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中国循证儿科杂志

中国循证儿科杂志 ›› 2022, Vol. 17 ›› Issue (2): 149-154.

• 论著 • 上一篇    下一篇

原发性纤毛运动障碍患儿及其父母焦虑抑郁影响因素分析

林雅丽1,2,郭卓瑶1,2,王立波1,钱莉玲1   

  1. 1 复旦大学附属儿科医院呼吸科上海，201102；2 共同第一作者
  • 收稿日期:2022-04-01 修回日期:2022-04-11 出版日期:2022-04-25 发布日期:2022-04-25
  • 通讯作者: 钱莉玲

Investigation and influencing factors of anxiety and depression in children with PCD and their parents

LIN Yali1,2, GUO Zhuoyao1,2, WANG Libo1, QIAN Liling1   

  1. Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai 201102,China; 2 Co-first author
  • Received:2022-04-01 Revised:2022-04-11 Online:2022-04-25 Published:2022-04-25
  • Contact: QIAN Liling, email: llqian@126.com

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摘要： 背景：国外文献报道原发性纤毛运动障碍（PCD）患儿更易焦虑、抑郁，我国尚无PCD患儿及家长焦虑、抑郁状况的报道。 目的：探讨PCD患儿及家长焦虑、抑郁现状及影响因素。 设计：病例对照研究。 方法：以确诊的>7岁PCD患儿及家长分别为PCD儿童组和PCD父母组；以确诊的哮喘患儿及家长分别为哮喘儿童组和哮喘父母组，以健康儿童及家长分别为对照儿童组和对照父母组，采用焦虑性情绪障碍筛查表(SCARED)和抑郁量表(CDI) 评价儿童焦虑和抑郁状况，以焦虑自评量表(SAS)、流调用抑郁自评量表(CESD)评价父母的焦虑和抑郁状况，以Zarit负担量表评估PCD患儿父母照顾负担。分析PCD患儿及家长焦虑和抑郁的影响因素。 主要结局指标：PCD患儿及家长焦虑、抑郁的发生率和影响因素。 结果：PCD儿童组38例、哮喘儿童组76例和对照儿童组76名；PCD父母组、哮喘父母组和对照父母组均为82名。PCD儿童组焦虑发生率和SCARED得分高于哮喘儿童组和对照儿童组（P<0.05），3组儿童CDI得分及抑郁发生率比较差异均无统计学意义（P≥0.05）；父母焦虑发生率、CESD得分和抑郁发生率PCD组高于哮喘组和对照组（P均<0.05），哮喘组与对照组差异均无统计学意义（P均≥0.05）。父母SAS得分PCD组与哮喘组差异无统计学意义。PCD患儿母亲焦虑发生率、抑郁发生率、CESD评分、SAS评分和Zarit得分均高于父亲（P均<0.05）。多因素二元Logistic回归分析显示，7~17岁PCD患儿，男孩较女孩易发生焦虑，规律气道护理是避免焦虑和抑郁发生的保护因素；4~17岁PCD患儿父母，受教育程度高、有稳定职业、患儿规律运动是避免焦虑发生的保护因素，受教育程度高、患儿近1年住院频率＜1次、患儿规律运动是避免抑郁发生的保护因素，Zarit负担量表得分高是焦虑和抑郁发生的危险因素。 结论：PCD患儿焦虑发生率较高，受性别和气道护理情况影响。PCD患儿父母焦虑、抑郁发生率较高，受职业、受教育程度、照顾负担、患儿运动情况及患儿近1年住院频率影响。

关键词: 关键词 原发性纤毛运动障碍, 患儿, 父母, 焦虑, 抑郁

Abstract: Background：Foreign literature has reported that children with primary ciliary dyskinesia (PCD) were prone to anxiety and depression. Until now, there were no reports on anxiety and depression of Chinese PCD children and their parents. Objective：To investigate the occurrence and influencing factors for anxiety and depression of PCD children and their parents. Design：Casecontrol study. Methods：Children with PCD over 7 years old and their parents were selected as the PCD children group and the PCD parents group. Children with asthma and their parents were selected as the asthma children group and asthma parents group, and healthy children and their parents were selected as the control children group and control parents group. Children's anxiety and depression were evaluated by the scale of Screen for Child Anxiety Related Emotional Disorders (SCARED) and Children's Depression Inventory (CDI). Parents' anxiety and depression were evaluated by SelfRating Anxiety Scale (SAS) and Center for Epidemiological Survey Depression Scale (CESD). The care burden on parents of children with PCD was evaluated by Zarit Caregiver Burden Scale. Influencing factors of anxiety and depression in children with PCD and their parents were analyzed. Main outcome measures：Incidence and influencing factors of anxiety and depression in children with PCD and their parents. Results：There were 38 cases in PCD children group, 76 cases in each of the asthma children group and control children group. There were 82 parents in each group including PCD group, asthma group and control group. The incidence of anxiety and the score of SCARED in PCD children group were higher than those in asthma children group and control group (P<0.05). There were no significant difference in the score of CDI and incidence of depression among the three children groups (P≥0.05). The incidence of anxiety and depression and the score of CESD in parents of children with PCD were higher than those in asthma group and control group (P<0.05). There were no significant difference in incidence of anxiety and depression and the score of CESD between parents of asthma group and control group (P≥0.05). There was no significant difference in the score of SAS between parents of PCD group and asthma group (P≥0.05). The incidence of anxiety and depression and the score of CESD, SAS and Zarit Caregiver Burden Scale in mothers of children with PCD were higher than those in fathers (P<0.05). Multivariate binary logistic regression analysis showed that, for the children with PCD aged 717, the boys were more prone to anxiety than the girls, and regular airway nursing was a protective factor to avoid anxiety and depression. For parents of children with PCD aged 417, high level of education, stable occupation and regular exercise of children were the protective factors to avoid anxiety, and high level of education, hospitalization frequency of children less than once in recent one year and regular exercise of children were the protective factors to avoid depression. The high score of Zarit Burden Scale was the risk factor for anxiety and depression in parents of children with PCD. Conclusion：The incidence of anxiety in children with PCD was higher, which was affected by gender and the situation of airway nursing. The incidence of anxiety and depression in parents of children with PCD were higher, which were affected by their occupation, level of education, care burden, children's exercise situation and hospitalization frequency of children in recent one year.

Key words: Key words Primary ciliary dyskinesia, Children, Parents, Depression, Anxiety