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中华移植杂志(电子版) ›› 2024, Vol. 18 ›› Issue (01) : 30 -34. doi: 10.3877/cma.j.issn.1674-3903.2024.01.006

论著

儿童肝移植术前患儿父母睡眠质量与心理社会问题的相关性研究
陈小艳1, 何康2, 黄明珠1,()   
  1. 1. 200127 上海交通大学医学院附属仁济医院护理部;200127 上海交通大学医学院附属仁济医院肝脏外科
    2. 200127 上海交通大学医学院附属仁济医院肝脏外科
  • 收稿日期:2023-06-15 出版日期:2024-02-25
  • 通信作者: 黄明珠
  • 基金资助:
    上海市自然科学基金(23ZR1438600)

Study on the relationship between sleep quality and psychosocial problem of parents before liver transplantation in children

Xiaoyan Chen1, Kang He2, Mingzhu Huang1,()   

  1. 1. Department of Nursing, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Department of Liver Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
    2. Department of Liver Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Received:2023-06-15 Published:2024-02-25
  • Corresponding author: Mingzhu Huang
引用本文:

陈小艳, 何康, 黄明珠. 儿童肝移植术前患儿父母睡眠质量与心理社会问题的相关性研究[J]. 中华移植杂志(电子版), 2024, 18(01): 30-34.

Xiaoyan Chen, Kang He, Mingzhu Huang. Study on the relationship between sleep quality and psychosocial problem of parents before liver transplantation in children[J]. Chinese Journal of Transplantation(Electronic Edition), 2024, 18(01): 30-34.

目的

对儿童肝移植术前患儿父亲或母亲的社会支持、亲职压力、焦虑、身心健康与睡眠质量进行调研,并进行相关性分析。

方法

选取355例拟在上海交通大学医学院附属仁济医院行活体肝移植患儿的父亲或母亲作为研究对象。采用一般资料调查表、社会支持评定量表(SSRS)、亲职压力量表(PSI-SF)、匹兹堡睡眠质量指数(PSQI)量表、广泛性焦虑(GAD-7)量表及世界卫生组织五项身心健康指标(WHO-5)进行问卷调查并分析。采用Pearson相关性分析进行相关性检验,采用Kruskal-Wallis秩和检验对不同特征患儿父母睡眠质量影响因素进行分析。P<0.05为差异有统计学意义。

结果

355例拟行肝移植患儿父亲或母亲SSRS平均得分为(43.9±9.0)分,PSI-SF平均得分为(81.2±27.5)分,GAD-7量表平均得分为(7.8±5.3)分,WHO-5平均得分为(12.4±6.5)分,PSQI量表中位得分为7.0(4.0,11.0)分。不同睡眠类型患儿父母PSQI量表分值差异有统计学意义(Z=4.759,P<0.05),明确晚睡晚起型患儿父母PSQI量表分值最高,明确早睡早起型分值最低,分别为10.0(5.0,13.5)和4.0(1.0,6.5)分。不同婚姻状况患儿父母PSQI量表分值差异有统计学意义(Z=2.732,P<0.05),最高为丧偶,其次是未婚。患儿父亲或母亲睡眠质量与焦虑成正相关(r=0.541),与身心健康呈负相关(r=-0.584);焦虑与身心健康呈负相关(r=-0.584),亲职压力与社会支持呈负相关(r=-0.380)。

结论

大部分拟行肝移植患儿父母存在睡眠障碍、轻度抑郁和焦虑,亲职压力大且社会支持低。应采取有效措施来改善其身心健康状态,为后续患儿肝移植提供有效且长久的支持。

Objective

A survey was conducted on the social support, parenting stress, anxiety, physical and mental health, and sleep quality of the fathers or mothers of children undergoing liver transplantation before the operation, and a correlation analysis was conducted.

Methods

A total of 355 fathers or mothers of children who were scheduled to undergo living liver transplantation at the Renji Hospital, Shanghai Jiao Tong University School of Medicine were selected as the research subjects. A general information questionnaire, the social support rating scale (SSRS), the parenting stress index-short form (PSI-SF), the Pittsburgh sleep quality index (PSQI) scale, the generalized anxiety disorder-7 (GAD-7) scale, and the World Health Organization five-item well-being index (WHO-5) were used for questionnaire survey and analysis. Pearson correlation analysis was used for correlation test, and Kruskal-Wallis rank sum test was used to analyze the factors affecting the sleep quality of parents with different characteristics of their children. P<0.05 was considered statistically significant.

Results

The average SSRS score of 355 children who needed liver transplantation was (43.9±9.0). The average PSI-SF score was (81.2±27.5), the average GAD-7 score was (7.8±5.3), the average WHO-5 score was (12.4±6.5), and the median PSQI score was 7.0 (4.0, 11.0). The difference in PSQI scores between parents of children with different sleep durations was statistically significant (Z=4.759, P<0.05). Children with a clear to sleep late and wake up late had the highest PSQI score, while those with a clear early to bed and wake up early had the lowest score, with scores of 10.0 (5.0, 13.5) and 4.0 (1.0, 6.5), respectively. The difference in PSQI scores between parents of children with different marital statuses was statistically significant (Z=2.732, P<0.05), with the highest being widowhood and the second being unmarried. The sleep quality of the father or mother of the patient was positively correlated with anxiety (r=0.541) and negatively correlated with physical and mental health (r=-0.584). Anxiety was negatively correlated with physical and mental health (r=-0.584), while parental stress was negatively correlated with social support (r=-0.380).

Conclusions

Most parents of children who plan to undergo liver transplantation have sleep disorders, mild depression and anxiety, high parental pressure, and low social support. Overall, effective measures should be taken to improve poor physical and mental health to provide effective and long-term support for subsequent pediatric liver transplantation.

表1 拟行肝移植患儿父母睡眠质量影响因素分析(n=355)[M(P25, P75)/±s]
因素 例数(%) PSQI量表得分(分) Z/F P
患儿性别        
165(46.5) 7.0(4.0,11.0) 0.054 >0.05
190(53.5) 7.0(5.0,11.0)    
患儿是否独生子女        
152(42.8) 8.0(5.0,11.8) 1.321 >0.05
203(57.2) 7.0(4.0,11.0)    
患儿是否做过肝门-空肠吻合术        
208(58.6) 9.0(5.0,12.8) 2.035 >0.05
102(28.7) 8.0(6.0,11.0)    
其他(拒绝回答) 45(12.7) 7.0(3.2, 9.0)    
患儿家庭类型        
大家庭(和老人同住) 175(49.3) 7.9±4.3 1.892 >0.05
单亲家庭 13( 3.7) 7.5±5.1    
核心家庭(父母和子女) 164(46.2) 7.5±4.6    
其他(不与父母居住) 3( 0.8) 13.3±2.9    
家庭年平均收入(万元)        
<5 241(67.9) 3.0(0.2, 6.2) 0.219 >0.05
5~<15 75(21.1) 4.0(3.0,10.5)    
15~30 16( 4.5) 5.0(3.2,11.0)    
>30 7( 2.0) 10.5(5.8,13.0)    
其他(拒绝回答) 16( 4.5) 9.0(5.2,11.8)    
人均居住面积(m2)        
<15 106(29.9) 8.5(4.2,13.8) 1.963 >0.05
15~<25 150(42.3) 7.0(4.2,10.0)    
25~35 55(15.5) 7.0(4.2,11.0)    
>35 44(12.4) 5.5(3.0,10.8)    
住房周围嘈杂程度        
安静 97(27.3) 7.0(3.0,14.0) 0.910 >0.05
吵闹 17( 4.8) 7.0(5.0,13.0)    
一般 241(67.9) 7.0(4.5, 9.5)    
父/母年龄(岁)        
≤23 10( 2.8) 8.0(3.8,13.0) 2.035 >0.05
>23~<33 177(49.9) 8.5(5.2,12.2)    
33~<43 149(42.0) 8.0(4.8,13.2)    
≥43 19( 5.4) 10.5(6.0,13.2)    
父/母教育程度        
高中及以下 153(43.1) 7.0(4.0,11.0) 2.007 >0.05
专科 107(30.1) 8.0(4.0,11.0)    
本科及以上 95(26.8) 8.0(5.0,12.0)    
父/母婚姻状况        
未婚 4( 1.1) 9.0( 3.5,15.2) 2.732 <0.05
已婚 329(92.7) 5.0( 4.0,13.5)    
离异 15( 4.2) 7.0( 4.0, 7.0)    
丧偶 7( 2.0) 14.5(10.0,17.5)    
父/母睡眠类型        
更倾向于晚睡晚起型 112(31.5) 7.0(5.0,11.5) 4.759 <0.05
更倾向于早睡早起型 78(22.0) 6.0(4.0, 9.5)    
上述二者均不是 39(11.0) 8.0(6.5,11.0)    
明确晚睡晚起型 38(10.7) 10.0(5.0,13.5)    
明确早睡早起型 63(17.7) 4.0(1.0, 6.5)    
其他(不清楚) 25( 7.0) 8.0(5.0,13.0)    
表2 拟行肝移植患儿父母睡眠质量与焦虑、亲职压力、社会支持、身心健康的相关性分析(n=355)
1
Yagi S, Singhal A, Jung D H, et al. Living-donor liver transplantation: right versus left[J]. Int J Surg, 2020, 82s:128-133.
2
夏强,朱欣烨. 儿童肝移植发展现状及展望[J]. 临床小儿外科杂志2022, 21(5):401-404.
3
Gutierrez-Colina AM, Quast LF, Eaton CK, et al. Sleep quality is associated with psychosocial functioning and health-related quality of life in pediatric transplant recipients[J]. Pediatr Transplant, 2019, 23(8): e13577.
4
肖水源,杨德森. 社会支持对身心健康的影响[J].中国心理卫生杂志1987, 1(4):183-187.
5
Haskett ME, Ahern LS, Ward CS, et al. Factor structure and validity of the parenting stress index-short form[J]. J Clin Child Adolesc Psychol, 2006, 35(2): 302-312.
6
Buysse DJ, Reynolds CF 3rd, Monk TH, et al. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research[J]. Psychiatry Res, 1989, 28(2):193-213.
7
李金英.PHQ-9和GAD-7量表在功能性胃肠病患者精神心理评测的应用研究[D]. 南宁:广西医科大学,2019.
8
Topp CW, Østergaard SD, Søndergaard S, et al. The WHO-5 Well-Being Index: a systematic review of the literature[J]. Psychother Psychosom, 2015, 84(3):167-176.
9
Cohn LN, 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.
10
Bishop MN, Gise JE, Donati MR, et al. Parenting stress, sleep, and psychological adjustment in parents of infants and toddlers with congenital heart disease[J]. J Pediatr Psychol, 2019, 44(8): 980-987.
11
薛芬芬,陈丽香,刘丽钦. 早产儿母亲亲职压力与睡眠质量的关系[J]. 世界睡眠医学杂志2021, 8(11):1946-1948.
12
Van Oers HA, Haverman L, Limperg PF, et al. Anxiety and depression in mothers and fathers of a chronically ill child[J]. Matern Child Health J, 2014, 18(8):1993-2002.
13
Haraguchi M.Relationship between mental health and stressors among fathers of children with chronic illnesses and cognitive structure of fathers′ stress experiences[J]. Sci Rep, 2023, 13(1): 22525.
14
胡紫月,雷金金,阚肖迪,等. 187名血液病患儿父母养育心理灵活性现状及影响因素分析[J]. 护理学报2023, 30 (23):62-66.
15
鲁小庆,崔佳欣,安子芬,等. 住院心房颤动患者睡眠质量及其影响因素分析[J]. 重庆医学2023, 52(9):1320-1324.
16
郑远松,廖锦仲,林汉民,等. 住院精神分裂症患儿陪护亲属的心理健康状况调查[J]. 中国临床康复2005, 9(24):33-35.
17
Wang Y, Huang Z, Kong F. Parenting stress and life satisfaction in mothers of children with cerebral palsy: The mediating effect of social support[J]. J Health Psychol, 2020, 25(3):416-425.
18
Estes A, Munson J, Dawson G, et al. Parenting stress and psychological functioning among mothers of preschool children with autism and developmental delay[J]. Autism, 2009, 13(4):375-387.
19
Åsberg KK, Vogel JJ, Bowers CA. Exploring correlates and predictors of stress in parents of children who are deaf: implications of perceived social support and mode of communication[J]. J Child Fam Stud, 2008, 17: 486-499.
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