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目的探讨白血病患儿情绪、自我意识特征及其父母的情绪特点。方法39例白血病患儿为山东大学附属省立医院2005年7月至2008年7月收治的病例。选用儿童焦虑性情绪障碍筛查表、儿童抑郁障碍自评量表和Piers-Harris儿童自我意识量表分别对20例初发白血病、19例长期无病生存白血病和40名正常对照儿童进行评定,同时采用焦虑自评量表、抑郁自评量表对2组白血病患儿的父母进行心理测评。结果长期无病生存组患儿在焦虑总分以及躯体化/惊恐、广泛性焦虑和社交恐怖分量表评分明显高于正常对照组(P<0.05),其抑郁评分高于正常对照组,但差异无统计学意义(P>0.05);初发白血病组患儿在焦虑总分及各分量表评分以及抑郁评分方面和正常对照比较差异无统计学意义(P>0.05);长期无病生存组患儿与初发组患儿相比,前者广泛性焦虑分量表评分显著高于后者(P=0.018)。两组白血病患儿自我意识总分均低于正常对照组(P<0.05),其中长期无病生存组在焦虑和合群分量表得分明显低于正常对照组(P<0.05),而初发白血病组患儿在行为、智力与学校情况、焦虑分量表得分显著低于正常对照组(P<0.05);长期无病生存组患儿与初发组患儿相比,在行为、智力与学校情况分量表得分方面前者显著高于后者(P值分别为0.033和0.046)。白血病组父母焦虑和抑郁得分均高于我国常模组,其差异有统计学意义(P<0.001),其中初发白血病组父母的焦虑和抑郁症状检出率高于长期无病生存组,P值分别为0.034和0.060。患儿父母的焦虑和抑郁得分有明显的相关性(r=0.95,P<0.001),但与患儿的焦虑、抑郁及自我意识得分相关性均无统计学意义(P>0.05)。结论长期无病生存白血病患儿较初发白血病患儿及正常儿童有更多的焦虑和抑郁情绪。白血病患儿的自我意识降低。白血病患儿父母较非白血病患儿父母有更多的焦虑和抑郁情绪。在治疗儿童躯体疾病的同时,对白血病患儿及其家庭进行社会心理干预非常必要。
Objective To investigate the characteristics of emotion and self-awareness of children with leukemia and their parents’ emotional characteristics. Methods Thirty-nine children with leukemia were admitted to Provincial Hospital Affiliated to Shandong University from July 2005 to July 2008. Twenty children with primary leukemia, 19 cases with chronic disease-free survival leukemia and 40 normal control children were evaluated by using the Childhood Anxiety Disorders Checklist, Childhood Depression Disability Self-Rating Scale and Piers-Harris Children’s Self-Consciousness Scale, respectively. At the same time, self-rating anxiety scale and self-rating depression scale were used to evaluate the parents of children with leukemia in the two groups. Results The scores of anxiety score, somatization / panic disorder, generalized anxiety and social terrorist scale scores in long-term disease-free survival group were significantly higher than those in normal control group (P <0.05), and their depression scores were higher than those in normal control group (P> 0.05). There was no significant difference in anxiety score, subscale scale and depression score in children with primary leukemia between the two groups (P> 0.05). There was no significant difference between long-term disease-free survival group The prevalence of the generalized anxiety scale was significantly higher in children than in those in the first episode (P = 0.018). The total score of self-awareness of children with leukemia in both groups was lower than that of the normal control group (P <0.05), and the long-term disease-free survival group was significantly lower than the normal control group (P <0.05), while the incidence of primary leukemia The score of anxiety scale was significantly lower in group A than in control group (P <0.05) in behavioral, mental, and school conditions (P <0.05). Compared with those in primary group, children in long-term disease- The former was significantly higher in the subscales than the latter (p = 0.033 and 0.046, respectively). The anxiety and depression scores of parents in leukemia group were higher than those in our country. The difference was statistically significant (P <0.001), and the detection rate of anxiety and depression in parents of primary leukemia group was higher than that of long-term disease-free survival group The values were 0.034 and 0.060, respectively. There was a significant correlation between anxiety and depression scores of children with parents (r = 0.95, P <0.001), but not with children’s anxiety, depression and self-awareness scores (P> 0.05). Conclusion Children with chronic disease-free survival have more anxiety and depression than those with first-onset leukemia and normal children. Children with leukemia reduce self-awareness. Children with leukemia have more anxiety and depression than non-leukemia parents. In the treatment of physical illness in children at the same time, children and their families with leukemia social psychological intervention is necessary.