小儿发育性髋关节发育不良对家庭决策者心理状况的影响

Influence of Developmental Dysplasia of the Hip on the Psychological Status of Family Decision Makers in Children:a 60-day Follow-up Study

目的探讨小儿发育性髋关节发育不良对家庭决策者心理状况的影响。方法选择2019年5月—2020年5月发育性髋关节发育不良患儿的家庭决策者为研究对象,共纳入家庭决策者200例,最终180例完成了所有时间点的数据采集。入院当天(T_(0))、入院后30天(T_(30))及入院后60天(T_(60))采用医院焦虑抑郁量表完成所有家庭决策者焦虑及抑郁症状的评估,采用事件冲击量表—修订版完成所有家庭决策者创伤后应激障碍症状的评估。采用有序logistics回归以分析影响家庭决策者PTSD严重程度变化的独立危险因素。结果T_(0)时,女性FDMs焦虑的发病率明显高于男性FDMs(P<0.05),而抑郁的发病率男性和女性FDMs之间无差异(P>0.05)。T_(30)和T_(60)时,男性和女性FDMs焦虑的发病率较入院当天显著降低(P<0.05),但女性和男性FDMs之间比较无差异(P>0.05)。T_(30)和T_(60)时,男性和女性FDMs抑郁的发病率较T0时显著升高(P<0.05),且女性FDMs抑郁发病率明显高于男性FDM(s P<0.05)。T_(0)时,FDMs重度PTSD发病率为35%,T_(30)时逐渐降低至22%,但T_(60)时仍有17%的FDMs有重度PTSD。有序logistics回归分析表明:患儿年龄、治疗方式、总治疗时间、并发症及女性FDMs是PTSD严重程度变化的独立危险因素。结论在整个随访期间,很大比例的FDMs表现出严重的焦虑、抑郁症状。超过30%的FDMs在T_(0)时报告了重度PTSD临床症状,随着时间推移,PTSD发病率逐渐下降,但直到T_(60)时其发病率仍保持在17%。PTSD严重程度变化的危险因素与患儿年龄、治疗方式、总治疗时间、并发症及女性FDMs相关。

Objective To understand the influence of developmental dysplasia of hip in children on the psychological status of family decision makers.Methods Family decision makers of children with developmental dysplasia of hip from May 2019 to May 2020 were taken as the research object.A total of 200 family decision makers were included,and finally 180 cases completed data collection at all time points.On the day of admission(T_(0)),30 days after admission(T_(30))and 60 days after admission(T_(60)),all family decision makers were assessed for anxiety and depression symptoms using the Hospital Anxiety and Depression Scale,and all family decision makers were assessed for post-traumatic stress disorder symptoms using the event impact Scale--revised version.Independent risk factors influencing the severity of PTSD among family decision makers were analyzed using an ordered logistics analysis.Results At T_(0),the incidence of anxiety in female FDMs was significantly higher than that in male FDMs(P<0.05),while the incidence of depression was not different between male and female FDMs(P>0.05).At T_(30)and T_(60),the incidence of FDMs anxiety in men and women was significantly lower than that T_(0)(P<0.05),but there was no difference between FDMs in women and men(P>0.05).At T_(30)and T_(60),the incidence of depression in male and female FDMs was significantly higher than that at T_(0)(P<0.05),and the incidence of depression in female was significantly higher than that in male(P<0.05).The incidence of severe PTSD in FDMs was 35%at T_(0)and decreased gradually to 22%at T_(30),but still 17%of FDMs had severe PTSD at T_(60).Ordered logistics regression analysis showed that age,treatment style,total treatment time,complications and female FDMs were independent risk factors for PTSD severity change of family decision makers.Conclusions A large percentage of FDMs showed severe anxiety and depression symptoms throughout the follow-up period.More than 30%of FDMs reported clinical symptoms of severe PTSD at T_(0),and the incidence of PTSD declined over time,but remained at 17%until T_(60).Risk factors for PTSD severity change were associated with age,treatment,total duration of treatment,complications,and female FDMs.