青少年特发性脊柱侧凸患者的社会心理行为分析及应对措施探讨  

Psychosocial behavior and coping strategies in patients with adolescent idiopathic scoliosis

作　　者：张桂芳[1] 黄焕杰[1] 葛乐 韩秀兰[1] 江海媚 肖文武 许轶 王楚怀[1] ZHANG Gui-fang;HUANG Huanjie;GE Le(The First Affiliated Hospital of Sun Yat-sen University,Guangzhou,Guangdong,510080)

机构地区：[1]中山大学附属第一医院,广州市510080 [2]中山大学附属第七医院

出　　处：《中国康复医学杂志》2023年第12期1656-1662,1668,共8页Chinese Journal of Rehabilitation Medicine

基　　金：广东省残疾人事业理论与实践研究立项课题(H2022035);国家自然科学基金面上项目(82172548)。

摘　　要：目的:探讨青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者社会心理行为状况及相关因素,提醒大家对AIS患者心理健康的重视,为开展此类青少年心理卫生服务和康复提供实证依据。方法:选取50例AIS患者及50例相匹配的健康青少年作为研究对象,收集2组受试者的一般情况,使用脊柱侧凸研究学会-22量表(the Scoliosis Research Society-22,SRS-22)、长处和困难问卷(学生版)(the strengths and difficulties questionnaire-self-report,SDQ-S)、焦虑自评量表(self-rating anxiety scale,SAS)、PHQ-9抑郁症筛查量表(nineitem patient health questionnaire,PHQ-9)评估2组受试者的生活质量、焦虑、抑郁等社会心理行为情况,比较2组研究对象生活质量、社会心理行为的异同,并进一步分析侧凸类型和程度与生活质量和社会心理行为的相关性。结果:SAS结果提示AIS组不同程度的焦虑人数明显多于健康对照组(Z=﹣3.998,P<0.001);SDQ-S结果表明AIS组的同伴交往问题(t=3.168,P=0.002)和亲社会行为(t=2.529,P=0.013)得分明显高于健康对照组;双弯患者疼痛得分比单弯患者更低(t=2.824,P=0.007);侧凸程度(Cobb角)与SRS-22中的活动能力(r=﹣0.283,P=0.008)、心理状况(r=﹣0.300,P=0.047)相关,与PHQ-9量表得分呈正相关(r=0.356,P=0.011)。结论:AIS患者存在不同程度的焦虑、同伴交往问题及较差的亲社会行为,应高度重视并尽早筛查、评估和干预。Objective:To investigate the psychosocial behavior status and related factors in patients with adolescent idiopathic scoliosis(AIS),in order to pay attention to the mental health and provide an empirical evidence of mental health service and rehabilitation for AIS patients.Method:Fifty participants with AIS and 50 matched healthy adolescents were selected.General information of the participants in the two groups was collected.The Scoliosis Research Society-22(SRS-22),the strengths and difficulties questionnaire-self-repor(t SDQ-S),self-rating anxiety scale(SAS),nine-item patient health questionnaire(PHQ-9) were used to evaluate the quality of life,anxiety,depression and other psychosocial behavior of all subjects.Statistical analysis was conducted to determine whether psychosocial behavior was difference between two groups.The correlation between the type and degree of scoliosis and the quality of life and psychosocial behavior was further analyzed.Result:The SAS results indicated that the number of participants with different degrees of anxiety in the AIS group was significantly higher than that in the control group(Z=﹣ 3.998,P<0.001);SDQ-S results showed that the scores of partner interaction problems(t=3.168,P=0.002) and prosocial behavior(t=2.529,P=0.013)in AIS group were significantly higher than those in control group.The scores of pain in double-bend patients were lower than those in single-bend patients(t=2.824,P=0.007);The degree of lateral bending(Cobb Angle)was correlated with the mobility(r=﹣0.283,P=0.008) and psychological status(r=﹣0.300,P=0.047) of SRS-22,and was positively correlated with the score of PHQ-9(r=0.356,P=0.011).Conclusion:AIS patients have different levels of anxiety,peer interaction problems and poor prosocial behavior.It is necessary to be high valued and screened,evaluated and intervened as soon as possible.

关 键 词：青少年特发性脊柱侧凸 社会心理行为 心理健康 应对措施 

分 类 号：R493[医药卫生—康复医学]