【作者】 高荣；

【导师】 陶芳标； 胡传来；

【作者基本信息】 安徽医科大学 ， 儿少卫生与妇幼保健学， 2010， 硕士

【摘要】 目的编制一套简单有效具有良好操作性、适合应用于在校青少年学生的预防自杀行为的培训教程,并评价该教程对提升在校青少年学生的心理社会能力的干预效果。方法通过文献复习和本课题组先期研究结果构建教程编制的理论基础,在此基础之上吸收当前心理社会能力培训的成熟方法,结合在校青少年学生的生活状态和心理特点,经反复实验和调整,形成覆盖初中、高中、大学三个层次的青少年心理社会应对能力培训教程。选取一所初中(初二)和一所大学(大二)的4个小班共206名学生进行两轮课程培训,在培训前、两轮培训之间、培训后用问卷的方法进行调查,内容包括自杀行为、应对方式、躯体症状和心理等亚健康症状,其中第一轮培训中的干预组在第二轮培训时为对照组。采用χ2检验对青少年学生自杀行为和亚健康状况检出率的性别、干预前后差异进行比较。结果分别编制了适用于初中、高中、大学的心理社会能力训练教程,每个教程由6个单元组成,适合2个课时教学。教程用于青少年学生参与性教学过程中,具有良好的可操作性和可接受性,干预之前有自杀意念的23人(11.1%),有自杀未遂行为的有4人(2%),符合躯体亚健康的36人(17.5%)、心理亚健康的23人(11.2%),身心亚健康的学生23人(11.2%),上述变量在干预组和对照组之间的差异无统计学意义。第一轮培训之后,干预对象高等级的积极应对方式分组有了较大的提高,低等级积极应对方式分组增加明显而中低等级的积极应对方式分组有相应的减少,与干预前相比差异均有统计学意义(P <0.01),中高等和高等级的消极应对方式分组比例降低了,与干预前相比差异也均有统计学意义(P <0.01);青少年学生在躯体亚健康、心理亚健康、身心亚健康的检出率均有明显的下降,差异均有统计学意义(P <0.01);干预组的自杀意念报告率下降了5.8%,与干预前相比差异无统计学意义(P>0.05)。第二轮培训后,在应对方式上,积极应对中等和中高等级有了较大的提高,差异较之前均有统计学意义(P <0.01),而消极应对中的高等级也有了下降,与干预前相比差异有统计学意义(P<0.01);与第一轮干预效果相似的是,青少年学生的躯体亚健康和身心亚健康状态有了明显的改善,差异均有统计学意义(P <0.01),但是心理亚健康水平的变化没有统计学意义;对照组自杀未遂报告率下降,差异有统计学意义(P<0.05)。结论自编基于提高心理社会应对能力的训练课程能够有效地帮助青少年提高其心理社会能力,降低心理病理症状,对青少年自杀行为有一定的干预作用,培训教程可广泛应用于青少年学生的自杀行为预防工作。更多还原

【Abstract】 Objectives The present study aims to develop a set of brief training course which is effective and operational for preventing adolescent suicide behaviors, and to evaluate its application to adolescent students and the intervention effect on psychosocial competence.Methods The curriculum formation was theoretically based on literature review and previous research. Based on convenient sample principle, questionnaire survey was carried out in 206 adolescents selected from second grade students in a junior middle school and second-year students in a college. Two rounds of adolescent suicide behavior intervention program were carried out using the above curriculum. Students intervened in the first round were turned to be the control group in the second round. Suicidal behaviors and sub-health status were investigated through questionnaire surveys before, during and after two interventions. Chi-square test was used to compare the report rates of suicidal behaviors, sub-health status and coping style in adolescents before and after intervention training.Results Competency-based improvement curriculum applying to middle school, high school and college students was developed,which have six units contained two class hours education. The curriculum exhibited good maneuverability when applied in adolescent selected. The spirit of the curriculum could be easily absorbed by participants. Report rate of suicide ideation, suicide plan and attempted suicide of adolescents was 11.1%, 3.9% and 2.0%, respectively, before curriculum implementation. The rate of physical, psychological sub-health and psychosomatic sub-health symptoms of adolescents was 17.5%, 11.2%, and 11.2% respectively. There was no statistical significance between treated group and blank control group.After the first round of training, high positive coping style percentile rank increased and it showed significant difference before and after the training (P<0.01). High and moderate negative coping style percentile rank were declined and the different before and after intervention showed statistically significance (P<0.01). Report rates of physical, psychological sub-health and psychosomatic sub-health symptoms of adolescents in treated adolescents were markedly declined and showed significant difference compared to report rates of those symptoms before intervention (P<0.01) . The rates of suicide ideation in treated group decreased by 5.8%, but the difference was not statistically significant (P>0.05).After the second round of training, high and moderate positive coping style percentile rank increased and showed significant difference compared with before (P<0.01). High negative coping style percentile rank decreased and the difference before and after intervention showed statistically significance (P<0.01).The rates of physical and psychosomatic sub-health symptoms of adolescents in blank control were markedly declined and there was significant difference compared with before (P<0.01), but the difference in psychological sub-health score was not statistically significant. The rates of attempted suicide in blank control decreased and there was significant difference compared with before (P<0.01).Conclusions The self-documenting curriculum development based on competency-based improvement is an effective curriculum for preventing suicidal behaviors of adolescents. It can exert effect on improving psychosocial competence, but also decrease psychopathological symptoms for adolescent students. The curriculum can be further applied and evaluated in preventing suicidal behaviors of adolescent students.更多还原