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背景:儿童发生心理行为问题的主要原因是家庭因素,从系统家庭理论的观点看,无论在何种情况下,儿童行为问题本身反映的都是社会、学校、家庭、亲友等各种人际系统网络与个体间复杂的交互作用的关系,家庭治疗是治疗儿童行为问题的重要途径。目的:观察系统家庭康复治疗是否适用于干预儿童的行为问题。设计:整群抽样,对比观察。单位:昆明医学院精神科。对象:选择2004-05/2005-03昆明市明通小学276名四年级学生及家长。根据整群抽样的原则对学生及其家长进行调查。方法:采用家庭动力学自评量表调查276名小学四年级学生的家庭动力学特征,采用Achenbach儿童行为父母问卷调查他们的行为情况。检出有行为问题儿童57例,全体家庭成员自愿参加的家庭作为干预组,任何一名家庭成员不愿参加活动的家庭作为异常对照组,对干预组及其父母进行4个月的系统家庭治疗。4个月后再次进行问卷调查。主要观察指标:干预前后两组家庭动力学及儿童行为比较。结果:干预组干预后家庭动力学和儿童行为发生了变化且有统计学差异:家庭气氛由“沉闷、敌对”向“和谐愉快、平等开放”的方向转变;家庭成员的个性化程度由低向高转变;疾病观念由“认为患者是无能为力的受害者”向“患者可以有所作为”的方向转变,实现“疾病观念的软化”,Achenbach儿童行为父母问卷调查总分下降[父亲问卷干预前后分别为(42.20±22.58),(28.95±21.90)分,母亲问卷干预前后分别为(50.95±14.60),(36.40±15.36)分,P<0.05]。异常对照组父母亲分别评定的儿童行为变化差异无显著性[父亲问卷干预前后分别为(38.32±17.30),(37.57±16.45)分,母亲问卷干预前后分别为(45.54±16.02),(40.14±17.95)分,P>0.05]。结论:应用系统家庭治疗的思想和技术,家庭治疗干预儿童的行为问题是可行的和有效的。
Background: The main reason for the psychological and behavioral problems in children is family factors. From the perspective of system-family theory, the problem of children’s behavior itself reflects all kinds of interpersonal networks such as society, schools, families, relatives and friends With the complex interaction between individuals, family therapy is an important way to treat children’s behavioral problems. OBJECTIVE: To observe whether systemic home rehabilitation is suitable for intervention in children’s behavioral problems. Design: cluster sampling, comparative observation. Unit: Kunming Medical College Psychiatric. PARTICIPANTS: A total of 276 fourth graders and parents from Ming Tong Primary School in Kunming City from May 2004 to March 2005 were selected. Students and their parents are investigated according to the principle of cluster sampling. Methods: The family dynamics of 276 primary fourth-year students were investigated using the Family Dynamics Self-Rating Scale. The Achenbach children’s behavioral parental questionnaire was used to investigate their behavior. 57 cases of children with behavioral problems were detected, all family members voluntarily participated in the family as an intervention group, any family members unwilling to participate in activities as an abnormal control group, the intervention group and their parents for 4 months of family therapy . 4 months after the questionnaire again. MAIN OUTCOME MEASURES: Family dynamics and behavior comparison of children before and after intervention. Results: Family dynamics and behavior changed after intervention in the intervention group with statistical differences: the family atmosphere changed from “dull and hostile” to “harmonious and happy, equal and open” direction; the individuality of family members changed from low High change; the concept of disease is changed from “thinking that the patient is helpless” to “doing something for the patient” to achieve “softening of the concept of disease”, Achenbach’s total score of children’s behavioral parents’ survey decreases [before and after his father’s questionnaire intervention (42.20 ± 22.58) and (28.95 ± 21.90) respectively. The questionnaire of maternal questionnaire before and after intervention was (50.95 ± 14.60) and (36.40 ± 15.36) points respectively, P <0.05]. There was no significant difference in behavior between children assessed by parents in abnormal control group [(38.32 ± 17.30) and (37.57 ± 16.45) before and after intervention, respectively, and (45.54 ± 16.02) and (40.14 ± 17.95) points, P> 0.05]. Conclusion: It is feasible and effective to use the family thinking and technology of family therapy to intervene the behavior of children in family therapy.