肾穿刺活检儿童心理状态的影响因素分析及其干预

目的 了解儿童肾穿刺活检术前后的心理影响因素及心理干预对其作用.方法 228例患儿随机分为对照组和干预组,其中114例干预组术前增加心理干预.所有患儿术前和术后在家属帮助下填写Birmaher的儿童焦虑性情绪障碍筛查表(SCARED)、儿童抑郁障碍自评量表(DSRSC)、症状自评量表(SCL-90)和基本情况表.评价患儿的心理状况,比较对照组和干预组、肾活检前后心理变化,分析影响患儿心理的因素.结果 对照组肾穿刺活检术前SCARED总分为(52.34±15.83)分、干预组为(50.73±14.97)分,均高于国内常模[(33.94±5.78)分];经过术前谈话及心理干预后SCARED总分降低;干预组手术前后SCARED总分变化较对照组升高,而DSRSC总分患儿肾穿刺活检术前后与国内常模比较,差异均无统计学意义;患儿年龄、家庭属地、家属文化程度对患儿焦虑性情绪影响均有统计学意义;手术前后躯体化、焦虑、敌对、恐怖等因子得分均高于国内常模,患儿术后较术前焦虑、敌对、恐怖因子得分降低;干预组手术前后焦虑、敌对、恐怖等因子得分差异与对照组比较有统计学意义.结论 肾穿刺活检患儿术前心理状态受多因素影响.术前患儿多存在焦虑、敌对、恐惧等心理问题.合理的心理干预可降低患儿对手术的恐惧及焦虑情绪.

Influencing Factors Analysis and Interventions of Psychological Status in Children with Percutaneous Renal Biopsy

Objective To study the influencing factors and interventions of psychological status in children with percutaneous renal biopsy(PRB).Methods Two hundred and twenty-eight children were divided into control group and intervention group randomly.Before and after PRB,the screen for children Anxiety Related Emotional Disorder(SCARED),Depression Self-Rating Scale for Children(DSRSC),Symptom Check List-90(SCL-90) and basic intormations list were filled in by all 228 children with the help of their parents.Of the total 114 children in intervention group were increased psychological intervention before PRB.To evaluate the psychological status of patients,the differences in psychological changes between the control group and intervention group before and after renal biopsy were compared,then the factors that affect the psychology of patiens were analyzed.Results Before PRB(before psychological intervention),the scores of the SCARED in control group was(52.34±15.83) scores and intervention group was(50.73±14.97) scores,they were all higher than that of the domestic routine model [(39.94±12.55) scores].The SCARED total score decreased after talking and psychological intervention before PRB;the intervention group′s change of the SCARED scores between preoperative and after surgery was higher than that of the control group,but the DSRSC scores′ differences between groups(including control group and intervention group) and domestic routine model before and after PRB were not significant.The anxiety symptoms were significantly related to the children′s age,the place the family belonging to,and pa-rents′ educational background.The scores of sonatical change,anxiety,hostility and phobias were higher than domestic routine model before and after PRB,but the scores of anxiety,hostility and phobias were decreased after PRB than before.Anxiety,hostility and phobias,the intervention group′s score differences before and after PRB were higher than that in control group.Conclusions Before PRB,many factors are involved in children′s psychological status.Anxiety,hostility and phobias are commonly accompanied in children before PRB.Reasonable psychological interventions can decrease anxiety and phobias of children with PRB.