脊髓损伤患儿及主要照顾者的心理状况及其对疾病家庭管理的影响

目的：探讨脊髓损伤（SCI）患儿及主要照顾者心理状况对其疾病家庭管理的影响。方法：选取2015年2月至2020年6月温州医科大学附属第二医院育英儿童医院收治的94例SCI患儿，采用儿童焦虑性情绪障碍筛查表和儿童抑郁障碍自评量表对患儿进行问卷调查，并采用一般资料量表、心理弹性问卷、焦虑自评量表、抑郁自评量表及家庭管理测量量表对患儿的主要照顾者进行问卷调查。采用Pearson相关性分析和多元线性回归分析考察家庭管理水平的影响因素。结果：SCI患儿的焦虑和抑郁水平较高，其主要照顾者的抑郁、焦虑水平也较高，均显著高于国内常模（P ＜0.05）；主要照顾者的心理弹性则较低，低于国内常模（P ＜0.001）。家庭疾病管理水平的“患儿生活水平”受患儿焦虑状况（β=-0.810，P ＜0.001）和抑郁状况（β=-3.144，P =0.002）影响，“家长疾病管理能力”受照顾者的“坚韧“（β=0.061，P =0.004）和“力量”（β=0.944，P ＜0.001）影响，“家长关心状况”受患儿的焦虑（β=0.078，P =0.041），照顾者的焦虑（β=0.990，P ＜0.001）及“力量”（β=0.019，P =0.044）影响，“家长疾病管理困难状况”受照顾者心理弹性（β=-0.098，P =0.004）及其“坚韧”维度（β=-0.892，P ＜0.001）影响，“家长疾病精力消耗状况”受照顾者的“乐观”（β=0.874，P ＜0.001）影响，“家长互相支持”受照顾者的抑郁（β=-0.145，P ＜0.001）和“力量”维度（β=0.088，P ＜0.001 ）、“乐观”（β=1.155，P ＜0.001）影响。结论：SCI患儿及主要照顾者心理状况是其疾病家庭管理的重要影响因素。

Psychological status of children with spinal cord injury and their primary caregivers with an analysis of its impact on family management of the diseacse

Objective: To investigate the psychological status of spinal cord injury (SCI) children and their primary caregivers to find out the influencing factors on family management of SCI. Methods: A total of 94 SCI children in the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University from February 2015 to June 2020 were enrolled, and their anxiety and depression levels were respectively evaluated via SCARED (the screen for child anxiety related emotional disorders) and DSRSC (depression self-rating scale for children). Besides, questionnaires were also carried out on the primary caregivers of SCI children by using General Information Scale, Connor-Davidson resilience scale (CD-RISC), self-rating anxiety scale (SAS), self-rating depression scale (SDS) and family management measure (FaMM). Pearson correlation analysis and multiple linear regression analysis were made to explore the influencing factors of household management. Results: Both SCI children and their primary caregivers had significantly higher level of depression and anxiety than those in the domestic normative model (both P<0.05). In addition, the psychological resilience of primary caregivers waslower than the domestic normative model (P<0.001). The “daily living standards of children” in FaMM was influenced by anxiety level (β=-0.810, P<0.001) and depression level (β=-3.144, P=0.002) of children. “Parents’ management ability on disease” was affected by“tenacity” (β=0.061, P=0.004) and “strength” (β=0.944, P<0.001);“parental concern” was affected by children’s anxiety (β=0.078, P=0.041), and caregiver’s anxiety (β=0.990,P=0.041) and “strength” (β=0.019, P=0.044); “parental difficulty in disease management” was associated with “psychological resilience” (β=-0.098, P=0.004) and “tenacity” (β=-0.892, P<0.001); “parents’ energy expenditure on disease” was affected by “optimism” (β=0.874, P<0.001); the “parents’ mutual support” was affected by“depression” (β=-0.145, P<0.001), “strength” (β=0.088, P<0.001) and “optimism” (β=1.155, P<0.001).Conclusion: The psychological status of SCI children and their primary caregivers was a vital factor affecting family management of the illness.