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THUC TRANG STRESS O CHA ME
CUA TRE CO ROI LOAN PHO TU KY
Nguyen Thj Mai Hucfng

TrUdng Dai hpc Sif pham Ha Ngi.
TOM TAT
Stress da duae nhieu tde gid trong nudc vd ngodi nude nghien ciru vai cdc
each tiep can khae nhau tren nhtrng doi tuang khde nhau. Tuy nhien, nghien euu ve
stress d cha me ciia tre co roi loan pho lu ky chua nhieu. Viee nghien ciru stress a cha
me cua Ire co roi loan pho tu ky vdi cdch tiep can mdi ndy a Viet Nam se mang lai y
nghia ve mat ly ludn eiing nhu thue lien. Nghien cuu ndy duac thuc hien tren 209 cha
me cua tre co roi loan pho tu ky d Ha Noi (Viet Nam). Ve tong the, hdu het cha me
trong mdu nghien cuu khi phdt hien con co roi loan pho lu ky deu rai vdo trang thdi
stress. Stress bieu hien a mdc khd thudng xuyen Ird len eo ty le cao nhdt, sau do Id
khong thudng xuyen vd thdp nhdt Id mice hiem khi. Stress bieu hien tren ldi cd ede
mat thue the, cdm xiic, nhdn ihuc. hdnh vi, trong do bieu hien ro ret nhdt Id cdm xue
va hdnh vi. Nhirng ddu hieu xudt hien pho bien Irong cdc nhom bieu hien stress a cha
me Ire roi loan phd tu ky la- (I) vi thuc the, ede ddu hieu thudng Id: hay quen, met
moi, dau ddu, dau nita ddu; gidm hdng thu linh due; an khong ngon; (2) ve nhdn
thirc, cdc ddu hieu thuang la: suy nghT qudn quanh, nhieu suy nghi lo du, tu ly^ gidi,
mac cd vdi chinh minh; hay nghT ve nhung buon phien. khong^ muon nghT ve linh
trgng cua con; (3) vi cdm xiic, cdc ddu hieu thudng la: soc, buon vd chdn ndn, earn
thdy CO iSi, cdu kinh vd ndi nong; (4) vi hdnh vi, cdc ddu hieu thudng la: kho quyet
dinh, khong thi tap trung, khong thi kien nhdn, lam viec kem, phdn urig thdi qud. Cdc
kit qud phong vdn cung luang ddng vdi kit qud ve mdt dinh lugng doi vdi nhung ddu
hieu xudt hien pho bien ndy.
Tu- khoa: Stress; Rdi loan phd lu ky, Stress a cha me cua tre eo roi loan pho
luky.
Ngdy nhdn bdi: 16/12/2019; Ngdy duyet ddng bdi: 25/3/2020.
1. Dat van dc
Stress la nhiJng phan ung cua co the truac nhirng yeu cau phai thay doi


tir phia moi truang ben ngoai, cung nhu cac yeu to ca nhan ben trong. Do la
each CO tha dap ung vai b^t ky loai nhu chx hoac m6i de dpa nao. Stress cang
tro nen ph6 biin han khi con nguoi phai d6i mat voi nhung thay doi chong mat
cua cuoc song day thach thuc hien nay.

TAP CHI TAM LV HOC, S6'4 (253), 4 - 2020

83


Phan irng stress la each eg the bao ve chiing ta. Khi lam viec dung each,
nd giup con ngudi tap trung, tran day nang lugng va tinh tao. Trong tinh hudng
khan cap, stress cd the ciiu mang hoac cho chiing ta them sire manh de ty vp
(Segal va cdng su, 2019). Nhung stress vugt qua ngugng se gay thiet hai ve the
chat, cam xiic va tam ly cho con ngudi (Gregory Fricchione, 2016).
Tu ky hay rdi loan phd ty ky deu la nhiing thuat ngii ndi den mgt nhdm
cac rdi loan phire tap trong sy phat trien ciia nao bp, dugc dac tryng bdi nhirng
khd khan va thieu hut trong tuong tac xa hdi, giao tiep bang ldi va khdng ldi,
cac banh vi, sd thich dinh hinh lap lai. Vdi ban chat la khiem khuyet trong
tugng tac xa hdi va rdi loan ve cam giac, tre rdi loan phd tu ky gap nhieu khd
khan trong mpi ITnh vyc ciia cudc sdng, tir viec hpc ndi cho den giao tiep, ting
xir, dieu chinh va the hien cam xuc, bgc tap cho den cudc sdng ddc lap va cdng
viec khi ldn Ien, Nhirng khd khan nay d tre rdi loan phd tu ky, vi the, gay ra
kha nhieu khd khan va stress cho gia dinh tre, dac biet la nhirng ngudi cham
sdc true tiep (Clark va cdng sy, 2010).
Nhtrng nghien cim ve cha me cd con tu ky cho thiiy, hg cd nguy ca cao
mac cac van de sue khde tam than (DeMyer, 1975; Koegel va cdng sy, 1992), cu
the nhu lo au va tram cam (J. Bromley va cdng sy, 2004; Hastings va Brgwn,
2002; Hastings, 2003). Dya tren phan tich ting hgp ket qua cua 23 nghien ciiu
tren ddi tugng nay, Catalano va cgng sy (2018) da chi ra rang, cha me cua tre

tu ky thudng bi stress d mirc cao khi so sanh vdi cha me cua tre phat triin binh
thudng, cung nhu cha mc cua tre dugc chan doan vdi cac khuylt tat khac hoac
khi so sanh vdi cha me ndi chung. Dieu dac biet la me cua tre cd rdi loan phd
tu ky dugc bao cao la cd mite do stress cao han va nang lyc lam cha me thip
ban so vdi nhirng ba me cua cac tre mic cac loai khuylt tat khac (BakerEriczen va cpng su, 2005; Baker va cdng sy, 2003; DeMyer, 1975; Dumas va
cdngsu, 1991; Emerson, 2003; Hwang va Olsson, 2001; Moes va cdng sy, 1992;
Rodrigue va cdng su, 1990; Sanders va Morgan, 1997; Wolf va cdng sy, 1989).
Nghien ciru cua Walsh va cpng sy (2013) cho thiy, hanh vi cd vin dl d tre la
mdt trong nhtrng trd ngai ldn nhat ddi vdi chit lupng sing cua gia dinh va cd
lien he chat vdi stress cua bd me. Cac trieu chirng tu ky d tre em cang nghiem
trpng, mirc do stress cua cha me cang ldn (Dunn va cdng sy, 2001). Do dd su
cang thang trong viec nudi day con cai ciia cha me cd con hi anh hudng vdi' rdi
loan phi ty ky dudng nhu cd nguy co cao han ddi vdi chit lugng cudc sons
tam ly va site khde ctia cha me, Chinh vi tbi, nhu ciu cham sdc siic khde tam
thin cua cha me khdng dupc dap img cd nguy co dang kl ddi vdi siic khde tam
ly, the chat va xa hdi ciia cha me cua tre roi loan phd ty ky va gay nguy hilm
cho boat ddng thich nghi cua gia dinh cung nhu kha nang ciia tre rli loan nhd
ty ky (Catalano va cdng sy, 2018).

84

TAP CHi TAM Vi HOC, S6 4 (253), 4 . 2020


Tai Viet Nam, rdi loan phd ty ky chi thyc sy dugc quan tam khgang 20
nam trd lai day. Do vay, cac nghien ciru cd quy md ldn, chuyen sau vl tu ky
cdn kha khiem tdn. Dac biet nghien ciiu vc tam trang ciia cha me cd con hi ty
ky chua dugc quan lam dung miic. Van dl tam trang cua cha me cd con bj ty
ky chi dugc nghien ciru Idng ghep vag trong nhtrng nghien cuu vl thai do,
nhan thiic cua gia dinh va xa hdi ve tre tu ky; vl vin dl giao due hda nhap cho

tre ty ky, tre rdi Igan phd ty ky giin nhu chi nhan dupc sy ho trg chinh ttr gia
dinh, cu the la bd mc, dng ba hoac c4c ca nhan, td chiic xa hdi tir thien dudi
nhiing hinh thuc khac nhau (Tran Van Cdng va Ngd Xuan Diep, 2017). Cd ihl
ndi, cha mc cua tre ty ky la ddi tugng cd nguy co mac rdi loan stress cao nhit
trong sd nhtrng ngudi cham sdc tre bdi tinh yeu thuang ciing nhu ky vgng,
mgng mdi ma hp dat vao con cai ciia minh.
Tai Viet Nam, nhtrng nam gan day cting cd nhieu nghien ciru ve vai trd
cua hd trg xa hdi ddi vdi vice giup giam thieu nhtrng khd khan ma gia dinh ire
rdi loan phd ty ky dang gap phai. Nghien ciru cua Nguyen Thj Hoang Yin va
cpng sy thyc bien tai Vict Nam vii Ire tu ky cho ibSy, cac yeu td ciia cdng
ddng, ky nang tu van cpng ddng anh hudng den sy phat trien ciia tre em, Su
phdi hgp giira giao vien, cha me va cac lyc lupng khac tham gia vao cdng tac
can ihicp sdm va giao due tre rdi loan phd tu ky la yeu td quan trpng tao nen su
thanh cdng ctia boat dpng nay. Ddng thdi, viec ldi cudn cac thanh vicn trong
cpng ddng tham gia hd trp tre; phdi hgp giua gia dinh va cpng ddng de tim ra
bien phap giup dd tre rdi loan phd ty ky tien bd (Nguyen Ihi Hoang Yen,
2015),
Nghien ciru ciia Nguyin Thj Trang (2015) ve van dc xay dung md hinh
hd trg tre ty ky va gia dinh da chi ra 3 ylu tl cin quan lam. Dd la: tre dupc hd
trg tri lieu tai gia dinh, gia dinh dugc iu vin hd trg va ket ndi ngudn luc, truyen
thdng cpng ddng. Diiu dac biet ma nghien ciru nay chi ra la 82,6% phu_ huynh
tra ldi ring minh thudng xuyen dupc cac giao vien tu van hoac hudng din each
day con tai nha va cd 79,3% phu huynh cd tham gia vao qua trinh tri lieu cho
con (Nguyin Thi Trang, 2015). Nghien cim cda Trin Van Cdngva cdng sy
(2017) da chi ra ring, chuyen vien can thiep din nha khdng chi hd trg ire ma
cdn hudng dan cho ca cha me ciia tre rdi loan phd tu ky, thing nhit dugc each
tiip can va irng xu vdi tre trong cac tinh hudng gia dinh, do vay cac van dc
hanh vi.ciia tre dugc it nhieu tac ddng va thay ddi.
Cd thi thiy, nhiing nghien ciru vl sire khde tam thin stress cua cha me
cd con ty ky vin cdn ban chi. Vi Ihl, nghien ciru nay nham phan anh thyc

trang stress ciia cha mc cd con ty ky dl tir do ggi y cho cac boat ddng cham sdc
sire khde tinh thin, hudng din nang cao chit lugng sdng cho hg.

TAP CHl TAM Lf HOC, Sd 4 (253), 4 - 2020

85


2. Phuffng phap nghien cuu
2.1. Mau nghien cu-u
Mau nghien cuu la nhirng nguai dap iing cac dieu kien sau: (1) Co con
mac roi loan pho tu ky a dp tuoi mam non va tieu hpc; (2) Con dang duoc can
thiep tai cac trung tam can thiep sam va giao due hoa nhap; (3) Tu nguy?n
tham gia nghien cuu va ky van ban cam ket; (4) Co du kha nang doc va hieu
bang hoi. Tong cpng co 209 cha/me dong y tham gia va tra loi bang hoi. Trong
nghien cuu nay, mau dugc co con dang duac can thiep tai 9 co so a Ha Noi,
Bac Ninh va Ninh Binh.
Bdng 1: Ddc diem mdu nghien ciru

I

2

3

So lirffna

Ty le %

^am


54

25,8

Nir

152

72,7

Dac diem

STT
Giai tinh

irinh do hgc van

Tuoi


3

1,4

Trung cap tro' xuong

55


26,4

Cao dang Ira len

151

72,2

Khuycllhicu

3

1,4

Tir 30 tuoi trd xuon^

50

23,9

Tir 31 - 40 lLi6i

SI

38,7

Tren 40 tuoi

30


14,4

Khuyt;t thieu

48

23,0

Trungbinh: 35,9; Do lech; 6,61

2.2. Cdng cu nghien cii-u
Bang hdi va phdiig vin sau la hai phuong phap chinh dugc sir dung dl thu
thap du lieu. Bang hdi ve stress gIm 29 mcnh dl (item), dugc xay dyng dua tren 4
nhdm diu hieu co ban cua stress do Vien Sue khde Tam thin Quic gia Singapore
liet ke (Institote of Mental Health) va cac bieu hien co ban cua stress tren thang
DASS (Loyibond va Lovibond, 1995). Cac nhdm diu hieu la: cac bilu hien '
thuc thi gdm 7 item nhu "Tdi hi dau diu"; vl cam xuc gdm 8 item vi du nliu
"Tdi thudng bdn chdn, lo lang va sp hai"; vl nhan thiic gdm 6 item vi du- "T"'
thudng cd suy nghi quin quanh vl tinh trang cua con" va vl hanh vi edm 8

86

TAP CHi TAM Ly HOC, Sd 4 (253), 4 _ 2020


item, vi du nhu "Tdi khdng nang ddng, linh hoat nhu binh thudng".(trong dd
cd 4 diu hieu hanh vi iiy tu thang DASS). Thang Likert 4 mirc dd dugc ap
dung vdi 1- Khdng bao gid/It khi den 4- Thudng xuyen. Bang hdi da dugc hdi
thu vdi 15 cha hgac me ciia tre ty ky dl xac djnh dp hieu lyc bl mat. Ngydi tra
ldi hieu tdt ndi dung cua tirng cau va khdng gap bit cii khd khan nao khi tra ldi

cac cau cua bang hdi. Dp tin cay Alpha ciia Cronbach ctia toan thang do la 0,96
va cua titng thanh phan dao dpng trong khoang ttr 0,84 din 0,90.
Ben canh dd, phdng van sau dupc thyc hien vdi hai ngudi dl lot ta sau
sic hon nhiing trai nghiem stress cila cha me. Cac cau bdi phdng vin dl nghi
hp chia se ve trai nghiem stress vdi van de rdi loan phd ty ky ciia con nhu: Hg
da trai qua cupe sdng nhu the nao khi biet con mac benh? Hp da cd nhtrng suy
nghT nhu the nao? NhOng cam xuc gi, mirc dp ra sao? Hp hanh xii nhu thi nao?
2.3. Phan tich
Diem stress dugc phan tich trgng bai viet nay gdm diem stress tdng hgp
va diem stress d timg thanh phan. Cac diem nay dugc tinh toan bang diem
trung binh cdng ciia cac item tuong irng trong thang/tieu thang. Diem cang cao
the hien miic do stress cang cao. Phan mem thdng ke SPSS 22,0 dugc sit dung
de mo ta dti lieu. Cac tham sd thing ke md ta nhu sd lupng, ty le % va diem
tmng binh, dp lech chuan dupc tinh toan trong phan tich.
3. Ket qua nghi6n ciiu
5.7. Ddnh gid chung ve stress & cha me cd con roi loan phd tu ky

Biiu dd 1: Phdn bd diem stress tdng hap

TAP CHi TAM Vi HOC, Sd' 4 (253), 4 - 2020

87


Tu goc dp tam ly, stress la trang thai khong thoai mai xuat hien khi ca
nhan danh gia chu quan ve sir kien, hoan canh ben ngoai nhu nhiJng tac nhan
CO tinh ch^t de dpa ve mat the chat hoac tinh than, vugt qua kha nang ung pho
va gay hai cho con nguai.
Phan bo diem stress tong hgp ciia cha me c6 con tu ky dupc hien thj a bieu
d6 1. K6t qua cho thay, di6m trung binh (M) cua stress la 2,60, dp lech chuan (SD)

la 0,71. Vai thang danh gia tir I den 4 diem, diem trung vi cua thang la 2,5 thi
di6m stress t6ng hgp thugc muc Idia thucmg xuyen. Do nghieng ciia do thi:
Skewness < 0, the hien phan bo nghieng ve ben phai nhieu hem, tuc la cha me co
con tu ky co muc diem stress nghieng ve phia diem cao nhieu hon diem thap.
Trong nghien ciiu nay, dira vao thang diem, chung toi phan chia 4 nhom
muc dp stress mot each tuong doi va phan bo diem nhu o bang 2.
Bdng 2: Tdn sudt bieu hien stress d cha me cua tre tu ky
xet theo cdc nhom bieu hien (ty le %)
Cac nhom
bieu hien
stress

Khong bao gia/
it khi
(< 1,5 diem)

Thinh thoang
(tir 1,5- dirol
2,5 diem)

Kha fhirirng
xuyen
(tCr 2,5 - duoi 3,5
diem)

long hgp

6,2(n=13)

40,2 (n = 84)


49,8 (n= 104)

3,8 (n = 8)

Thuc the

77 (n= 16)

32,1 (n = 67)

55,0 (n= 115)

5,3 (n= 11)

Nhan ihirc

6,2(n=13)

26,3 (n = 55)

56,0 (n= 117)

11,5 (n = 24)

Cam xue

11,0 01 = 23)

39,2 (n = 82)


34,4 (n = 72)

I5,3(n = 32)

Hanh vi

8,6(n=18)

42,6 (n = 89)

45,0 (n = 94)

3,8 (n = 8)

Thu'ong xuyen
(tir 3,5 diem trolen)

Ghi chit- n: so luimg cha me.

Kit qua thing ke cho thiy, hon 90% cha me tre ty ky bj stress d cac miic
do khac nhau, trong dd bon 50% cha me tre tu ky cd stress d mirc "kha thudng
xuyen" trd len, 40,2% cha me tre hr ky cd stress d mire "thinh thoang". Nhu vay,
ty le cha me tre ty ky cd stress d mirc dp "kha thudng xuyen" trd len duoc chi ra
trong nghien cira nay cung nim trong xu hudng vol nhiiTig ly le da dugc cdng bl
ciia nhilu nghien cim khac d Vict Nam va iren ihl gidi trudc dd nhu nghien ciru
cua Catalano va cdng su (2018), cha me chain sdc Ire cd rli loan phd tu ky
thucmg bao cao mire do stress, tram cam va lo lang gia tang.
Xem xet theo tirng nhdm bieu hien cu thi, nhdm cac diu hieu bilu hien
ve "nhan thirc" va "thuc the" cd muc dp tir kha thudng xuyen trd len chilm tv

le cao nhii. Nhdm bilu hien vl "cam xuc" cd mirc dp kha thudng xuyen thin

88

TAP CHi TAM Vi HOC, Sd 4 (253).

4 - 2020


nhit, chilm 34,4% nhung miic thudng xuyen lai cao nhit (ban 15%).
Nhu vay.cd the ndi, hiu hit cha me khi phat hien cgn dugc chin doan
mic rdi lo?n phi ty ky diu rai vao trang thai stress, lo ling. Nhtrng thay ddi vl
thi chit dl khien cac cha me cd cac cam giac bj dau diu, dau mia diu, met
mdi, an khdng ngon mieng, khd ngu... Do vay, cac bilu hien stress vl mat
thuc thi cung dl dang xuit hien. Ben canh dd, thdng thudng, cac vin dl vl
cam xuc dugc xem la cac rdi loan ben trong/ndi hien, cdn cac vin dl vl hanh
vi dugc cgi la cac vin dl ben ngoai/ngoai hien (din theo Nguyin Thi Minh
HSng, 2014). Diiu nay cd thi khien cho cha me tre ty ky gap stress, trong dd,
tan suat cao la cac bieu hien ve mat cam xuc.
3.2. Cdc bieu hien cu the vS stress & cha me cd con rdi loan phd tu ky
3.2.1. Bieu hien ve mat thuc the
Tim hieu cac dau hieu stress bilu hien d mat ca thi, kit qua cho thiy
nhttng dau hieu phi biin nhat thudng xuit hien d cha me tre ty ky la "Tdi hay
quen" (M = 2,89; SD = 0,90); "Tdi thiy met mdi" (M = 2,76, SD = 0,94)
vdi 69,4% cha me trai nghiem d mirc kha thudng xuyen trd len; "Tdi hay bj
" dau diu, dau mra diu" (M = 2,71; SD = 1,02) cd din 66,3% cha me cd bilu
hien thudng xuyen va kha thudng xuyen. Ben canh do, bilu hien "Tdj bi giam
himg thii tinh dye" (M = 2,56; SD = 0,99), cd 60,3% sd khach the gap phai.
Ngoai ra, cac dau hieu "Tdi an khdng ngon mieng", "Tdi hi mit ngil hoac ngii
khdng ngon giic" ciing nhieu khach the trai nghiem d miic kha thudng xuyen

trd len.
Bdng 3: Cdc bieu hien stress ve mat thuc the

TT

Cac nhan dinh

Kha
Khong
Thinh thu'crng Thirofng
bao gio'/
thoang xuyen xuyen
Hiem
(%) (%) (%)
khi (%)

M

SD

1

Toi bi dau dau, dau nua dau.

13,5

20,2

48,3


18,0

2,71

1.02

2

Toi hay quen.

12,4

15,7

49,4

22,5

2,89

0,90

3

Toi bi giam hirng thu tinh due.

19,3

20,5


43,4

16,8

2,56

0,99

4

Toi thdy met moi.

13,6

17,0

45,5

23,9

2,76

0,94

5

Toi an khong ngon mieng.

18,4


23,0

44,8

13,8

2,47

0,92

6

Toi an qua nhieu hoac qua it.

24,1

37,9

27,7

10,3

2,27

0,94

7

Toi bi mat ngii hoac ngD khong
ngon gilc.


23,5

29,4

27,1

20,0

2,46

0,99

Ghi chit: 1
TAP CHi TAM LV mc,

Sd' 4 (253), 4 - 2020

89


Tren day la cac dau hieu bieu hien v6 mat ca the ciia stress d cha me cua
tre cd rdi loan phd tu ky. Tuy nhien, ban than cha mc va nhtrng ngudi xung
quanh thudng khdng de nhan bilt cac ylu id nay nhu la cac dau hieu bieu hien ra
ben ngoai cua stress ma cd the thudng coi do la cac van de thudc benh ly thyc
the. Ci gdc dp tam ly hpc Iam sang, day la cac trieu chimg dien hinh ciia stress.
Trong qua trinh phdng van sau, chj T.L.S. ndi trong nudc mat: "Chdu a
nhd ngoai cdn dugc dua di dao hdng ngdy, biet xung quanh, den khi ve nhd ndi
thi 6 thdng trdi chi a trong nhd, bd ngi khdng cho ra ngodi vi sa d nhiem, bui

bam... tiiai gian ddu chdu cdn ggi bd, ggi me. Mdy thdng sdng nhu vay, chi gidi
minh khi thdy con minh cd nhirng bieu hien la liing, dua di kham, biet tin chdu bi
nhu vay chi chodng vdng nhu- trdi ddt sup dd. Chdu duac can thiep dugc gdn
mgt ndm cung cd nhieu tien bg nhung dng bd ngi liic ndo cUng than thd the ndy
Ihl den bao gid mdi theo kip cdc ban be... Idm chi thdy tdi thdn kinh khting'\
Khdng chi the, chj cdn chia se mdt dieu ma chi chua bao gid ndi vdi ai; ''That sir
Id til- khi chdu bi nhu vay, va chdng minh khdng he cd quan he chdn gdi nua.
Mdt phdn cUng vi bi dm dnh sg khdng ddm sinh con nua, nhd nd ciing gidng anh
nd thi sao. Mdt phdn Id chi phdi lo toan qud nhieu cdng viec nen stress qud,
khdng cdn ngin den nhu cdu dd nira. Chi cung buc chdng chi id it quan tdm den
benh tinh ciia con, chi thinh thodng mdi di ddn con cdn todn chi phdi lo hef\
Nhu vay, cd the thay tinh trang stress ciia chi S. cyc ky nghiem trgng.
Rdi loan phd ty ky la mdt trong sd cac loai khuyet t|t chua ro nguyen
nhan, rdi loan nay se idn tai suit cudc ddi cua tre khiln cac cha me dl xuit
hien bieu bien stress vdi eac khia canh vl ca thi nhu tren. Nlu khdng dugc
nhan dipn chinh xac va phat hien kip thdi, cac diu hien nay cd thi anh hudng
khdng tdt den sue khde cua chinh cac cha me va qua trinh cham sdc, giao due
con mac benh, mdi quan he vdi nhtrng ngudi than xung quanh.
3.2.2. Bieu hien stress ve mat nhan time
Trong nghien citu nay, dilm trung binh stress vl mat nhan thitc d cha
me tre tu ky la 2,63. Nhirng cha me cd mirc dp stress cao thudng gap phai cac
van de ve nhan thitc phd bien nhat d cac bilu bien sau: 41,8%) cha me cd bilu
hien thudng xuyen, "Tdi hay nghT lai nhirng buon phiin gin day nhit" (M = 2 80'
SD = (),87), "Tdi cd nhilu suy nghT lo au" (M = 2,97; SD = 0,88). Ben canh'ddi
cac bilu hien khac cha me ire ty ky cung thudng gap phai la: 18,7% thudng
xuyen "Tdi ty ly giiii, mac ca vdi chinh minh vl vin dl ciia con"'(M = 2 66'
SD = 0,98); 10% thudng xuyen gap phai vin dl "Tdi thiy minh tu duy chaiii
hoac khdng mudn suy nghT ve tinh trang cua con" (M = 2,41; SD = 1 021
Ngoai ra, 4,7% cha me ire ty ky gap vin dl "Tdi nhin thiy'mat tieu'euc
cila mpi van de, danh gia cao khd khan, danh gia thip ban than" iM = 2 -ie.

SD = 0,92).
^
^•^''•

90

TAP CHi TAM Vi HOC, So' 4 (253), 4 . 2020


Sd cha me khdng bao gid trai nghiem cac trieu chirng cua stress nhan
thtic chi chilm ty le tit 6,8% den khoang 24%). Diiu dd cd nghTa da sd cha me
diu roi vao nhiing suy nghi tieu cyc, cd each nhin nhan vin dl kha tieu cyc khi
hi stress.
Bdng 4: Cdc bieu hien stress ve mat nhdn thirc

TT

Cac nhan dinh

Khong
Kha
Thinh
Thiro'ng
bao gio/
thirong
thoang
xuyen
Ilicm
xuyen
khi (%) (%)

(%) (%)

M

SD

Toi thSy minh tir duy cham hoac
1 khong muon suy nghT ve tinh trang
cua con.

24,1

25,3

35,7

14,9

2,41

1,02

2 Toi tir ly giai, mac ca vai chinh
minh ve van de ciia con.

16,1

21,8

41,4


20,7

2,66

0,98

3 Toi hay nghT lai nhung buon phien
gan day nhat.

9,1

21,6

48,9

20,4

2,80

0,87

4 Toi CO nhieu suy nghT lo au.

8,1

15,1

47,7


29,1

2,97

0,88

5 Toi thuong co suy nghT quan quanh
ve tinh trang ciia con.

6,8

11,4

45,4

36,4

3,11

0,86

Toi nhin thay mat tieu cue cua mgi
6 van de, danh gia cao kho khan, danh
gia thap ban than.

23,9

34,5

33,3


8,3

2,26

0,92

3.2.3. Bieu hien stress ve mat cdm xitc
Cac bilu hien stress vl mat cam xuc xuit hien vdi dilm tmng binh va ty le
kha cao d cha me tre ty ky (biing 5).
Cac diu hieu cd mire dilm trung binh cao nhit la: "Tdi cau kinh, de
nil ndng" (M = 2,73; SD = 0,93), "Tdi bj sic khi bilt con tu ky" (M = 2,69:
SD = 0,93), "Tdi cam thiy cd loi va khdng ra gi khi con hi ty ky" (M = 2,64:
SD = 0,98), "Tdi thudng budn va chan nan vdi tuong lai ciia con" (M = 2,61
SD = 0,91).
Xet vl ty le, cd 40% cha me thudng xuyen va kha thudng xuyen cd cam
xiic "Tdi de bj roi vao trang thai tieu cyc", 43,7% cam thiy "Tdi cam thay btre
bii, khdng dju dugc stress", 38,1% cam thiy "Tdi thudng bdn chdn, lo lang va
sg hai".

TAP CHi TAM LY HOC, Sd 4 (253), 4 - 2020


Chi N.T.V.: 'Toi qud stress khi thdy con khong tir chii diroc, khdng gion^
nhimg dua tre binh thudng khde. Toi vira dau kho, vira buon chdn, xen lan that
vong, nghi lung tung vd rdt met moi, ddm ra lai trut gidn do hit len gia dinh,
ngirai than, nhdt la do loi cho chong Id khong chiu de y con, khong chju noi
chuyin vdi con. Moi ngudi trong gia dinh nhieu khi khong hieu, dnh mdt nhin
minh thiiu thiin cdm lgi cdng lam minh cdng thdng han... Nhieu liic khong biet
lam thi ndo, muon buong xuoi md nght buong xuoi thi truac hit kho con minh,

sau la din minh...'\ NhiJng cam xiic tieu circ cuon \ky nguoi me, quanh quan,
thircmg true ben hp khien hg khong th^ thoat ra duac boi m6i ngay deu co the
quan sat thSy a con nhirng dieu bat Ihu-cmg ma bat lire.
Bdng 5: Cdc bieu hien stress ve mat cdm xuc

TT

Cac nhan dinh

Khong
Kha
Thu-iyng
Thinh
thuang
bao giff/
xuyen
thoiing
xuyen
Iliem khi

(%)
1 Toi bi soc khi biet con mac tir
kv.

(%)

(%)

(%)


M

SD

14,0

20,9

46,5

18,6

2,69

0,93

2 Toi cau kinh, de noi nong.

11,4

25,0

42,0

21,6

2,73

0,93


3 Toi cam thay buc boi, khong
chiu duoc stress.

24,1

32,2

29,9

13,8

2,33

0,99

Toi thuang buon va chan nan
voi tuong lai ciia con.

19,8

24,4

37,2

18,6

2,54

1,01


5 Toi cam thay co loi va khong
ra gi khi eon bi tu ky.

18,2

17,0

46,6

18,2

2,64

0,98

6 Toi cam thay co dgc, bi co
lap.

28,2

29,4

31,8

10,6

2,24

0,99


7 Toi de bi ro'i vao trang tha
tieu cue.

36,5

23,5

29,4

10,6

2,14

1,04

8 Toi thuong bon chon, lo lang
va so hai.

31,0

31,0

237

14,3

2,21

1,04


4

Nhu vay, khi trong cha me tre tu ky xuit hien nhtrng cam xuc am tinh
Bd cd thi la nhiing ylu td canh bao viec hg cd thi dang phai duong diu vdi
stress. Nhirng hieu biet ve cac diu hieu nay cin phai dugc trang bj cho cha me
tre ty ky, qua dd cd the hd trg phdng ngira giam thilu stress.

92

TAP CHi TAM LV HOC, Sd 4 (253), 4 - 2020


3.2.4. Bieu hien stress ve mat hdnh vi
Nhu da chi ra d tren, stress cung cd tugng quan chat che vdi cac bilu
hien vl mat hanh vi. Theo David N. Miller (2010), cac vin dl vl hanh vi dugc
xem la cac rdi lotin ben ngoai/ngoai hien (externalizing disorders) ciia nhOng
vin dl rdi nhilu ve cam xuc ben trong.
Stress bieu hien d mat hanh vi cd dilm trung binh la 2,62 (SD = 0,84).
Stress thudng lien he vdi cac van de ve hanh vi bilu hien d cha me tre hi ky la:
"Tdi thiy mmh khdng the kien nhan dugc khi phai chd dgi" (M = 2,65; SD = 0,87),
"Tdi khdng thi tap trung vao cdng viec" (M = 2,58; SD = 0,93), "Tdi thudng thu
minh, khdng mudn tiep xuc vdi ngudi khac" (M = 2,49; SD = 0,91).
Bang 6: Cdc bieu hien stress ve mat hdnh vi

TT

Cac nhan dmh

Khong
Kha

Thinh
Thuo'ng
bao gio*/
thu'o'ng
thoang
xuyen
xuyen
Hiem
(%)
khi (%) (%)
(%)

M

SD

1 Toi khong the tap trung vao
cong viec.

15,7

24,8

44,9

14,6

2,58

0,93


2

Toi thay kha nang lam viec ciia
minh kem di.

20,5

34,1

35,2

10,2

2,35

0,92

3

Toi khong nang dong, linh hoat
nhu binh thuang.

27,6

23,0

33,3

16,1


2,37

1,06

4

Toi hay boi roi truac nhifng viee
chang dau vao dau.

16,9

28,1

43,8

11,2

1,95

0,94

5

Toi thuang thu minh, khong muon
tiep xue vai nguoi khac.

43,0

22,1


31,4

3,5

2,49

0,91

6

Toi CO xu huong phan urng thai
qua vai moi tinh huong.

17,0

40,9

34,1

8,0

2,32

0,85

7

Toi thky minh khong the kien
nhan dugc khi phai cha doi.


10,2

29,5

44,4

15,9

2,65

0,87

8

Toi khong chap nhan dugc viec
CO cai gi do xen vao can tra viec 17,8
toi dang lam.

37,8

35,5

8,9

2,35

0,88

Cd thi thiy, cha me tre ty ky diu gap phai stress d cac mirc do khac nhau,

hiu hit cac diu hieu ciia stress diu xuit hien. Trong dd, d mdi nhdm dau hieu co

T«P CHl TAM L ? HOC, Sd' 4 (253), 4 - 2020

93


the, cam xuc, nhan thiic, hanh vi, cac bidu hien sau day xu^t hien pho bien {la
nhijng dau hieu co kha thucmg xuyen tro len a hon 50% s6 nguai tra lai).
Hop 1: Nhiing bieu hien stress xudt hien pho biin d cha me
O mat thue the. dau dau, dau nua dau, hay quen, giam hung ^ u tinh due, met moi,
an khong ngon mieng, an qua nhieu hoac qua it, ngu qua nhieu hoac qua it.
Omdl edm xuc: soc khi biet con mac tu ky, cau kinh, dl noi nong, cam thay biic boi
khong diu duoc cang lhang, buon va chan nan voi tucmg lai cua con, cam thay co loi
va khong ra gi khi con bj tu ky, co nhieu suy nghi lo au, roi vao trang thai tieu cue,
thucmg bon chon, lo lang va so hai.
O mat nhdn Ihirc. tu duy cham hoac khong muon suy nghT ve tinh trang cua con, tu
Iy giai, mac ca vai chinh minh ve van de cua con, nght Iai nhiing buon phien gan
day nhat, co nhieu suy nghT Io au, suy nghT quan quanh ve tinh trang cua con, nhin
thay mat tieu cue cua mgi van de, danh gia cao kho khan, danh gia thap ban than.
O mat hanh vi: khong the tap trung vao cong viec, kha nang lam viec kem di, khong
nang dgng, linh hoat nhu binh thuang, hay boi roi truac nhiing viec chang dau vao
dau, CO xu huang phan ung thai qua voi mgi tinh huong, khong the kien nhan dugc
khi phai cha dgi, khong chap nhan dugc viec c6 cai gi do xen vao can tro viec minh
_
_
^
dang Iam.
Nhir vay, co thg thay, stress co bilu hien tren ca bon mat nhu he thdng
cac diu hieu cua stress do Vien Sire khoe Tam than Thd giai dua ra ma nghien

ciiu nay dira vao dl xay dung bg cong cu g6m: co th6, cam xuc, nhan thiic,
hanh vi, trong do, the hien manh hon 6 eac bidu hien v6 mat cam xuc, tiip d6n
la mat nhan thiie. O nhom cha me tre tu ky co nguy ca cao vai stress, cac ddu
hieu stress rat da dang. Nhirng dau hieu stress ndu dugc nhan biat va phat hien
kip thoi se giiip phong ngira cac nguy ca diln bi6n thanh miic dp benh ly.
Ngugc lai, ndu khong dugc nhan bilt, phat hien va h6 trg co thi de lai rit nhilu
anh huang den cuoc song ca nhan, qua trinh cham soc, giao due con va m6i
quan he vai nhiing nguoi xung quanh, dac biet la nguoi than khac trong gia
dinh. Vice phat hien cac bilu hien diln hinh cua stress tren eac phuang dien ca
the, cam xiic, nhan thiic, hanh vi cr cha me tre tu ky trong nghien ciiu nay gop
phan chi ra mot biic tranh t6ng thi vl cac bilu hien dae trung cua stress a cha
me cua tre tu ky 6 Viet Nam. Day se la ea sa dl c6 thi tien toi chuan hoa mot
cong cu ve stress cho cha me tre tu ky mang dac trung van hoa Viet Nam

94

TAP CHI TAM L? HOC, S6' 4 (253), 4 . 2020


4. Ket luan va khuyin nghj
Qua kit qua tighien ciru, chung tdi thiy ring: Thii nhit, vl tdng thi, hiu
het cha me trong mau nghien ciiu khi phat hien con cd rdi loan phd tu ky diu
roi vao frang thai stress, Thil hai, ty le ngudi cd stress bilu hien d mirc kha
thudng xuyen trd len chiem cao nhat, khdng nhilu ngudi cd stress d mirc hilm
khi. Thii ba, stress bieu hien tren tat ca cac mat thuc thi, cam xiic, nhan thitc
hanh vt, trong dd bieu hien rd ret nhat la cam xiic va hanh vi.
Nghien ciiu nay cQng chi ra nhirng diu hieu xuit hien phi biin trong
cac nhdm bieu hien stress d cha me tre rdi loan phi tu ky thudng thiy vl thuc
the la cac dau hieu: hay quen, met mdi, dau diu, dau nua diu; giam hiing thu
tinh due; ati khdng ngon, Ve nhan thitc, cac diu hieu thudng la: suy nghi quin

quanh, nhieu suy nghi lo au, ty ly giai, mac ca vdi chinh minh, hay nghT vl
nhung budn phien, khdng rnudn nghi vl tinh trang cua con. Cac diu hieu vl
cam xiic thudng la: sdc, budn va chan nan, thiy cd ldi, cau kinh va nil ndng,
Ve hanh vi.cac dau hieu thudng la: khd quyit dinh, khdng ihl tap trung, khdng
the kien nhan, lam viec kem, phan ting thai qua. Cac kit qua phdng vin cung
hrong ddng vdi ket qua vl mat dinh lugng ddi vdi nhirng diu hieu xuit hien
phd bien nay.
Tir ket cjua nay cho thiy, cdng tac tham vin ca nhan, ty vin hd trg cha
me h-e ty ky can tap trung dac biet hd trg cha me tre roi loan phd ty ky d ca
phdng ngira va img phd vdi stress cd hai. Hd trg ca cha me cd hiiu bilt han chi
va cha me cd nhieu hiiu biet vl rdi loan phd tu ky cung nhu cac ky nang can
thiep, giao due tre rdi loan phd ty ky,
Tai lieu tham khao
Tai lilu tiing Viet
1. Tran Van Cong (2017). Mo hinh can thiep cho tre rdi loan phd tu ky dua tren cdng
dong: td chiic thue Men vd nhiing kil qud ban ddu. I loi thao "LTng dung tam ly hpc,
giao due hoc vao can thiep rdi loan phat triin". NXB Thi gidi. Ha Ngi.
2. Tran Van Cdng, Ngd Xuan Diep (2017). Hieu qud cita chuang trinh can thiep Ire
tu ky dua tren su ket hap giiia gia dinh vd ca sd can thiep. Tap chi Khoa hoc vit Cong
nghe Viet Nam. Tap 17. Sl 6. Trang 48-54.
3. Nguyen Thi Trang (2015). Xdy dimg md hinh hd trg tre tvr ky vd gia dinh co tre lit
Icy Iren dia bdn huyen Gia Ldm, Ihdnh phd Hd Ndi. Luan van thac si. Trudng Dai hgc
Khoa hgc xa hgi va nhan van, Dai hgc QuIc gia Ha Ngi.
4. Nguyen Thi Hoang Yen (2015). Nghien ciru bien phdp can thiep sdm vd gido due
hoa nhap eho ire lu ky d nudc ta hien nay vd trong giai doan 2011 - 2020 (Trudng
i3ai hgc Su pham Ha Ngi). Dl tai cip Nha nudc.

W CHI TAM Vi HOC, Sd 4 (253), 4 - 2020

95



Tdi lieu tieng Anh
5. Baker-Ericzen M.J., Brookman-Frazce L. & Stahmer A. (2005). Stress levels and
adaptability in parents of toddlers with and without autism spectrum disorders.
Research and Practice for Persons with Severe Disabilities. 30 (4). P. 194 - 204. DOI:
10.251 l/rpsd.30.4.194.
6. Baker B.L., Mclntyre L.L., Blacher J., Cmic K., Edelbrock C. & Low C. (2003).
Preschool children with and wUhout developmental delay: Behaviour problems and
parenting stress over time. Journal of Intellectual Disability Research. 47 (4 - 5).
P. 217 - 230. DOI: 10.1046/j,1365-2788.2003.00484.x.
7. Bromley J., Hare D.J., Davison K. & Emerson E. (2004). Mothers supporting
children with autistic spectrum disorders- Social support, mental health status and
satisfaction with services. Audsm. 8 (4). P. 409-423. DOI: 10.1177/ 1362361304047224.
8. Catalano D., Holloway L. & Mpofu E. (2018). Mental health interventions for
parent carers of children with autistic spectrum disorder: Practice guidelines from a
critical inlerprelive synthesis (CIS) systematic review. International Joumal of
Environmental Research and Public Health. 15 (2). P. 1 - 23. DOI: 10.3390/ijerphl5020341.
9. Clark A.N., Sander A.M., Pappadis M.R., L.evans G., Truchen M.A.S. & ChiouTan F.Y. (2010). Caregiver characteristics and their relationship to health service
utilization in minority patients with first episode stroke. NeuroRehabilitation. 27 (1).
P. 95 - 104. DOI: 10.3233/NRE-2010-0584.
10. DeMyer M.K. (1975). The nature of the neuropsychological disability in autistic
children. Joumal of Autism and Childhood Schizophrenia. 5 (2). P. 109 - 128. DOI'
10.1007/BF01537928.
11. Dumas J.E., Wolf L.C, Fisman S.N. & CuUigan A. (1991). Parenting stress,
child behavior problems, and dysphoria in parents of children with autism, down
syndrome, behavior disorders, and normal development. Exceptionality: A Special
Education Joumal. 2 (2). P. 97 - 110. DOI: 10.1080/09362839109524770.
12. Dunn M.E., Burbme T., Bowers CA. & Tantleff-Dunn S. (2001). Moderators of
Stress in Parents of Children with Autism. Community Mental Health Joumal 37 il)

P. 39 - 52. DOI: 10.1023/A:1026592305436.
13. Emerson E. (2003). Mothers of children and adolescents with inteliectual
disability: social and economic situation, mental health status, and the self-assessed
social and psychological impact of the child's difficulties. Joumal of Intellectual
Disability Research. Vol. 47 (4 - 5). P. 385 - 399.
14. Hastings R.P. (2003). Child behaviour problems and partner mental health as
correlates of stress in mothers and fathers of children with autism Journal nf
Intellectual Disability Research. Vol. 47 (4 - 5). P. 231 - 237.

96

TAP CHI TAM Vi HOC, Sd 4 (253), 4 _ 2020


15. Hastings R.P. & Brown T. (2002). liehavior problems of children with autism,
parental self-efficacy, and mental health. American Joumal on Mental Retardation
107 (3). P. 204-205.DOl:10.1352/0895-8017(2002)107<0222:BPOCWA>2.0.CO;2
16. Hwang CP. & Olsson M.B. (2001). Depression in mothers and fathers of
children with intellectual disability. Journal of Inlcllcciual Disabililies. 45(6). P. 535 543. blips ://pdfs.semanticscholar.org/c95c/dl92r425c31175db433dl9bc4c4f4434fi6a.pdf
17. Institute of Mental Health (n.d.). Understanding your menial health/Overcoming
stress/Symptoms. hiips://www.imh.com.sg/wcllncss/page.aspx?id=558.
18. Lovibond S.H. & Lovibond P. (1995). Manual for the depression anxiely stress
scales [kit] (2nd cd.). Sydney. N.S, W. Psychology Foundation of Australia.
19. Melinda Smith M. (2019). Stress symptoms, signs and causes. Retrieved from:
hitp://www.hclpguidc.org/mcntal/slrcss signs.htm.
20. Mocs D., Kocgcl R.L., Schrcibman L. & Loos L.M. (1992). .Stress profiles for
mothers and fathers of children with autism. Psychological Reports. Vol. 71. P. 1.272
-1.274. DOL 10.2466/pr0.71.8.1272-1274.
21. Rodrigue J.R., Morgan S.B. & Gcflken 0. (1990). FamUies of autistic children:
Psychological functioning of mothers. Journal of Clinical Child Psychology. 19 (4).

P. 371 -379. DOI: 10.1207/sl5374424jccpl904_9.
22. Sanders J.L. & Morgan S.B. (1997). Family stress and adjustment as perceived by
parents oi children with autism or down syndrome: Implications for intervention.
Child & Family Behavior 'l-berapy. 19 (4). P. 15 - 32. DOI: 10.1300/J019vl9n04.
23. Walsh C.E., Mulder [i. & Tudor M.E. (2013). Predictors of parent .stress in a
.sample of children with ASD- Pain, problem behavior, and parental coping. Research
in Autism Spectrum Disorders. 7 (2). P. 256 - 264. DOI: 10.1016/j.rasd.2012.08.0IO.
24. Wolf L.C, Nob S., Fisman S.N. & Spccchley M. (1989). Brief report:
Psychological effects of parenting sti-ess on parents of autistic children. Journal of
Autism and Developmental Disorders. 19 (1). P. 157 - 166. DOI: 10,1007/BF022I2727,

TAP CHi TAM Vi HOC, Sd 4 (253), 4 - 2020

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