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病耻感是指病人因患病而产生的一种内心的耻辱体验,反映了病人的一种心理应激反应,是病人因社会对疾病的歧视而产生的内化的病耻观念[1]。传统观念、偏见及社会上对精神疾病病人持有刻板的消极态度,精神疾病病人普遍遭受更多的歧视[2-4],病人家属也因为亲属被贴疾病“标签”而产生病耻感,对病人整个家庭产生不良影响[5-6]。在儿童青少年重性精神疾病中,精神分裂病人常见,他们表现出明显病耻感,因病耻感的存在,不敢和人交流,影响其求治行为及治疗的依从性和学习成绩,进而社会适应能力下降,家长也因孩子产生精神疾病心理健康状况受到影响,以上均对病人疾病康复造成了负性影响。而孩子是每个家庭的希望和未来,因此,降低病耻感对儿童青少年精神分裂症病人的心理社会功能康复及提高生活质量及适应能力有重要意义,对病人及其家庭存在积极作用。本研究根据本院实际情况及可行性,采取集体作业治疗对病人进行训练,探讨该疗法对儿童青少年精神分裂症病人病耻感的影响。现作报道。
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集体作业干预前,观察组与对照组间歧视分、病情掩饰分、积极效应分及病耻感总分差异均无统计学意义(P>0.05)。观察组在集体作业干预后的积极效应分高于干预前(P < 0.01),病情掩饰分低于干预前(P < 0.01);而对照组的病耻感各项评分在实验前后差异均无统计学意义(P>0.05)。集体作业干预后,观察组的积极效应分明显高于对照组(P < 0.01);2组间歧视分与病情掩饰分及病耻感总分差异均无统计学意义(P>0.05)(见表 1)。
分组 n 歧视 病情掩饰 积极效应 病耻感总分 干预前 观察组 17 20.35±6.17 18.94±5.66 13.06±4.44 52.41±9.64 对照组 16 20.13±9.22 16.13±6.14 10.19±5.80 46.56±13.21 t — 0.80 1.37 1.60 1.46 P — >0.05 >0.05 >0.05 >0.05 干预后 观察组 17 18.94±8.63 13.88±4.73** 16.76±2.61** 49.59±9.87 对照组 16 20.25±10.24 16.94±7.15 11.13±6.41 48.31±16.35 t — 0.40 1.46 3.35 0.27 P — >0.05 >0.05 < 0.01 >0.05 组内配对t检验:与干预前比较**P < 0.01 表 1 2组组间干预前及干预后病耻感评分的比较(x±s;分)
集体作业干预对儿童青少年精神分裂症病人病耻感的影响
Effect of group-task training therapy on the stigma of children and adolescents with schizophrenia
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摘要:
目的探讨集体作业治疗对儿童青少年精神分裂症病人病耻感的影响。 方法将33例病人随机分为2组,对照组16例进行常规的康复活动训练,观察组17例进行集中的作业治疗训练,比较2组病人训练前后的病耻感数据。 结果干预后,观察组的积极效应分高于干预前(P < 0.01),且高于对照组(P < 0.01),观察组在干预后的病情掩饰分低于干预前(P < 0.01);对照组在干预前后的病耻感各项评分差异均无统计学意义(P>0.05)。 结论集体作业治疗能够降低儿童青少年精神分裂症病人对病情掩饰程度,使病人获得更多的积极效应。 Abstract:ObjectiveTo explore the effects of group-task training therapy on the stigma of children and adolescents with schizophrenia. MethodsThirty-three patients were randomly divided into the control group(n=16) and observation group(n=17).The control group and observation group were trained using routine rehabilitation activity and group-task training therapy, respectively.The data of stigma before and after training were compared between two groups. ResultsAfter intervention, the positive effect score in observation group was higher than that before intervention(P < 0.01), and higher than that in control group(P < 0.01).The disease concealment score in observation group after intervention was lower than that before intervention(P < 0.01).The difference of the tigma score in control group between before and after intervention was not statistically significant(P>0.05). ConclusionsThe treatment of group-task training therapy can reduce the extent of the disease concealment in children and adolescents, and make patients get more positive effects. -
Key words:
- chizophrenia /
- stigma /
- children and adolescents /
- group-task training therapy
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表 1 2组组间干预前及干预后病耻感评分的比较(x±s;分)
分组 n 歧视 病情掩饰 积极效应 病耻感总分 干预前 观察组 17 20.35±6.17 18.94±5.66 13.06±4.44 52.41±9.64 对照组 16 20.13±9.22 16.13±6.14 10.19±5.80 46.56±13.21 t — 0.80 1.37 1.60 1.46 P — >0.05 >0.05 >0.05 >0.05 干预后 观察组 17 18.94±8.63 13.88±4.73** 16.76±2.61** 49.59±9.87 对照组 16 20.25±10.24 16.94±7.15 11.13±6.41 48.31±16.35 t — 0.40 1.46 3.35 0.27 P — >0.05 >0.05 < 0.01 >0.05 组内配对t检验:与干预前比较**P < 0.01 -
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