认知行为干预对重型颅脑损伤患儿照顾者照顾负担及应对方式的影响  

Effects of Cognitive Behavioral Intervention on Burden and Coping Style among Primary Care-givers of Children with Severe Traumatic Brain Injury

作　　者：周筱春[1] 赵凯怡 李霞[1] 刘一苇[1] 朱聪[2] 陈翔[1] ZHOU Xiao-chun;ZHAO Kai-yi;LI Xia;LIU Yi-wei;ZHU Cong;CHEN Xiang(Dept.of Paediatric Rehabilitation;Dept.of Nursing Administration,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,China)

机构地区：[1]温州医科大学附属第二医院儿童康复科,浙江温州325027 [2]温州医科大学附属第二医院护理部,浙江温州325027

出　　处：《护理学报》2018年第17期50-54,共5页Journal of Nursing（China）

基　　金：温州市科技局公益性科技计划项目(Y20140624)

摘　　要：目的探讨认知行为干预对重型颅脑损伤患儿照顾者照顾负担及应对方式的影响。方法 2015年5月—2017年6月,选取温州医科大学附属第二医院儿童康复科住院的重型颅脑损伤患儿及其照顾者作为研究对象。采用随机数字表法分为观察组(n=25)和对照组(n=26),对照组接受常规宣教及康复指导,观察组在对照组基础上予认知行为干预,30~60 min/次,每周1次,共4周。干预前、干预4周末采用护理负担量表、简易应对方式量表评价主要照顾者的照顾负担和应对方式。结果干预前,2组重型颅脑损伤患儿照顾者照顾负担得分比较,差异无统计学意义(P>0.05);干预4周末,观察组重型颅脑损伤患儿照顾者照顾负担得分低于对照组及本组干预前(均P<0.01)。干预前,2组重型颅脑损伤患儿照顾者积极应对、消极应对得分比较,差异均无统计学意义(P>0.05);干预4周末,观察组重型颅脑损伤患儿照顾者积极应对得分高于对照组及本组干预前(均P<0.01);干预4周末,2组消极应对得分组内及组间比较,差异均无统计学意义(P>0.05)。结论认知行为干预有助于改善重型颅脑损伤患儿照顾者照顾负担及积极应对得分,帮助照顾者建立正确的认知及采取积极有效的应对方式。Objective To evaluate the effect of cognitive behavioral intervention on the burden and coping style of primary care-givers of children with severe traumatic brain injury （TBI）. Methods From May 2015 to June 2017, 51 cases of hospitalized children with severe head injury and their primary caregivers were randomly assigned into control group （n=26） and intervention group （n=25）. The control group received routine health education and rehabilitation guidance, while the intervention group was treated with additional cognitive behavioral intervention 30-60 min per week for 4 weeks. Care burden and coping styles were assessed by using Zarit Caregiver Burden Interview （ZBI） and Simplified Coping Style Questionnaire （SCSQ） before and after the intervention in the 2 groups. Results The score of ZBI showed no statistical significance in the 2 groups before the intervention （P〉0.05）; that in the intervention group at the end of the 4-week intervention was lower than that before the intervention and that in the control group （all P〈0.01）. The score of positive and negative coping style in the 2 groups was not statistically significant （P〉0.05） before the intervention, but the score of positive coping style in the intervention group at the end of the 4-week intervention was higher than that before the intervention and that in the control group （all P〈0.01）. At the end of the intervention, the intra- and inter- group comparison of the score of negative coping style suggested no statistical significance （P〉0.05）. Conclusion Cognitive behavioral intervention can improve the score of ZBI and positive coping style of the primary care-givers of children with severe traumatic brain injury, enhance their positive coping style.

关 键 词：认知行为干预 重型颅脑损伤 儿童 主要照顾者 照顾负担 应对方式 

分 类 号：R47[医药卫生—护理学] R49[医药卫生—临床医学]