脑瘫患儿主要照护者焦虑、抑郁状况影响因素分析

目的：探讨脑瘫患儿主要照护者焦虑、抑郁现状及影响因素，为改善主要照护者心理健康状况，提高患儿康复治疗水平提供参考依据。方法采用焦虑自评量表（ SAS）、抑郁自评量表（ SDS）、世界卫生组织生存质量测定量表简表（ WHOQOL-BREF ），整群抽取145名住院脑瘫患儿的照护者进行调查。结果脑瘫患儿主要照护者焦虑和抑郁的发生率分别为42．76％和53．79％，焦虑水平为（47．73＆#177;10．96）分，显著高于国内常模（29．78＆#177;0．46）分，差异有统计学意义（t＝19．730，P＜0．01）。焦虑、抑郁得分随着生命质量得分增加而增加。单因素分析结果显示：不同职业、文化程度、年龄、月收入、有无并发症间焦虑发生率差异有统计学意义（χ2分别为11．695，10．787，3．919，5．133，9．942；P＜0．05），不同性别、年龄组间抑郁的发生率差异有统计学意义（χ2分别为10．393，8．919；P＜0．05）。经多因素Logistic逐步回归分析结果显示：女性照护者、有并发症、以半自费和新农合为医疗形式的照护者更容易出现抑郁情绪；工人、农民、病程在10年以上的照护者更容易出现焦虑情绪。结论脑瘫患儿照护者心理状况较差，存在比较严重的焦虑和抑郁情况。医务工作者应在进行患儿康复的同时，注意主要照护者心理状况的改变，对他们进行健康教育和心理关怀。对于已经出现心理疾病的主要照护者建议他们及时进行心理治疗，从而全面提高患儿的康复水平。

Analysis of influence factors and status of anxiety and depression in main caregivers with cerebral palsy children

Objective To explore the influence factors and the status of anxiety and depression in main caregivers with cerebral palsy children , improve caregivers psychological health status , and offer references for improving the rehabilitation level of cerebral palsy children .Methods A total of 145 caregivers of cerebral palsy children were selected by cluster sampling to carry on the investigation by using SAS , SDS, WHOQOL-BREF. Results The incidence of anxiety and depression was 42.76%and 53.79%, respectively.The score of anxiety was 47.73 ＆#177;10.96, which was higher significantly than domestic routine norm （29.78 ＆#177;0.46） with a statistical difference （t =19.730; P ＆lt;0.01）.Anxiety and depression score increased as the life quality score of increased.The single factor analysis results indicated that there was a statistical significance in rate of anxiety among different jobs, education levels,ages,monthly income,and with complications or not （χ2 =11.695, 10.787, 3.919, 5.133, 9.942, respectively; P＆lt;0.05）, so did the depression among different genders ,and age groups （χ2 =10.393 and 8.919; P＆lt;0.05）.Multivariate Logistic stepwise regression analysis found the results as following：female caregivers , with complications , and half-paidcombining with New Rural Cooperative Medical System （NRCMS） were easier to have the depressed mood .Workers, peasants, and course of disease above 10 years appeared anxiety easily .Conclusions The caregivers of cerebral palsy children psychological status are relatively poor in hospital , which exists seriously anxious and depression .Medical workers should pay attention to the psychological changes of main caregivers , offering health education and psychological care during the treatment.For there have been mental illness caregivers , it is recommended for them to receive timely psychological treatment , thereby improving the rehabilitation level of cerebral palsy children in an all -round way.