目的 评估幼年性类风湿性关节炎(JRA)患儿的心理社会行为问题和家庭功能, 分析患儿行为问题的影响因素,为有针对性地进行以家庭为导向的干预治疗提供科学依据。 方法 以方便抽样的方法选择2013年6月-2014年6月在西安市第五医院骨科接受系统治疗并资料齐全的56例JRA患儿及其监护者为研究对象,52名健康儿童为对照组,采用儿童行为量表和Feetham 家庭功能量表对患儿及健康儿童父母进行问卷调查, 分析患儿心理问题及家庭功能并与正常儿童进行比较。 结果 JRA患儿的内向性因子、外向性因子和行为异常问题得分均较正常儿童偏高,心理行为问题发生率明显偏高,社会能力和学校表现普遍差于正常儿童,差异有统计学意义(P<0.05)。与正常家庭比较,JRA患儿的FFFS三个分量表得分(1.30±0.79,1.21±0.68,2.20±1.10)均明显高于一般正常家庭(0.98±0.32,0.79±0.31,0.93±0.37),总d分(1.60±0.67)明显高于一般正常家庭(0.90±0.31),差异均有统计学意义(P<0.05)。家庭的功能、结构和经济状况对患儿行为问题均有明显影响。 结论 JRA患儿心理行为问题发生率较高,家庭功能与患儿的诊疗又相互影响,需要有针对性的、以家庭为导向的干预,促进JRA患儿的健康恢复。
Abstract
Objective To describe psychosocial behavior problems and family function of children with juvenile rheumatoid arthritis (JRA), and to explore the risk factors of behavioral problems,in order to provide scientific basis for family-oriented intervention. Methods Totally 56 children diagnosed with JRA and their parents in the Fifth Hospital of Xi′an were selected as the case group from June 2013 to June 2014.And 52 health children were as the control group.Caregivers were asked to fill out the Child Behavior Checklist (CBCL) and Feetham Family Functioning Survey (FFFS) during the hospitalization of children.Psychosocial behavior problems and family function of the case group and control group were analyzed and compared. Results JRA children had higher scores on introverted factors、extrovert factors and behavior problems than healthy children, and their social capacity and school performance were also worse than those of healthy children(P<0.05).Compared with healthy family, three subscales of FFFS(1.30±0.79,1.21±0.68,2.20±1.10) and the total d score(1.60±0.67)in JRA children were significantly higher than those of normal family(0.98±0.32,0.79±0.31,0.93±0.37) and 0.90±0.31(P<0.05).Meanwhile, the function, structure and economic status had obvious effect on behavioral problems in children. Conclusion Behavioral problems in JRA children are prevalent, leading to the impact of family function.And family function will in turn affect the diagnosis and treatment of children.So it is necessary to assess family-related factors and develop family-oriented interventions in order to improve children′s psychosocial function and the normalcy of their families.
关键词
幼年性类风湿性关节炎 /
心理行为问题 /
影响因素 /
Feetham 家庭功能量表 /
Achenbach儿童行为量表 /
儿童
Key words
juvenile rheumatoid arthritis /
psychosocial behavioral problem /
risk factors /
Feetham Family Functioning Survey /
Child Behavior Checklist /
children
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基金
西安交通大学医学院第二附属医院院科研基金青年项目[YJ(QN)201320]
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