先天性心脏病患儿情绪行为问题与社会适应能力的相关性分析

摘要

目的：探讨先天性心脏病（先心病）患儿的情绪行为问题与社会适应能力的关系。方法选择2014年10月至2015年3月在吉首大学第一附属医院儿科、胸心外科住院的先心病患儿55例（病例组）和在性别、年龄等方面与之相匹配的上呼吸道感染患儿68例（对照组），应用长处和困难问卷（SDQ）、儿童适应行为评定量表（SAB）分别测试其情绪行为问题与社会适应能力。采用Pearson相关性分析和多元线性逐步回归分析，探讨先心病患儿SDQ和SAB评分的关系。结果病例组患儿SDQ中情绪症状、同伴交往问题、困难总分均高于对照组，差异均有统计学意义（P<0.01）；亲社会行为得分低于对照组，差异有统计学意义（P<0.01）；两组患儿品行问题、多动/注意不能得分比较，差异均无统计学意义（P>0.05）；病例组SAB 除认知功能因子得分与对照组无差异外，独立功能因子、社会/自制因子、适应能力商数（ADQ）得分均低于对照组，差异均有统计学意义（P<0.01）。病例组情绪行为异常、适应能力不良、情绪行为异常合并适应能力不良检出率均高于对照组，差异均有统计学意义（P<0.01）。SDQ中情绪症状、多动/注意不能、同伴交往问题等3个因子与SAB呈负相关（P<0.05）；SDQ的亲社会行为因子与SAB呈正相关（P<0.01）。多元线性逐步回归分析显示，先心病患儿的情绪症状（β=-0.37，P<0.01）、亲社会行为（β=0.25，P<0.01）和同伴交往问题（β=-0.15，P<0.01）对SAB评分有一定预测作用，可解释总变异的31%。结论先心病患儿较正常儿童更易出现情绪行为问题与适应能力不良，只有情绪行为问题越少，社会适应能力才可能越好。%Objective To investigate the correlation between the emotional behavioral problems and social adaptive ca-pacity in children with congenital heart disease(CHD). Methods Fifty-five children patients with CHD(case group) and 68 age and gender matched children patients with upper respiratory tract infection (control group) in the pediatric department and car-diothoracic departments of the First Affiliated Hospital of Jishou University from October 2014 to March 2015 were selected. The Strength and Difficulties Questionnaire (SDQ)and Scale of Social of Adaptive Behavior (SAB) were used to test their emotional behavioral problems and social adaptive capacity respectively. The Pearson correlation analysis and multivariate linear stepwise regression analysis were adopted to analyze the relation between CHD with SDQ and SAB scores. Results The total scores of e-motion symptoms,peer interaction problems and difficulty of SDQ in the case group were higher than those in the control group with statistical difference(P<0.01);while the pro-social problems score was lower than that in the control group with statistical difference(P<0.01);but the conduct problems,hyperactivity/aprosexia scores had no statistical difference between the two groups (P>0.05);except no difference in the cognitive function score of SAB,the scores of independence function factor,social/self-re straint factor and adaptive quotient(ADQ) in the case group were lower than those in the control group,and the difference was statistically significant (P<0.01). The detection rate of emotional/behavioral abnormality,poor adaptive capacity and emotional/behavioral abnormality complicating social maladjustment in the case group were higher than those in control group ,and the dif ference was statistically significant(P<0.01). The 3 SDQ factors of motional symptoms,hyperactivity/aprosexia and peer interaction were negatively correlated with SAB(P<0.05),while the SDQ pro-social behavior factor was positively correlated with SAB(P<0.01). The multivariate linear stepwise regression analysis showed that emotional symptoms (β=-0.37,P<0.01),pro-social behavior (β=0.25,P<0.01) and peer interaction problems (β=-0.15,P<0.01) in CHD children patients had some predictive effect on the SAB scores and could explain 31%of the total variable. Conclusion Children patients with CHD are more likely to have emotional behavioral problems and social maladjustment. Those with less emotional behavioral problems may have better social adaptive capacity.