| Objective :To investigate the behavior problems of school-age children with chronic diseases and the current state of anxiety and depression of their caregiver,and to provide a basis for further behavior intervention;to evaluate the application effeteness of Sandplay therapy on behavior problems of school-age children with chronic diseases and the anxiety and depression of their caregiver,so as to provide a reference for the management of children chronic diseases.Methods:1 Study on the current status and main influencing factors of behavior problems in school-age children with common chronic diseases1.1 Research objectThrough convenient sampling and continuous enrollment,according to the order of the number of school-age children with chronic diseases hospitalized in the Children's Hospital of Chongqing Medical University,the admission department for common chronic diseases(Rheumatology and Immunology,Nephrology,Hematology)inpatients with 3 representative diseases(juvenile idiopathic arthritis,chronic kidney disease,leukemia)and caregiver are the subjects of the study.1.2 Research methodsThis section is a descriptive study.Use general demographic data sheets to investigate basic family information of children with common chronic diseases at school age;use Achenbach Child Behavior Checklist(CBCL)and Eysenck Personality Questionnaire(EPQ)to investigate behavior problems Status ofchildren;using the Zung-self-rating anxiety scale(SAS)and the Zung-self-rating depression scale(SDS)to investigate the emotional status of the caregiver.To analyze the main influencing factors of emotional and behavioral problems in children with chronic diseases.2 Intervention study of sandplay therapy on behavior problems of school-age children with chronic diseases2.1 Research objectAccording to the order of the number of school-age children with chronic diseases hospitalized in the Children's Hospital of Chongqing Medical University,we selected the hospitalized children with nephrotic syndrome and leukemia from January 2018 to October 2019 as well as a caregiver as the research objects.2.2 Research methodsThis section belongs to experimental study.Before the intervention,the research teamstudied the current status of the intervention of behavioral problems of children with chronic diseases at home and abroad through literature retrieval analysis.Based on the literature collection and collation,the content of the literature was analyzed using inductive and deductive methods,factor analysis,etc.The current situation and problems of children's behavioral problems intervention,preliminary selection of intervention strategies,consultation and referral standards for children with chronic diseases.On the basis of the initially selected plan,seek expert advice,including specialist doctors,specialist nurses,psychotherapists,and psychologists.Through the discussion of the research team,the comprehensive expert's opinions will be compiled to improve the screening intervention process,consultation and referral standards to ensure the scientific and feasibility of the intervention.The intervention group adopts sandplay therapy,led by sand table therapists,psychologists,nurses,etc.,and implements an eight-week intervention on the included study subjects,60-90 minutes each time.The included study subjects all received two follow-up evaluations before and after the intervention,and the evaluation content was the same as the previous part to evaluate the effect of the intervention.Results:1.Behavioral problems of children with common chronic diseases in school age and its main influencing factors(1)A total of 182 children with chronic diseases were included.Based on the reference cut-off value of the national norm CBCL scale,children aged 6-12 were divided into male and female groups.The topthree detection rate of single behavioral factors in male children were social withdrawal(72.81%),compulsive(67.96%)and discipline violation(54.90%),the difference between diseases was not statistically significant(P> 0.05);the top three female patients were split forced(52.50%),social withdrawal(48.75%)and depression(46.25 %),Of which the difference between social withdrawal and depression was not statistically significant(P> 0.05).The detection rates of anxiety of the caregiver of hospitalized children with juvenile idiopathic arthritis,chronic kidney disease and leukemia were 83.13%,77.08% and 80.39%,respectively;the detection rates of depression were 84.33%,95.83% and 86.27%.There was no statistically significant difference in scores between different diseases(P> 0.05).Among 182 children,introverted stable type was 34.62%,extroverted stable type was 46.15%,introverted unstable type was 8.24% and extroverted unstable type was 10.99%.There was no statistically significant difference between different diseases(P> 0.05).(2)The anxiety scores of the 182 caregivers in the school-aged children with idiopathic arthritis,chronic kidney disease,and leukemia were 60.21 ± 9.86,58.43 ± 11.97,60.77 ± 11.73;the depression scores were 60.26 ± 8.87,61.49 ± 6.98,63.17 ± 8.53,and there was no significant difference in scores between different diseases(P> 0.05).the scores were higher than the Chinese norm(29.78 ± 10.01)(33.46 ± 8.55)and was statistically significant(P <0.01).(3)The degree of social withdrawal of boys is mainly affected by the duration of illness(OR = 4.865,P <0.05)and the tendency of introversion and extroversion(OR = 0.918,P <0.05);the degree of social withdrawal of girls is mainly affected by the duration of illness(OR = 4.720,P <0.05),introversion and extroversion(OR = 0.162,P <0.05)and mental dimension(OR = 4.072,P <0.05);the depression status of girls is mainly affected by the time of illness(OR = 12.290,P <0.05)and the depression of the adopted person(OR = 4.676,P <0.05).2.Intervention study of sandplay therapy on behavior problems of school-age children with chronic diseases2.1 A total of 60 patients and their caregiver participated in this intervention.The results show that,according to the CBCL score reduction rate,the effective rate is 53%.There is no difference between the intervention group and the control group before the intervention in total scores(P> 0.05),and the difference after the intervention is statistically significant(P <0.05);The scores of anxiety and depression,withdrawal behavior,aggression,and social problems were significantly different in the self-control group before and after(P <0.05).They have significant differences(P <0.05).2.2(1)The scores of emotional stability and mental quality of the intervention group before and after the intervention were statistically significant(P <0.05),but there was no statistical significance of introversion and concealment(P> 0.05);the scores of the four subscales of the control group was no statistical significance before and after the intervention(P >0.05).(2)In the comparison between the two groups before the intervention,except for the inward and outward scores(P = 0.017),the remaining three subscales had no statistical difference(P> 0.05).(3)After intervention,the two groups had statistical significance in extroversion,emotional stability and mental quality scores(P <0.05).2.3 In the scores of the anxiety and depression scales of the 60 caregiver,the SAS and SDS scores of the caregiver in the intervention group were statistically significant before and after the intervention(P <0.05),compared with the control group the comparison between them is also statistically significant(P <0.05).Conclusion:(1)The top three most frequent psychological behavior problems of girls with common chronic diseases in school age are schizophrenia,social withdrawal and depression;boys are social withdrawal,coercion and discipline violation.In addition,the anxiety and depression of the children caregiver are common.(2)The main influencing factors of the degree of social withdrawal of boys with common chronic diseases at school age are the duration of illness and the tendency of introversion and extroversion;the degree of social withdrawal of girls is mainly affected by the duration of illness,the introversion and extroversion of personality,and the mental dimension,and the degree of depression is affected by the duration of illness and the depression status of the caregiver.(3)Sandplay therapy can effectively reduce the behavioral problem level of anxiety,depression,withdrawal behavior,and social problems in children with common chronic diseases in school age,reduce the emotional stability and mental quality of children,and also reduce the anxiety and depression of their caregivers. |
PDF Full Text Request