压力状态对提高脑瘫儿童康复效果的作用

目的 分析改善母亲亲职压力提高脑瘫儿童康复效果的可行性。 方法 将2016年3—12月在连云港医院康复治疗的68对脑瘫儿童及其存在中重度亲职压力的母亲随机分为实验组与对照组,儿童和母亲分别接受综合康复治疗和家庭康复训练指导,实验组母亲加予心理干预,实验周期6个月。用SPSS 19.0分析比较实验前后母亲亲职压力和脑瘫儿童运动、语言及日常生活自理能力(ADL)量表得分。结果 干预6个月后,与对照组相比,实验组母亲的亲职压力明显降低(t=-7.051,P<0.001),脑瘫儿童运动、语言、ADL也明显改善(χ²=6.222、6.745、6.344,P<0.05)。结论 降低脑瘫儿童母亲的亲职压力有助于提高脑瘫儿童的康复效果。     

ASD儿童父母的亲职压力及心理影响因素研究

目的 探讨孤独症谱系障碍(ASD)儿童父母的亲职压力及心理影响因素.方法 选取2014至2015年由福建省福州儿童医院心理科和福建医科大学附属协和医院儿童神经专科高年资主治以上医师确诊、并其父母完成问卷调查的ASD儿童134例,采用亲职压力指标简表(包括父母困扰、亲子失功能及困难儿童3个分量表)、一般自我效能感量表、特质应对方式问卷对134名ASD儿童父母(实验组)进行调查,同时对115名正常儿童父母(对照组)施测,对结果进行分析.结果 实验组亲职压力总分及各维度得分均高于对照组(t =8.40 ～9.95,P＜0.05);实验组一般自我效能感低于对照组(t=-6.61,P＜0.05),且采用更多的消极应对方式和更少的积极应对方式(t值分别为6.39、-4.72,P＜0.05).相关分析显示:ASD儿童父母的亲职压力与消极应对呈正相关(r=0.328,P＜0.01),ASD儿童父母的亲职压力总分、父母困扰及困难儿童得分与患儿父母一般自我效能感均呈负相关(r值分别为-0.222、-0.251、-0.177,P＜0.05).结论 ASD儿童父母普遍存在较高水平的亲职压力,其亲职压力与家长的一般自我效能感及消极应对方式有关.     

高功能孤独症和Asperger综合征儿童的中央凝聚性研究

【目的】探讨高功能孤独症（high function autism，HFA）和Asperger综合征（Asperger syndrom，AS）儿童在中央凝聚性方面的认知神经心理特征，为其治疗提供理论依据。【方法】应用视觉和言语语义记忆任务和木块图形测验分别对19例学龄前及学龄期HFA儿童、26例AS儿童和20例正常健康儿童（normal controls，NC）进行测试，为其治疗提供理论依据。【结果】在视觉模式或言语模式下，给予语义相关系列的刺激时，三组儿童组能回忆的正确图片或词语数目均比非相关系列刺激能回忆正确的图片或词语数目显著增多（P〈0．05）；各组儿童在视觉模式下能回忆的图片数目均比在言语模式下能回忆的词语数目显著增多（P〈0．01）；HFA组儿童在视觉模式相对言语的记忆优势比正常组更明显。HFA组木块图量表分明显低于正常儿童组（P〈0．05），AS组量表分与正常儿童组差异无显著性（P〉0．05）。【结论】学龄前及学龄期HFA和AS儿童的中央凝聚性薄弱并不明显，推测HFA和AS患者的中央凝聚性薄弱的认知特征可能会随着年龄的增长逐渐明显。     

南京市城区学龄前儿童母亲育儿压力影响因素分析

目的 调查南京市城区3~6岁幼儿母亲的育儿压力并分析相关的影响因素,为指导母亲科学育儿提供依据。方法 采用简式育儿压力问卷(Parenting Stress Index-short Form,PSI-SF)和自编基本情况调查表、育儿环境调查表、母亲工作情况调查表对随机抽取的400名南京市城区的3~6岁幼儿及其母亲进行调查并比较分析。结果 在调查的母儿生理因素、家庭育儿环境、母亲文化程度及母亲工作状况相关因素中,母亲健康状况、母亲流产史、家庭住房面积、养育方法、母亲文化程度、母亲职业(企业单位与事业及机关单位)、母亲工作量增减及母亲收入增减与母亲育儿压力差异有统计学相关(P均<0.05)。结论 学龄前儿童母亲的育儿压力受多方面因素影响。     

Parenting in a crisis: conceptualising mothers of children with cancer

Much research on the experiences of parents of children with cancer has been conducted within a discourse of psycho-pathology, or has tended to see parents mostly as a proxy source of information on the well-being of their children. Using empirical data from semi-structured interviews with 20 mothers of a child with cancer, in one area of the UK, we draw on sociological literatures on motherhood, childhood, caring, and chronic illness to suggest a more helpful and informative way of understanding their experiences. We suggest that mothers, although not ill themselves, experience many of the consequences of chronic illness. Biographical disruption begins for them when they first notice something wrong with their child, and intensifies with diagnosis, altering their sense of self and their social identity. The diagnosis brings with it a set of new responsibilities and role expectations, including an obligation of 'proximity'-being physically close to their child at all times to provide 'comfort' and 'keep-watch'. For mothers, caring evokes an intense emotional interdependence with their sick child, and involves a range of technical tasks and emotional work, including acting as 'brokers' of information for their child and managing their cooperation with treatment. Managing these obligations was achieved at high cost to the mothers themselves, and resulted in severe role strain by compromising their ability to function in other roles, including their role as the mother of their other children. Against the backdrop of a severe and life-threatening illness, everyday concerns about their child's diet or appropriate discipline take on a new significance and carry a heightened potential for generating conflict and distress for mothers. In presenting their accounts, mothers draw on prevailing cultural discourses about motherhood, childhood and cancer, and these clearly influence the context in which they care for their child, and shape their reflexive constructions of their experiences. Caring for a child with cancer had many adverse implications for the quality of life of the women we studied. Mothers of a child with cancer warrant study in their own right, and such study benefits from interpretive perspectives.     

Parenting stress in mothers and fathers of a child with a hemiparesis: sources of stress, intervening factors and long-term expressions of stress

Background In a substantial minority of children with a hemiparesis, motor impairments are accompanied by behavioural problems. This combination confronts parents with several persistent, frequently intense, sources of stress. At the same time, it is likely to reduce the effectiveness of psychosocial resources, such as feelings of competence, which would normally buffer the impact of the stressors. Aim To investigate the association between motor and behavioural problems in children with a hemiparesis and symptoms of stress in their parents, with particular attention to psychosocial factors which may mediate between the child's problems and parents’ symptoms of stress. Method Questionnaires assessing the medical, functional and behaviour problems of the child, and the parents’ experience of stress were completed by the mothers and fathers of 108 children with a hemiparesis who were members of the Association for the Motor Handicapped in the Netherlands. Results Both parents reported (extremely) high levels of long‐term stress significantly more frequently than parents in a normative sample. Indices of long‐term stress were associated with the child's behavioural problems and, less strongly, with dysfunctionality in daily life. However, behavioural problems and dysfunctionality also reduced parents’ feelings of competence and social support. A mediation analysis showed that feelings of incompetence and social isolation mediated between the child's problems and the parents’ symptoms of stress. Fathers and mothers did not differ in level of reported stress, or in the associations between the child's problems and degree of experienced stress. Conclusion Both parents of a child with a hemiparesis experience high levels of stress, which are strongly associated with feelings of incompetence and social isolation. This suggests that one focus of intervention should be the alleviation of parenting stress with particular attention to increasing perceived competence in the parenting role and reducing feelings of social isolation.     

孤独症患儿父母压力和情绪变化及相关因素

【目的】 探讨孤独症患儿父母压力和情绪变化及其相关因素。 【方法】 采用父母压力指数量表(PSI)、孤独症行为量表(ABC)、孤独症评定量表(CARS)、抑郁自评量表(SDS)和焦虑自评量表(SAS)对孤独症患儿父母进行评定;采用PSI、SDS和SAS量表对正常儿童父母进行评定。 【结果】 1)孤独症患儿父母PSI总分及各分量表分均显著高于正常儿童父母(P=0.000);2)患儿父、母亲SDS和SAS分均显著高于正常儿童父母(P= 0.000)。患儿母亲SDS和SAS分均高于患儿父亲得分(P=0.000),患儿母亲抑郁发生率高于父亲(P=0.000);3)患儿父母的压力与患儿症状严重度正相关(P<0.01);4)多元回归结果表明孤独症患儿ABC量表分、孤独症患儿母亲的焦虑以及患儿年龄影响孤独症儿童父母压力,解释了总变异的54.9%。 【结论】 孤独症患儿父母承受着较高的压力、焦虑和抑郁水平,孤独症患儿母亲比患儿父亲及正常儿童父母更易发生抑郁,患儿行为问题是父母压力的主要影响因素。     

孤独症谱系障碍儿童家长压力及相关影响因素研究

目的 研究孤独症谱系障碍(ASD)儿童家长压力及相关影响因素,为缓解育儿压力及提升干预疗效提供依据。方法 选取复旦大学附属儿科医院儿保科首次诊断为ASD患儿家长为研究对象,并将同期诊断的精神发育迟缓/言语障碍和正常儿童家长作为对照组,分析不同组家长育儿压力的差异。采用家长育儿压力简表(PSI-SF)对家长压力值进行评定,一般育儿信息问卷调查相关育儿压力因素,0~6岁发育筛查测试(DST)评估ASD儿童发育商。结果 多数入组的ASD儿童伴随发育迟缓,存在智力及社会适应发育落后的几率高于运动发育。ASD组儿童家长在压力总分、亲子互动失调及困难儿童分量表得分显著高于精神发育迟缓/言语障碍儿童组家长及正常儿童家长(总分:100.67±15.08 vs 93.19±13.85 vs 82.61±17.68,F=43.85,P<0.05)。孤独症家长在育儿愁苦分量表压力值高于正常儿童家长(33.34±7.07 vs 29.77±7.47,P<0.05),与精神发育迟缓/言语障碍儿童组家长的差异不显著。增加父亲带养时间以及家庭经济收入,父母拥有更高的文化程度能帮助缓解家长育儿压力。结论 1)多数ASD儿童伴随发育迟缓,其家长承受着更高的育儿压力。2)增加父亲带养时间、引导父亲更多参与家庭干预,政府、社会对ASD儿童及家长投入更多的资金与教育支持,将对缓解患儿家长育儿压力以及提升干预疗效具有重要的作用。     

Parenting deficits of mothers living with HIV/AIDS who have young children

The purpose of this study was to examine a model of the relationships between parenting deficits and skills, along with child outcomes, in a sample of mothers living with HIV (MLH) and their 6- to 14-year-old children. Sixty-two MLH (61% Latina, 26% black, 3% white, and 10% multiracial) and their well children (age 6–14) were recruited from the greater Los Angeles, California, region to participate in an intervention (IMAGE: Improving Mothers’ parenting Abilities, Growth, and Effectiveness) designed to assist MLH with parenting and self-care skills. Constructs examined included parenting deficits, parenting skills, and child outcomes. Covariance structural modeling was used for the analyses. Covariance structural modeling confirmed the hypothesized set of construct associations. As predicted, fewer parenting deficits were associated with better parenting skills, which, in turn, were associated with better child outcomes. This study delineated further the parenting issues with which MLH struggle, providing information on the interventions needed for this population. MLH who have little confidence they can enact parenting skills and limited knowledge of basic parenting practices appear to be less likely to provide family routines consistently, monitor their children, or to engender family cohesion or a close parent–child relationship. Such parenting skills were found to be associated with child functioning.