169例先天性心脏病患儿父母感知脆弱现状及影响因素分析

doi:10.16460/j.issn1008-9969.2019.20.033

摘要/Abstract

摘要： 目的调查先天性心脏病患儿父母感知脆弱现状,探析其影响因素。方法采用一般资料调查表、感知脆弱程度量表、抑郁-焦虑-压力量表、领悟社会支持评价量表对169例先天性心脏病患儿父母进行调查,采用多元线性回归分析其影响因素。结果先天性心脏病患儿父母感知脆弱总分为（5.47±3.89）分,多元线性回归分析结果显示：患儿年龄、患儿父母年龄、焦虑、社会支持家庭维度进入回归方程（P<0.05）。结论先天性心脏病患儿父母感知脆弱处于一般水平,受患儿年龄、患儿父母年龄、焦虑水平、社会支持家庭维度的影响。医护人员应密切关注低龄患儿及年轻父母,及时评估患儿父母焦虑及社会支持水平,提供个性化、多元化健康宣教方式,注重疾病知识掌握程度反馈,拓宽患儿父母人际社交网络,促进患儿生理、心理健康良性循环发展,减轻父母负担,改善先天性心脏病患儿父母感知脆弱水平。

关键词: 先天性心脏病, 父母, 感知脆弱, 社会支持

Abstract: Objective To describe the perceived vulnerability of parents of children with congenital heart disease (CHD) and to explore its influence factors. Methods A convenient sampling method was used and 169 children with CHD and their parents from a tertiary grade-A hospital in Jiangsu were investigated by using general information questionnaire, Child Vulnerability Scale (CVS), Depression-anxiety-stress Scale and Perceived Social Support Scale to measure the perceived vulnerability of caregivers. Multiple linear regression analysis was conducted for analyzing the influence factors. Results The total score of the parents' perceived vulnerability was 5.47±3.89. Multiple linear regression analysis showed that the age of the child and their parents, anxiety, and social support entered into the regression equation (P<0.05). Conclusion The perceived vulnerability of parents of CHD children is at a mediate level and its influence factors include the age of the child and their parents, anxiety, and social support. More attention should go to the younger children and their parents. Timely assessment of the anxiety and social support, individualized and multiple health education methods and wider social network will benefit the improvement of psychological and physical development of CHD children and reducing the burden of their parents, thus to enhance the perceived vulnerability of the parents of CHD children.

Key words: congenital heart disease, parents, perceived vulnerability, social support

中图分类号:

R473.72

蒋琴, 张彩霞, 孟影, 陈梅. 169例先天性心脏病患儿父母感知脆弱现状及影响因素分析[J]. 护理学报, 2019, 26(20): 33-37.

JIANG Qin, ZHANG Cai-xia, MENG Ying, CHEN Mei. Perceived Vulnerability of 169 Parents of Children with Congenital Heart Disease and Its Influence Factors[J]. Journal of Nursing, 2019, 26(20): 33-37.

参考文献

[1] Green M.Vulnerable Child Syndrome and Its Variants[J]. Pediatr Rev,1986,8(3):75-80.
[2] Guan G, Liu H, Wang Y, et al.Behavioural and Emotional Outcomes in School-aged Children after Surgery or Transcatheter Closure Treatment for Ventricular Septal Defect[J]. Cardiol Young,2014,24(5):910-917.DOI:10.1017/S104795111300142X.
[3] Samra H, Mcgrath J M.Infant Vulnerability and Parent Overprotection: Recommendations for Health Professionals[J]. Newborn and Infant Nursing Reviews, 2009,9(3):136-138.
[4] 中华人民共和国国家卫生部.中国出生缺陷防治报告[R].北京:中华人民共和国国家卫生部,2012.
[5] 陶覃龙,徐良,袁杰.先天性心血管病的病因学及流行病学研究概况[J].中国优生与遗传杂志,2015,23(8):1-4. DOI:10.13404/j.cnki.cjbhh.2015.08.001.
[6] 管国涛. 经导管介入封堵术或外科手术后室间隔缺损患儿学龄期的认知功能及行为问题[D].济南:山东大学,2011. DOI:10.7666/d.y2045446.
[7] 中国医师协会心血管内科分会先心病工作委员会.常见先天性心脏病介入治疗中国专家共识一、房间隔缺损介入治疗[J].介入放射学杂志,2011,20(1):3-9. DOI:10.3969/j.issn.1008-794X.2011.01.002.
[8] 中国医师协会心血管内科分会先心病工作委员会.常见先天性心脏病介入治疗中国专家共识二、室间隔缺损介入治疗[J].介入放射学杂志,2011,20(2):87-92. DOI:10.3969/j.issn.1008-794X.2011.02.002.
[9] 李乐之,路潜.外科学护理[M].5版.北京:人民卫生出版社,2012:37.
[10] 倪平,陈京立,刘娜.护理研究中量性研究的样本量估计[J].中华护理杂志,2010, 45(4):378-380.DOI:10.3761/j.issn.0254-1769.2010.04.037.
[11] Forsyth B W, Horwitz S M, Leventhal J M, et al.The Child Vulnerability Scale:An Instrument to Measure Parental Perceptions of Child Vulnerability1[J].J Pediatr Psychol,1996,21(1):89-101.
[12] 袁艳丽,陈京立.中文版父母感知脆弱程度量表在先心病患儿父母中的信度效度研究[J].中国护理管理,2017,17(6):774-778.DOI:10.3969/j.issn.1672-1756.2017.06.012.
[13] Lovibond S H, Lovibond P F.Manual for the Depression Anxiety Stress Scales[M]. Sydney: Psychology Foundation,1995:112-118.
[14] 龚栩,谢熹瑶,徐蕊,等.抑郁-焦虑-压力量表简体中文版(DASS-21)在中国大学生中的测试报告[J].中国临床心理学杂志,2010,18(4):443-446.DOI:10.16128/j.cnki.1005-3611.2010.04.020.
[15] 汪向东,王希林,马弘.心理卫生评定量表手册(增订版)[M].北京:中国心理卫生杂志社,1999:131-133.
[16] 袁艳丽. 室间隔缺损修补术后患儿母亲感知脆弱现状调查及影响因素研究[D].北京:北京协和医学院,2017.
[17] Vrijmoet-Wiersma C M, Egeler R M, Koopman H M, et al. Parental Stress and Perceived Vulnerability at 5 and 10 Years after Pediatric SCT[J]. Bone Marrow Transplant,2010,45(6):1102-1108.DOI:10.1038/bmt.2009.309.
[18] 洪文. 先天性心脏病患儿父母焦虑状况及相关因素分析[J].护理研究,2011,25(10A):871-873. DOI:10.3969/j.issn.1009-6493.2011.10.011.
[19] Cukor D, Coplan J, Brown C, et al.Depression and Anxiety in Urban Hemodialysis Patients[J].Clin J Am Soc Nephrol,2007,2(3):484-490. DOI:10.2215/CJN.00040107.
[20] Samra H A, Mcgrath J M,Wey H.Are Former Late-preterm Children at Risk for Child Vulnerability and Overprotection?[J].Early Hum Dev,2010,86(9):557-562.DOI:10.1016/j.earlhumdev.2010.07.005.
[21] 张晓红,刘慧慧,孟丽娜,等.先天性心脏病患儿父母心理问题的研究进展[J].护理学报,2017,24(10):35-38. DOI:10.16460/j.issn1008-9969.2017.10.035.
[22] Houtzager B A, Moller E L, Maurice-Stam H, et al.Parental Perceptions of Child Vulnerability in a Community-based Sample: Association with Chronic Illness and Health-related Quality of Life[J]. J Child Health Care, 2015,19(4):454-465. DOI:10.1177/1367493514530954.
[23] Vrijmoet-Wiersma C M, Ottenkamp J, van Roozendaal M, et al. A Multicentric Study of Disease-related Stress, and Perceived Vulnerability, in Parents of Children with Congenital Cardiac Disease[J]. Cardiol Young, 2009, 19(6):608. DOI:10.1017/S1047951109991831.
[24] 宋明阳,周兰姝.先天性心脏病患儿照顾者负担现状及影响因素[J].解放军护理杂志,2018, 35(3):17-20.DOI:10.3969/j.issn.1008-9993.2018.03.004.
[25] 徐志霞,韩二环,张艳.对先天性心脏病患儿家属采用回授法健康教育的效果观察[J].护理学报,2017,24(12):68-70.DOI:10.16460/j.issn1008-9969.2017.12.068.
[26] Horwitz S M, Leibovitz A, Lilo E, et al.Does an Intervention to Reduce Maternal Depression and Trauma also Improve Mother's Perceptions of their Infants Vulnerability?[J]. Infant Ment Health J,2015,36(1):42-52. DOI:10.1002/imhj.21484.
[27] 张远波,翟海昕,邓海波.复杂先天性心脏病孤残患儿的护理[J].护理学报,2011, 18(9B):39-41. DOI:10.3969/j.issn.1008-9969.2011.18.015.
[28] 吴筱筱,陈京立.室间隔缺损修补术后患儿母亲居家护理需求质性研究[J].护理研究, 2014,28(4B):1333-1335. DOI:10.3969/j.issn.10096493.2014.11.021.

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