反复呼吸道感染患儿家长心理健康状况及生活质量调查

刘伟; 陈长浩; 王芳

doi:10.16766/j.cnki.issn.1674-4152.002600

反复呼吸道感染患儿家长心理健康状况及生活质量调查

doi: 10.16766/j.cnki.issn.1674-4152.002600

刘伟¹,
陈长浩²,
王芳^2, ,

1.
安徽医科大学附属宿州医院儿科, 安徽宿州 234000
2.
宿州市第二人民医院精神科, 安徽宿州 234000

基金项目:

安徽省卫生健康科研项目 AHWJ2021a044

详细信息

通讯作者:
王芳, E-mail: 1204045168@qq.com

中图分类号: R725.6 R195
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- 文章访问数: 416
- HTML全文浏览量: 129
- PDF下载量: 10
- 被引次数: 0
出版历程
- 收稿日期: 2021-09-11
- 网络出版日期: 2022-09-26

Mental health status and quality of life in families of children with recurrent respiratory infections

1.
Department of Pediatrics, Suzhou Hospital of Anhui Medical University, Suzhou, Anhui 234000, China

摘要

摘要: 目的反复呼吸道感染(recurrent respiratory tract infection, RRTI)是临床常见的儿科问题, 影响儿童生长发育, 对其家庭和社会造成负担。通过比较RRTI患儿家长和对照家长的心理健康、生活质量指标的差异, 分析患儿RRTI对家长心理健康状况及生活质量的影响。方法采用横断面调查的研究方法, 选取2021年1-5月就诊于安徽医科大学附属宿州医院儿科, 且被诊断为反复呼吸道感染患儿的陪护家长(研究组, 315例), 以及同一时期、同一地区招募的幼儿家长(对照组, 278例), 收集一般资料, 采用患者健康问卷抑郁量表(PHQ-9)、广泛性焦虑障碍量表(GAD-7)以及生活质量测定量表简表(WHOQOL-BREF)分别对抑郁、焦虑症状以及生活质量进行评估。分别比较2组的抑郁、焦虑比例以及生活质量各领域评分, 并分析抑郁、焦虑与生活质量的关系。结果研究组抑郁(27.1% vs.9.5%)和焦虑(21.7% vs.6.0%)的比例高于对照组(均P < 0.001)。控制社会人口学变量后, 差异仍有统计学意义(均P < 0.001)。研究组生活质量总分、生理领域以及环境领域得分均低于对照组(均P < 0.05)。控制社会人口学变量后, 差异仍有统计学意义(均P < 0.05)。抑郁和焦虑均会降低生活质量总分以及各领域得分(均P < 0.05)。结论 RRTI患儿家长易产生抑郁、焦虑情绪, 各领域生活质量下降, 提示需要改变护理方式与加强沟通, 提供适宜的个体化心理干预。
- 反复呼吸道感染 /
- 家长 /
- 抑郁 /
- 焦虑 /
- 生活质量
Abstract: Objective Recurrent respiratory tract infection (RRTI) is a common clinical paediatric problem that affects the growth and development of children and places a burden on families and society.By comparing the differences in mental health and quality of life indicators between the families of children with RRTI and control families, we analysed the impact of children's RRTI on their families'mental health status and quality of life. Methods In the cross-sectional survey, chaperone family members of children who attended the paediatric (Research group, 315 cases) department of Suzhou Hospital of Anhui Medical University and were diagnosed with RRTIs from January to May, 2021, as well as parents of young children recruited (Control group, 278 cases) during the same period and in the same region were selected.General information was collected, and depression and anxiety symptoms and quality of life were assessed using the patient health questionnaire-9(PHQ-9), 7-item generalised anxiety dsorder scale (GAD-7) and World Health Organization quality of life schedule-brief version (WHOQOL-BREF), respectively.We compared the prevalence of depression and anxiety and quality of life scores in each domain between two groups and analysed the relationship amongst depression, anxiety and quality of life. Results The prevalence of depression (27.1% vs.9.5%) and anxiety (21.7% vs.6.0%) was higher in the study group than in the control group (all P < 0.001).After controlling for sociodemographic variables, the differences remained statistically significant (all P < 0.001).Total quality of life scores, physical, psychological, social and environmental scores were lower in the study group than in the control group (all P < 0.05).After controlling for sociodemographic variables, the difference was still statistically significant (all P < 0.05).Both depression and anxiety reduced the total quality of life score and each domain score (all P < 0.05). Conclusion Families of children with RRTI are prone to depression, anxiety and decreased quality of life in all domains, suggesting the need for changes in care with enhanced communication and the provision of appropriate individualised psychological interventions.
- Recurrent respiratory tract infection /
- Families /
- Depression /
- Anxiety /
- Quality of life

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表 1 反复呼吸道感染儿童家长与对照组一般资料和心理健康、生活质量比较

Table 1. Comparison of general information, mental health and quality of life between parents of children with recurrent respiratory tract infection and control group

组别	例数	年龄 (x±s，岁)	性别[例(%)]		教育程度[例(%)]		婚姻状况[例(%)]		子女数量[例(%)]		吸烟 [例(%)]
组别	例数	年龄 (x±s，岁)	男性	女性	大专及以下	本科及以上	已婚/同居	独身	1个子女	2个及以上	吸烟 [例(%)]
研究组	277	30.3±4.9	32(11.6)	245(88.4)	242(87.4)	35(12.6)	274(98.9)	3(1.1)	105(37.9)	172(62.1)	15(5.4)
对照组	199	31.0±4.6	31(15.6)	168(84.4)	165(82.9)	34(17.1)	196(98.5)	3(1.5)	92(46.2)	107(53.8)	16(8.0)
统计量		-1.582^a	1.634^b		1.850^b				3.309^b		1.311^b
P值		0.114	0.201		0.174		0.698^c		0.069		0.252

组别	例数	月收入[例(%)]		抑郁 [例(%)]	焦虑[例(%)]	生活质量总分 (x±s，分)	生理领域 (x±s，分)	心理领域 (x±s，分)	社会领域 (x±s，分)	环境领域 (x±s，分)
组别	例数	>5 000元	≤5 000元	抑郁 [例(%)]	焦虑[例(%)]	生活质量总分 (x±s，分)	生理领域 (x±s，分)	心理领域 (x±s，分)	社会领域 (x±s，分)	环境领域 (x±s，分)
研究组	277	74(26.8)	202(73.2)	75(27.1)	60(21.7)	53.3±8.3	13.6±2.3	13.3±2.3	14.0±2.7	12.4±2.3
对照组	199	59(29.6)	140(70.4)	19(9.5)	12(6.0)	56.3±11.3	15.1±2.6	13.8±3.2	14.1±3.4	13.2±3.4
统计量		0.462^b		22.450^b	22.038^b	-3.115^a	-6.807^a	-1.798^a	-0.493^a	-2.704^a
P值		0.497		< 0.001	< 0.001	0.002	< 0.001	0.073	0.622	0.007
注：^a为t值，^b为χ²值，^c为采用Fisher精确检验；独身包括离异、分居、丧偶。

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表 2 伴与不伴抑郁、焦虑的反复呼吸道儿童家长各领域生活质量得分的比较(x ±s，分)

Table 2. With and without depression, anxiety, repeated respiratory tract in children parents in various areas the quality of life score comparison (x ±s, scores)

项目	抑郁		非抑郁		抑郁		焦虑		抑郁×焦虑
项目	焦虑(n=47)	非焦虑(n=28)	焦虑(n=13)	非焦虑(n=189)	F值	P值	F值	P值	F值	P值
生理领域	11.5±1.8	12.3±1.8	12.5±2.2	14.4±2.1	16.706	< 0.001	13.425	< 0.001	1.781	0.183
心理领域	11.3±2.0	12.4±1.8	12.8±1.7	14.0±2.2	15.930	< 0.001	8.545	0.004	0.027	0.869
社会领域	12.1±2.2	12.7±2.6	12.9±1.8	14.7±2.5	9.716	0.002	6.528	0.011	1.955	0.163
环境领域	11.0±1.8	11.6±1.9	11.7±1.7	13.0±2.4	6.308	0.013	5.308	0.022	0.638	0.425
总分	45.9±5.9	49.0±6.7	49.9±5.6	56.1±7.7	16.699	< 0.001	11.623	0.001	1.270	0.261
注：F值、P值均为控制了一般人社会人口学变量后的统计量。

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参考文献(24)

[1]	白思远, 郭素香, 陈慧. 儿童反复呼吸道感染危险因素的Meta分析[J]. 中华医院感染学杂志, 2021, 31(12): 1811-1816. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHYY202112011.htm BAI S Y, GUO S X, CHEN H. Meta-analysis of risk factors for recurrent respiratory infections in children[J]. Chinese Journal of Nosocomiology, 2021, 31(12): 1811-1816. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHYY202112011.htm
[2]	林立, 李昌崇. 儿童反复呼吸道感染判断条件和防治[J]. 中华实用儿科临床杂志, 2017, 32(4): 249-252. doi: 10.3760/cma.j.issn.2095-428X.2017.04.003 LIN L, LI C C. Judgement, prevention and treatment of recurrent respiratory tract infections in children[J]. Journal of Applied Clinical Pediatrics, 2017, 32(4): 249-252. doi: 10.3760/cma.j.issn.2095-428X.2017.04.003
[3]	张明, 邱蕾, 贺玉霜, 等. 潍坊地区5 132例6岁以下儿童维生素D水平调查及相关危险因素分析[J]. 中华全科医学, 2020, 18(5): 779-782. doi: 10.16766/j.cnki.issn.1674-4152.001355 ZHANG M, QIU L, HE Y S, et al. Investigation of vitamin D levels and analysis of related risk factors in 5 132 children under 6 years old in Weifang area[J]. Chinese Journal of General Practice, 2020, 18(5): 779-782. doi: 10.16766/j.cnki.issn.1674-4152.001355
[4]	KANSEN H M, LEBBINK M A, MUL J, et al. Risk factors for atopic diseases and recurrent respiratory tract infections in children[J]. Pediatr Pulmonol, 2020, 55(11): 3168-3179. doi: 10.1002/ppul.25042
[5]	AMELI F, BROCCHETTI F, MIGNOSI S, et al. Recurrent respiratory infections in children: A study in clinical practice[J]. Acta Biomed, 2020, 91(4): e2020179. DOI: 10.23750/abm.v91i4.8585.
[6]	李润芝, 徐真谛. 反复呼吸道感染患儿家庭养育情况和血清微量元素的相关性研究[J]. 现代医药卫生, 2020, 36(22): 3621-3623. doi: 10.3969/j.issn.1009-5519.2020.22.026 LI R Z, XV Z Z. Correlation between family rearing and serum trace elements in children with recurrent respiratory tract infection[J]. Journal of Modern Medicine & Health, 2020, 36(22): 3621-3623. doi: 10.3969/j.issn.1009-5519.2020.22.026
[7]	白英杰, 黄姗姗, 汪云. 维生素A和维生素D及维生素E与儿童反复呼吸道感染的相关性研究[J]. 中国医药, 2020, 15(10): 1542-1544. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYG202010013.htm BEI Y J, HUANG S S, WANG Y. Association between serum vitamin A, vitamin D, vitamin E levels and recurrent respiratory tract infection in children[J]. China Medicine, 2020, 15(10): 1542-1544. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYG202010013.htm
[8]	沈仁, 杨善浦, 吴月超, 等. 玉环海岛地区儿童呼吸道感染相关因素的临床研究[J]. 中华全科医学, 2019, 17(3): 426-429. doi: 10.16766/j.cnki.issn.1674-4152.000699 SHEN R, YANG S P, WU Y C, et al. Clinical study on related factors of respiratory tract infection in children in island area of Yuhuan[J]. Chinese Journal of General Practice, 2019, 17(3): 426-429. doi: 10.16766/j.cnki.issn.1674-4152.000699
[9]	蔺小培, 严成明, 张榴榴. 反复呼吸道感染患儿血清维生素A E水平的临床研究[J]. 安徽医学, 2020, 41(11): 1254-1257. doi: 10.3969/j.issn.1000-0399.2020.11.002 LIN X P, YAN C M, ZHANG L L. Clinical analysis of serum vitamin A and E levels in children with recurrent respiratory tract infection[J]. Anhui Medical Journal, 2020, 41(11): 1254-1257. doi: 10.3969/j.issn.1000-0399.2020.11.002
[10]	罗丽, 王晓东, 祁海滨, 等. ApoE基因多态性与肥胖儿童肺炎支原体感染及反复呼吸道感染的关系[J]. 中华医院感染学杂志, 2021, 31(14): 2224-2227. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHYY202114031.htm LUO L, WANG X D, QI H B, et al. Association of ApoE gene polymorphisms with Mycoplasma pneumoniae infection and recurrent respiratory tract infection in obese children[J]. Chinese Journal of Nosocomiology, 2021, 31(14): 2224-2227. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHYY202114031.htm
[11]	COHN L N, PECHLIVANOGLOU P, LEE Y, et al. Health outcomes of parents of children with chronic illness: A systematic review and meta-analysis[J]. J Pediatr, 2020, 218: 166-177. e2. DOI: 10.1016/j.jpeds.2019.10.068.
[12]	VAN WARMERDAM J, ZABIH V, KURDYAK P, et al. Prevalence of anxiety, depression, and posttraumatic stress disorder in parents of children with cancer: A meta-analysis[J]. Pediatr Blood Cancer, 2019, 66(6): e27677. DOI: 10.1002/pbc.27677.
[13]	BARRETO T M, BENTO M N, BARRETO T M, et al. Prevalence of depression, anxiety, and substance-related disorders in parents of children with cerebral palsy: A systematic review[J]. Dev Med Child Neurol, 2020, 62(2): 163-168. doi: 10.1111/dmcn.14321
[14]	MAJMUDAR I K, ENGEL L, MUSCARA F, et al. Exploring health state utility values of parents of children with a serious illness[J]. Qual Life Res, 2020, 29(7): 1947-1959. doi: 10.1007/s11136-020-02466-w
[15]	房艳荣, 赫文静. 传统护理与家长参与式护理在儿科护理中的应用效果对比[J]. 山西医药杂志, 2020, 49(7): 909-912. doi: 10.3969/j.issn.0253-9926.2020.07.060 FANG Y R, HAO W J. Comparison of application effect of traditional nursing and parent participatory nursing in pediatric nursing[J]. Shanxi Medical Journal, 2020, 49(7): 909-912. doi: 10.3969/j.issn.0253-9926.2020.07.060
[16]	周风琴, 向娜, 陈秀琴. 家庭浸润式护理对儿科患儿护理效果及自尊水平的影响[J]. 国际护理学杂志, 2020, 39(20): 3817-3820. doi: 10.3760/cma.j.cn221370-20190718-01173 ZHOU F Q, XIANG N, CHEN X Q. Influence of family infiltration nursing on nursing effect and self-esteem level of pediatric children[J]. International Journal of Nursing, 2020, 39(20): 3817-3820. doi: 10.3760/cma.j.cn221370-20190718-01173
[17]	吕扬. 小儿反复呼吸道感染应用整体护理模式的效果及并发症影响[J]. 中国医药指南, 2020, 18(33): 138-139. https://www.cnki.com.cn/Article/CJFDTOTAL-YYXK202033066.htm LYU Y. Effect of holistic nursing mode on children with recurrent respiratory tract infection and its complications[J]. Guide of China Medicine, 2020, 18(33): 138-139. https://www.cnki.com.cn/Article/CJFDTOTAL-YYXK202033066.htm
[18]	李思圆. 小儿反复呼吸道感染预防及综合护理的措施及效果分析[J]. 实用临床护理学电子杂志, 2019, 4(19): 54, 60. https://www.cnki.com.cn/Article/CJFDTOTAL-SLHL201919045.htm LI S Y. Measures and effect analysis of prevention and comprehensive nursing of recurrent respiratory tract infection in children[J]. Journal of Clinic Nursing ' s Practicality, 2019, 4(19): 54, 60. https://www.cnki.com.cn/Article/CJFDTOTAL-SLHL201919045.htm
[19]	钱美英, 王红, 谢安慰. 儿科低年资护士护患沟通影响因素的现象学研究[J]. 中国实用护理杂志, 2021, 37(2): 134-138. QIAN M Y, WANG H, XIE A W. A phenomenological study on influencing factors of nursing-patient communication of junior pediatric nurses[J]. Chinese Journal of Practical Nursing, 2021, 37(2): 134-138.
[20]	王宇, 王鹏, 孟欢欢. 基于CICARE沟通模式的肢体语言沟通在儿科护理中的应用效果[J]. 中华现代护理杂志, 2021, 27(14): 1906-1909. WANG Y, WANG P, MENG H H. Effect of body language communication based on CICARE communication mode in pediatric nursing[J]. Chinese Journal of Modern Nursing, 2021, 27(14): 1906-1909.
[21]	LAW E, FISHER E, ECCLESTON C, et al. Psychological interventions for parents of children and adolescents with chronic illness[J]. Cochrane Database Syst Rev, 2019, 3(3): CD009660. DOI: 10.1002/14651858.CD009660.pub3.
[22]	李大凤, 孟颖慧, 范媛. 四级预检分诊系统对儿科急诊分诊质量及患儿家长满意度的影响[J]. 医学临床研究, 2019, 36(11): 2198-2200. LI D F, MENG Y H, FAN Y. Effect of four-level pre-examination triage system on the quality of pediatric emergency triage and parents ' satisfaction[J]. Journal of Clinical Research, 2019, 36(11): 2198-2200.
[23]	汤维, 郭洁, 张敏, 等. 远程延续性护理在儿童反复呼吸道感染中的应用[J]. 中国当代医药, 2021, 28(14): 239-242. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGUD202114064.htm TANG W, GUO J, ZHANG M, et al. Application of remote continuing nursing in recurrent respiratory infection in children[J]. China Modern Medicine, 2021, 28(14): 239-242. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGUD202114064.htm
[24]	李文敏, 黄丽霞, 黄燕. 探讨延续性护理对反复呼吸道感染患儿治疗依从性的影响[J]. 中西医结合心血管病电子杂志, 2020, 8(27): 161-162. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXJH202027116.htm LI W M, HUANG L X, HUANG Y. To explore the effect of continuous nursing on treatment compliance of children with recurrent respiratory tract infection[J]. Cardiovascular Disease Journal of Integrated Traditional Chinese and Western Medicine(Electronic), 2020, 8(27): 161-162. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXJH202027116.htm