结构式家庭治疗对血液肿瘤患儿家庭结构与功能的影响

Effect of structural family therapy on family structure and function in children with hematological tumors

摘要:

目的 结构式家庭治疗（structural family therapy, SFT） 是指应用结构式家庭治疗理论和技术，通过重组家庭角色、任务和界限，改善患儿的家庭内部环境。该研究旨在探索 SFT 对血液肿瘤儿童家庭结构与功能的影响。方法 血液肿瘤患儿共 40 例，随机分为 SFT 组与对照组，每组 20 例。对照组为接受常规化疗患儿，SFT 组在常规化疗的基础上接受结构式家庭治疗，由受过 SFT 专业培训的治疗师主持，每个病例家庭接受治疗4次，每两周 1 次。在 SFT 治疗前和结束后 1 个月，采用家庭功能评定量表（FAD）和家庭环境量表（FES-CV）各进行一次评定。结果 SFT 组在治疗后，家庭功能评定量表各因子得分显著下降，与对照组比较差异有统计学意义（P<0.05），显示患儿家庭在问题解决、沟通、角色、情感介入、行为控制和总体功能方面均明显改善。家庭环境量表评定显示，SFT 治疗后家庭的亲密度、情感表达、知识性和娱乐性等评分均有明显提高，而矛盾性评分显著降低，与对照组比较差异有统计学意义（P<0.05）。结论 SFT 能促进血液肿瘤儿童家庭发生良性的改变，改善其家庭功能和内部环境，有利于提高患儿与家长对长期化疗的依从性。

Abstract:

Objective To explore the effect of structural family therapy（SFT), which refers to the application of the theory and technology of SFT for improving the internal family environment of pediatric patients through reorganization of the family roles, tasks, and boundaries, on the family structure and function in children with hematological tumors.Methods Forty children with hematological tumors were randomly divided into SFT and control groups（n=20 each). The control group received conventional chemotherapy. The SFT group received SFT by a trained therapist in addition to conventional chemotherapy; the family of each patient received SFT four times（once every two weeks). Both groups were assessed by the Family Assessment Device（FAD) and Family Environment Scale-Chinese Version（FES-CV) on admission and one month after the end of SFT.Results After treatment, the SFT group showed significant decreases in all factor scores of FAD（P<0.05); the SFT group had significantly lower scores of problem solving, communication, roles, affective involvement, behavior control, and general functioning than the control group（P<0.05). In addition, the SFT group had significantly increased FES-CV scores of cohesion, emotional expression, intellectual-cultural orientation, and active-recreational orientation and a significantly decreased score of conflict after treatment（P<0.05), and the SFT group was significantly superior to the control group in terms of these items（P<0.05).Conclusion SFT could promote beneficial family changes in children with hematological tumors by improving the family function and internal environment, which would increase the long-term chemotherapy compliance of these children and their parents.