1. Analysis of psychological characteristics
The psychological characteristics of children with cerebral palsy are different from those of normal hospitalized children due to limb movement disorders and restricted social activities, which are mainly manifested in the following aspects.
1.1 Emotional disorders cause a lot of inconvenience to children with cerebral palsy, which restricts their activities and requires long-term or even lifelong rehabilitation, so they are prone to tension, anxiety, fear and worry about being ridiculed. In addition, the discrimination and prejudice against children with cerebral palsy in the society may make them feel inferior and depressed, and they may easily give up on themselves. Older children may develop panic behavior and fear contact with the outside world. Li Huawei, Department of Pediatrics, The First Affiliated Hospital of Henan College of Traditional Chinese Medicine
1.2 Behavioral abnormalities Children with cerebral palsy are stubborn, hyperactive, impulsive, socially withdrawn, aggressive, and even self-harming. In addition, they may show selective mutism, mainly refusing to talk to anyone, accompanied by panic, worry, and anxiety.
1.3 Cognitive impairment Children with cerebral palsy often exhibit memory impairment and difficulty concentrating. Cognitive impairment is one of the most important factors affecting the quality of life of the affected children.
2.4 Dependency Psychology Children with cerebral palsy are particularly dependent and lack a sense of independence because they have motor impairment and unchanging mobility, and others do everything for them.
1.5 Other psychology Some children with cerebral palsy have been overly cared for and patronized since childhood because of their physical defects, so they are more fragile and sensitive psychologically, but their self-esteem is relatively strong, and they can’t stand a little frustration and aggression, and they will throw a tantrum and cry if others don’t comply with their wishes at the slightest.
2 Care
3.1 General care The child’s hospital stay is relatively long, so it is very important to do a good job of all kinds of care.
2.1.1 Introduce the hospital environment and the purpose of examination and treatment to the child and parents according to the child’s age and intelligence, so that the child can eliminate fear and actively cooperate with the treatment. According to the child’s condition, provide parents with health education, including the causes of the disease, clinical manifestations, treatment methods and treatment precautions, the prognosis of the disease and the cooperation of parents, etc., so as to encourage the child and parents and make them feel confident about the treatment.
2.1.2 Reasonable nutrition The children are hospitalized for a long time, with many treatment items and high physical exertion, so attention should be paid to the reasonable combination of nutrition, giving high-calorie, high-protein, high-vitamin and easy-to-digest diet. In addition to ensuring sufficient nutrition for the child, attention should be paid to creating a good eating environment for the child, paying attention to whether the child is overeating and partiality during meals, and formulating individual reasonable diet plans if necessary.
2.2 Symptomatic care Follow the principles of rehabilitation treatment, cooperate with all treatments, and give reasonable life guidance and targeted training.
2.3 Early psychological intervention through observation of the early psychological development of the child. For example, observation in terms of responding to people, objects, speech, expression, movement, behavior, etc., to distinguish the difference between the child and children of the same age, if it lags behind other children, it is necessary to conduct intelligence testing, timely find out which area is poor, and conduct early training, such as early education, early language, homework training, functional training, cognitive activity training, etc.
2.4 Psychotherapy According to the child’s age, cognitive level and the degree of psychological disorder, the child should be given reasonable psychotherapy when necessary, including psychological counseling, cognitive-behavioral therapy, motor therapy and social support.
2.5 Education for children with cerebral palsy While providing motor function training for the children, the basic principles of education for children with cerebral palsy are followed according to the degree of cerebral palsy of the children, and education and training for the children are provided in a systematic and organized manner.
2.6 Psychological care.
(1) Establish a good nurse-patient relationship with the child and set a dedicated person for nursing care. Only with mutual trust and respect can the child reflect his or her existing psychological problems in a true and detailed manner, actively cooperate with the treatment and improve the treatment effect.
(2) Nursing staff can use conversation, questions and answers and specific and effective scales or questionnaires to conduct psychological tests on children and their relatives to understand the psychological and behavioral problems of children and their relatives, and take corresponding nursing measures according to the psychological problems of children.
(3) Nurses should make frequent visits to the ward, communicate with the child, encourage the child to interact more with others, ignore the misunderstanding and discrimination against cerebral palsy patients in the society, eliminate the fear, exercise social skills, and educate the child that he/she can still be self-reliant through exercise and grow up to be a person with a disability.
(4) Parents should be instructed to help the child overcome the dependency mentality, not to do everything for the child, but to let the child do as much as possible on his or her own, to cultivate his or her sense of independence, so that he or she can take care of himself or herself, and to reduce the parents’ burden.
(5) Communicate with the child patiently, carefully, softly, slowly, use simple and clear language, listen patiently and adequately, and try to answer the questions raised by the child.
(6) Comfort and encourage the child more, and criticize less. When the child makes some progress, the nurse should give praise and encouragement in time.
(7) Assist parents to properly educate and guide the child, try to overcome psychological barriers, so that the child’s body and mind will develop in a healthy direction.
(8) Instruct parents to communicate with their children more often and tell them that the rehabilitation of children with cerebral palsy is a long-term or even lifelong process, and the training of the training staff alone is far from enough. The effect of half the effort is twice as great.
3.7 Parental psychological care If parents have psychological problems, they should be provided with psychological care in a timely manner.
3.8 Social publicity Publicize the basic knowledge of cerebral palsy to eliminate the fear, misunderstanding and even discrimination of cerebral palsy patients in the society.