Abstract: Background　Children with cerebral palsy，autism and intellectual disability need constant rehabilitation training throughout their growth，in which family plays a vital role.Family medical coping mode can influence the rehabilitation process and efficacy for these children.Objective　To understand family medical coping mode for children with special needs and its influencing factors，so as to provide references in health education and rehabilitation guidance for people concerned.Methods　Respondents were selected by taking three-stage sampling method from June to August，2017：in the first stage，8 cities/prefectures were selected from Sichuan Province by simple stochastic sampling method；in the second stage，two schools and/or rehabilitation institutions for children with cerebral palsy，autism and intellectual disability were selected within each of the 8 cities/prefectures by simple stochastic sampling method；in the third stage，those children's parents from these schools or rehabilitation institutions were selected as respondents by cluster sampling method.The survey was conducted through questionnaires for basic information of children with special needs and their families and questionnaires for medical coping modes.A total of 320 questionnaires were distributed，and 292 valid questionnaires were recollected，with 91.3% of recovery rate.The scores of family medical coping modes for children with special needs and norms were compared to analyze the status quo of family medical coping mode for children with special needs.The influencing factors of medical coping modes were studied by multiple linear stepwise regressions.Results　Among all respondents，142 tended to be confronting（48.6%），30 tended to be avoiding（10.3%），and 120 tended to be yielding（41.1%）．Families with children of special needs scored lower than families with norms in the dimensions of confrontation and avoidance，and higher in the dimension of yielding（P<0.05）．The results of multiple linear stepwise regressions showed that the diagnosis，disability grading，self-care ability，rehabilitation assistance，educational level of mother and parents' marital status were factors influencing the score of confrontation mode dimension（P<0.05）；educational level of father and annual household income were influencing factors of the score of avoidance mode dimension（P<0.05）；and disability grading，rehabilitation assistance，educational level of father，parents' marital status and annual household income were factors influencing the score of yielding dimension（P<0.05）．Conclusion　Family medical coping modes for children with special needs is still to be improved.The diagnosis，disability grading，self-care ability，rehabilitation assistance，parents educational level and their marital status，and annual household income are main influencing factors for family coping mode.Targeted psychological health assistance based on fore mentioned influencing factors should be implemented among parents to change the passive family coping mode and improve the rehabilitation efficacy of children with special needs.

Key words: Child, exceptional；Family；Medical coping modes；Root cause analysis

摘要： 背景　脑瘫、自闭症、智力障碍等特殊儿童在其成长过程中需要持续的康复训练，而家庭在此过程中起着至关重要的作用，家庭医学应对方式会影响孩子的康复过程和疗效。目的　调查了解特殊儿童家庭医学应对方式，分析其影响因素，为相关人员进行健康宣教和康复指导提供参考。方法　2017年6—8月，采用三阶段抽样法抽取调查对象，即第一阶段采用单纯随机抽样法抽取四川省8个市/州，第二阶段在抽取的8个市/州中采用单纯随机抽样法各抽取2家有脑瘫、自闭症和智力障碍等特殊儿童就读的学校和/或进行康复的机构，第三阶段采用整群抽样法抽取第二阶段抽取的学校或机构的特殊儿童的家长为调查对象。采用特殊儿童及其家庭基本情况问卷和医学应对方式问卷对其进行调查。共发放问卷320份，回收有效问卷292份，有效回收率为91.3%。将特殊儿童家庭医学应对方式得分与常模比较，分析特殊儿童家庭医学应对方式现状，医学应对方式的影响因素分析采用多元线性逐步回归分析。结果　特殊儿童家庭医学应对方式倾向面对者142名（48.6%），回避者30名（10.3%），屈服者120名（41.1%）。特殊儿童家庭面对、回避维度得分低于常模，屈服维度得分高于常模（P<0.05）。多元线性逐步回归分析结果显示：疾病诊断、残疾等级、自理能力、康复救助情况、母亲文化程度和父母婚姻状况是面对维度得分的影响因素（P<0.05），父亲文化程度和家庭年收入是回避维度得分的影响因素（P<0.05），残疾等级、康复救助情况、父亲文化程度、父母婚姻状况和家庭年收入是屈服维度得分的影响因素（P<0.05）。结论　特殊儿童家庭医学应对方式有待改善；疾病诊断、残疾等级、自理能力、康复救助情况、父/母亲文化程度、父母婚姻状况和家庭年收入为影响家庭应对方式的主要因素，应针对上述影响因素对家长实施有针对性的心理健康教育，改变家庭消极应对的现状，提高特殊儿童康复效果。

关键词: 儿童, 特殊；家庭；医学应对方式；影响因素分析