白血病患儿父母焦虑抑郁的调查和干预  

Investigation and Intervention for Anxiety and Depression in Parents of Children with Leukemia

作　　者：吴心怡[1] 张瑞东[1] 刘华清[2] 王秀梅[1] 胡亚美[1] 陆小彦[1] 郜慧芳[1] 霍莉钦[3] 郑胡镛[1] 

机构地区：[1]首都医科大学附属北京儿童医院,北京100045 [2]北京回龙观医院,北京100096 [3]北京大学医学部,北京100191

出　　处：《中国心理卫生杂志》2009年第5期311-315,共5页Chinese Mental Health Journal

基　　金：北京市科委重点科研项目(9555101800)

摘　　要：目的:探讨白血病患儿父母的情绪抑郁和焦虑障碍,为今后有针对性地开展心理干预和支持提供理论依据。方法:采用国际公认并具有我国常模的家庭环境量表及医院焦虑抑郁量表,对2004年3月至2006年3月期间在北京儿童医院诊治的白血病患儿的父母进行问卷测评,分三个阶段分别调查了初诊组、心理干预组和未干预组父母的家庭环境特征和情绪改变情况。对患儿父母的干预方法有个别心理治疗、小组治疗和家庭系统治疗。共收回可分析量表353份,其中初诊组138份、干预组103份、未干预组112份。结果:①白血病患儿父母在娱乐性、成功性、文化性、情感表达等因素上得分均低于常模[如,娱乐性得分常模为(4.9±2.0),三组父母分别为(3.0±2.3),(3.2±2.3),(4.1±2.1)],而在矛盾性、道德宗教上得分则高于常模[如,矛盾性得分常模为(2.2±1.9),三组父母分别为(3.9±2.6),(3.1±2.1),(3.6±2.3)]。②初诊白血病患儿父母的焦虑和抑郁分分别高于临界值38.4%和24.1%,差异有统计学意义。③白血病患儿治疗6月后未干预组父母在文化性(4.9±1.9)、娱乐性(4.1±2.1)和独立性(5.9±1.3)上得分均高于初诊组[(4.0±2.0),(3.0±2.3),(5.3±1.5)],接近常模分值水平;干预组父亲的矛盾性得分(3.0±2.3)低于未干预组父亲(4.4±2.3)。④治疗6月后患儿家长的焦虑(9.5±4.3)和抑郁(7.6±4.3)分值已降到临界值水平。结论:白血病患儿的诊治过程严重影响患儿父母的心理情感,初诊白血病患儿父母抑郁和焦虑情绪严重、家庭矛盾性上升;绝大多数白血病患儿父母通过及时、有效的人文关怀即能达到良好的干预效果,专业心理干预对家庭矛盾性的降低作用最大。Objective： To investigate the anxiety and depression in parents of children with leukemia and to develop a set of theoretical guidelines for future psychological intervention. Methods： Parents of children with leukemia treated in Beijing Children＇s Hospital （BCH） from March of 2004 to March of 2006 were evaluated with the Family Environment Scale （ FES ） and Hospital Anxiety and Depression （ HAD） questionnaires. Three groups of parents, including parents of newly-diagnosed-children, parents with or without psychological intervention, were tested. Parents in intervention group were given individual psychotherapy, group therapy or systemic family therapy. A total of 353 questionnaires were analyzed, including 138 in newly-diagnosed-children group, 103 in intervention group and 112 in nonintervention group. Results： 1. The family environment scores of expressiveness, achievement, cultural and recreational orientations were significantly lower, but the scores of conflict and ethics religion were much higher in parents of leukemia children, especially in newly-diagnosed-children group, than that in normative population. For example, the scores of expressiveness and conflict were 4. 9 and 2. 3 in normative population, but the scores were 2. 3 and 3.9 in parents of leukemia children. 2. The HAD test in parents of newly-diagnosed-children group showed that the scores of anxiety and depression were 38.4% and 24. 1% higher than the baseline score respectively. 3. Six months after treatment for children, the parents＇ cultural, recreational orientations and independence scores [ （ 4. 9 ± 1.9 ）, （ 4. 1 ±2. 1 ） , （5.9 ± 1.3） , respectively] in non-intervention group were increased to normal level compared to the newly-diagnosed group [ （4.0±2.0）, （3.0±2. 3）, （5.3±1.5）, respectively] . Fathers＇eonflict score decreased to normal level in imervention group compared to non-intervention group [ （ 3. 0±2. 3 ） vs. （ 4. 4 ± 2. 3 ）, P 〈 0. 05 ] . 4. The scores of parents

关 键 词：白血病 父母 抑郁 焦虑 问卷 干预 病例对照研究 

分 类 号：R733.7[医药卫生—肿瘤] R395.1[医药卫生—临床医学]