学龄期复发性过敏性紫癜患儿焦虑现状及影响因素分析

Analysis of anxiety status and influencing factors in school-age children with recurrent Henoch-Schönlein purpura

  • 摘要:
    目的 探讨学龄期复发性过敏性紫癜(HSP)患儿焦虑现状及影响因素。
    方法 选取158例学龄期复发性HSP患儿作为研究对象,采用儿童焦虑性情绪筛查量表(SCARED)评估患儿焦虑情况。根据评估结果将158例患儿分为焦虑组和非焦虑组,采用单因素分析和多因素Logistic回归分析筛选焦虑发生的影响因素。构建Logistic回归模型,并采用Hosmer-Lemeshow检验评估模型拟合度。
    结果 158例患儿中, 43例伴有焦虑,焦虑发生率为27.22%(43/158)。焦虑组与非焦虑组患儿在年龄、神经质性格特征、紫癜部位、紫癜复发次数、家庭关怀度、主要照护者受教育程度、家庭人均月收入、主要照护者是否焦虑、主要照护者是否抑郁等方面比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄≥10岁(OR=7.192, 95%CI: 2.450~21.114, P<0.001)、神经质性格特征(OR=5.202, 95%CI: 1.486~18.208, P=0.010)、紫癜部位为面部(OR=5.648, 95%CI: 1.606~19.861, P=0.007)、紫癜复发次数≥2次(OR=5.017, 95%CI: 1.753~14.361, P=0.003)、家庭关怀度一般(OR=3.809, 95%CI: 1.153~12.579, P=0.028)、主要照护者受教育程度为初中以下(OR=3.005, 95%CI: 1.051~8.592, P=0.040)、主要照护者焦虑(OR=6.484, 95%CI: 2.140~19.647, P=0.001)、主要照护者抑郁(OR=9.327, 95%CI: 2.473~35.172, P=0.001)是学龄期复发性HSP患儿焦虑发生的独立危险因素。基于上述危险因素及其回归系数构建Logistic回归预测模型, Hosmer-Lemeshow检验结果显示模型拟合度良好(χ2=10.363, P=0.169)。
    结论 年龄、神经质性格特征、紫癜部位、紫癜复发次数、家庭关怀度、主要照护者受教育程度、主要照护者是否焦虑、主要照护者是否抑郁是学龄期复发性HSP患儿焦虑发生的影响因素。医务人员应关注伴有焦虑高危因素的患儿,并依据上述因素制订相应预防措施,以降低学龄期复发性HSP患儿焦虑发生率。

     

    Abstract:
    Objective To explore the anxiety status and influencing factors in school-age children with recurrent Henoch-Schönlein purpura (HSP).
    Methods A total of 158 school-age children with recurrent HSP were selected as the study subjects. The Screen for Child Anxiety Related Emotional Disorders (SCARED) was used to assess the anxiety status of the children. Based on the assessment results, the 158 children were divided into anxiety group and non-anxiety group. Univariate and multivariate logistic regression analyses were employed to screen for the influencing factors of anxiety occurrence. A logistic regression model was constructed, and the Hosmer-Lemeshow test was used to evaluate the model′s goodness-of-fit.
    Results Among the 158 children, 43 presented anxiety, with an anxiety incidence rate of 27.22%(43/158). There were significant differences between the anxiety and non-anxiety groups in terms of age, neurotic personality traits, purpura location, the number of purpura recurrences, family care level, educational level of the primary caregiver, monthly per capita household income, and whether the primary caregiver had anxiety or depression (P < 0.05). Multivariate logistic regression analysis revealed that age ≥10 years (OR=7.192, 95%CI, 2.450 to 21.114, P < 0.001), neurotic personality traits (OR=5.202, 95%CI, 1.486 to 18.208, P=0.010), purpura located on the face (OR=5.648, 95%CI, 1.606 to 19.861, P=0.007), the number of purpura recurrences ≥2 times (OR=5.017, 95%CI, 1.753 to 14.361, P=0.003), a general family care level (OR=3.809, 95%CI, 1.153 to 12.579, P=0.028), the primary caregiver having an educational level below junior high school (OR=3.005, 95%CI, 1.051 to 8.592, P=0.040), the primary caregiver having anxiety (OR=6.484, 95%CI, 2.140 to 19.647, P=0.001), and the primary caregiver having depression (OR=9.327, 95%CI, 2.473 to 35.172, P=0.001) were independent risk factors for anxiety occurrence in school-age children with recurrent HSP. A logistic regression prediction model was constructed based on the above risk factors and their regression coefficients. The Hosmer-Lemeshow test results indicated a good model fit (χ2=10.363, P=0.169).
    Conclusion Age, neurotic personality traits, purpura location, the number of purpura recurrences, family care level, educational level of the primary caregiver, and whether the primary caregiver has anxiety or depression are influencing factors for anxiety occurrence in school-age children with recurrent HSP. Medical personnel should pay attention to children with high-risk factors for anxiety and formulate corresponding preventive measures based on the above factors to reduce the anxiety incidence rate in school-age children with recurrent HSP.

     

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