发达地区残疾儿童照护者应对行为现状及影响因素分析

目的 了解照护者在残疾儿童康复情境下的应对行为并分析相关的影响因素。方法 2019年12月至2020年1月以及2020年8月至9月,方便抽样选取残疾儿童照护者中的358例父母。采用父母应对方式量表(CHIP)在残疾儿童康复情境下对照护者应对行为进行评估,并通过多元线性逐步回归模型分析影响应对行为的因素。结果 残疾儿童照护者应对行为总作用得分为(106.00±23.45),平均作用得分为(2.36±0.52)。照护者因素中母亲(B = 7.607, 95%CI 2.477~12.737, P = 0.004)、不需要照顾他人(B = 5.758, 95%CI 1.174~10.343, P = 0.014)的照护者应对行为得分更高。儿童因素中,伙伴数量越多(B = 2.925, 95%CI 1.233~4.618, P < 0.001)、参与公共空间活动越频繁(B = 3.906, 95%CI 1.743~6.068, P < 0.001)、康复效果有变化(B = -16.832, 95%CI -31.471~-2.193, P = 0.024)的照护者应对行为得分更高;儿童年龄3~< 6岁(B = -7.914, 95%CI -15.157~-0.671, P = 0.032)、残疾类型为智力残疾(B = -11.153, 95%CI -21.360~-0.947, P = 0.032)的照护者应对行为得分更低。环境因素中感知社会态度越友好(B = 2.560, 95%CI 0.615~4.505, P = 0.010)的照护者应对行为得分更高。结论 残疾儿童照护者需要掌握在儿童康复情境下的应对行为方法。在处理残疾儿童康复相关问题时,照护者应对行为受到儿童个体、照护者及环境多维因素的共同影响。

Coping Behaviors and Its Influential Factors for Caregivers of Children with Disabilities in Developed Areas in China

Objective To investigate the current status of coping behaviors among caregivers of children with disabilities in the context of rehabilitation and its influencing factors.Methods From December, 2019 to January, 2020, and August to September, 2020, a total of 358 caregivers (parents) of children with disabilities were surveyed in Shanghai. They were evaluated in the context of rehabilitation of children with disabilities with Coping Health Inventory for Parents (CHIP). Multiple linear stepwise regression analysis was used to explore the influencing factors.Results The total score of CHIP was (106.00±23.45) and the average score of CHIP was (2.36±0.52). Among the caregiver factor, mothers (B = 7.607, 95%CI 2.477 to 12.737, P = 0.004), and caregivers who didn't need to care for others (B = 5.758, 95%CI 1.174 to 10.343, P = 0.014) reported higher CHIP score. Among the child factors, higher CHIP score was reported in caregivers who had more partners (B = 2.925, 95%CI 1.233 to 4.618, P < 0.001), participated in public space activities more frequently (B = 3.906, 95%CI 1.743 to 6.068, P < 0.001) and perceived changes in rehabilitation outcomes (B = -16.832, 95%CI -31.471 to -2.193, P = 0.024); CHIP score was lower in thoses of 3 to < 6 years old (B = -7.914, 95%CI -15.157 to -0.671, P = 0.032) and with intellectual disability children (B = -11.153, 95%CI -21.360 to -0.947, P = 0.032). Among the environmental factors, caregivers who perceived more friendly social attitude (B = 2.560, 95%CI 0.615 to 4.505, P = 0.010) reported higher CHIP score.Conclusion It is proposed to learn the coping needs of caregivers of children with disabilities in the context of rehabilitation. The coping behaviors of caregivers are influenced by multiple factors, such as children's individual, caregivers and environment.