摘要
目的:分析住院精神分裂症患儿陪护亲属的心理健康状况,并与全国常模及正常对照组比较。方法:选择2003-06/2004-06惠州市第二人民医院南二区的住院精神分裂症患儿陪护亲属47名为陪护组。所有患儿均符合中国精神疾病分类方案与诊断标准第3版关于儿童精神分裂症的诊断标准,年龄<16岁,性别不限,陪护为精神分裂症患儿的一级亲属,年龄18～60岁,无严重躯体及精神疾病。在普通人群随机选择60人为正常对照组,其家庭成员及本人均无严重躯体及精神疾病。所有调查对象均获全面知情同意并志愿接受调查。陪护亲属的心理健康状况采用症状自评量表评定犤包括躯体化、强迫、人际关系敏感、忧郁、焦虑、敌对、恐怖、偏执、精神病性等9项因子共90个条目,采用0～4的五级评分,0分为从无,l分为轻度,2分为中度,3分为相当重,4分为严重犦。陪护亲属的生活质量采用综合生活质量问卷评定犤包括躯体健康(睡眠与精力,身体不适感,进食与性生活,躯体运动与感官)、心理健康(精神紧张度,正负情感,认知功能,自尊)、社会功能(社交与社会支持,娱乐与学习,工作,婚姻与家庭)、物质生活(住房,经济状态,社区服务,生活环境)四个维度,共16个因子64个条目,评分越高,生活质量越好犦。精神分裂症患儿均予常规抗精神病药治疗,在患儿治疗前及治疗后1周,2周,4周,6周对陪护组进行症状自评量表评定并与国内常模比较;于治疗前及治疗后6周对其进行综合生活质量问卷评定并与正常对照组比较。组间比较采用χ2检验或t检验。结果:陪护组47人及正常对照组60人全部进入结果分析。①症状自评量表评分结果:陪护组症状自评量表总分及躯体化,强迫症状,忧郁,焦虑4个因子分均高于全国常模(P<0.01～0.05),在精神分裂症患儿治疗4周后陪护组的躯体化,强迫症状,忧郁,焦虑各因子分显著低于患儿治疗前(P<0.01～0.05)。②综合生活质量问卷各维度评分结果:除认知功能、住房、生活环境3个因子外,其它各因子分陪护组均显著低于正常对照组(P<0.01～0.05)。治疗6周后陪护组躯体健康维度及其睡眠与精力因子,心理健康维度及其精神紧张度因子、自尊因子,社会功能维度及其社交与社会支持因子、娱乐与学习因子,物质生活维度及经济状态因子、社区服务因子分同样显著低于正常对照组(P<0.01～0.05)。治疗6周后陪护组在躯体健康维度及其所有4个因子、心理健康维度中的正负性情感、社会功能维度中的工作、婚姻与家庭2项因子显著高于治疗前(P<0.01～0.05)。结论:①住院精神分裂症患儿陪护亲属症状自评量表总分及躯体化,强迫症状,忧郁,焦虑4个因子分均高于全国常模,说明其心理健康状况较差。②在综合生活质量问卷中除了认知功能、住房、生活环境3个因子外,其他各因子均低于正常对照组,说明其生活质量较差。③经过4～6周治疗患儿病情稳定或基本稳定后,陪护亲属的心理健康状况及生活质量有所改善和提高,但与正常对照组比较仍存在较多的心理及社会问题。
AIM：To evaluate the mental status of relatives in the nursing of hospitalized children with schizophrenia as compared with the Chinese norm and control group. METHODS： Forty-seven relatives who nursed children with schizophrenia from June 2003 to June 2004 were selected from No. 2 South Region, Huizhou Second People＇ s Hospital. All the children met the diagnostic criteria of Classification and Diagnostic Criteria of Mental Disorders-3rd edition. The children of either gender aged less than 16 years. Their relatives are all the fist degree relatives at an age of 18-60 years, who had no severe body or mental diseases. Sixty normal persons were selected as controls, and no severe body or mental diseases were found in them and their families. All the subjects agreed to participate in the study. Symptom checklist 90 （SCL-90） was performed to evaluate the mental status of the relatives. SCL-90 consists of 9 factors, that is, somatization, obsessive- compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism, and totally 90 items; Five-grade scoring （scores 0-4） were adopted, score 0 as no symptoms, score 1 as mild, score 2 as moderate, score 3 as severe, and score 4 as very severe. General quality of life questionnaire was adopted to assess the quality of life of the relatives. The questionnaire includes four dimensions of body health （sleeping and vigor, discomfort, eating and sex life, body motor and sense organ）, mental health （mental stress, positive and negative emotion, cognitive function, self-esteem）, social function （social intercourse and social support, recreation and learning, working, marriage and family） and material life （housing, economic situation, community serve, living environment）, and totally 16 factors and 64 items. The higher the score, the better the quality of life. Children with schizophrenia underwent routine treatment of antipsychotic drugs. Before and 1, 2, 4 and 6 weeks after the children with schizophrenia received treatment, their relatives were scored on SCL-90, and the results were compared with the Chinese norm. Before and 6 weeks after the children received treatment, their relatives were scored on the general quality of life questionnaire, and the results were compared with those of the normal controls. Chi-square test or t test were adopted for inter-group comparison. RESULTS： All the 47 relatives and 60 healthy controls were involved in the result analysis. ① SCL-90： In the relative group, scores on somatization, obsessive-compulsive, depression and anxiety were higher than those of the Chinese norm （P 〈 0.01-0.05）. Four weeks after treatment, the scores were significantly lower than those before treatment（P 〈 0.01-0.05）. ② General quality of life questionnaire： In the relative group, scores on all the factors except cognitive function, housing and living environment were significantly lower than those of the normal control group （P 〈 0.01-0.05）. Six weeks after treatment, scores on the four dimensions, and the sleeping and vigor of body health, the mental stress and self-esteem of mental health, the social intercourse and social support, recreation and learning of social function, and the economic situation and community serve of material life were significantly lower than those of the normal control group （P 〈 0.01-0.05）. Six weeks after treatment, the scores on the dimension of body health and all its four factors, positive and negative emotion of mental health, and working, marriage and family of social function were significantly increased as compared with those before treatment. CONCLUSION： ① In the study, the total score of SCL-90 and the scores on .somatizaiton, obsessive-compulsive, depression and anxiety in the relatives were all higher than the Chinese norm, which indicates that mental status of relatives in the nursing of schizophrenia children become worse. ② Except the scores on cognitive function, housing and living environment in the general quality of life questionnaire, the scores on the other factors were all lower than those of the normal controls, which indicates that the relatives have a worse quality of life. ③ After 4-6 week treatment, condition of children with schizophrenia became better, and the mental state and quality of life of their relatives began to improve and promote, but there were still many mental and social problems in comparison with the normal controls.
出处
《中国临床康复》
CSCD
北大核心
2005年第24期33-35,共3页
Chinese Journal of Clinical Rehabilitation
