慢性病患儿心理行为适应特征的潜在类别分析

Latent class analysis of psychological behavior adaption among children with chronic diseases

目的探讨慢性病患儿心理行为适应特征的潜在类别,比较不同类别慢性病患儿在人口学特征及家庭复原力上的差异,分析潜在类别的影响因素。方法采用便利抽样法,选取2019年6月—9月在上海市与浙江省4所三级甲等医院门诊就诊或住院的307名慢性病患儿家长作为调查对象,采用一般人口学资料问卷、长处与困难问卷(家长版)和家庭复原力评估量表进行调查。对慢性病患儿的心理行为适应特征进行潜在类别分析,并通过单因素分析和Logistic回归识别其潜在类别的影响因素。结果慢性病患儿的心理行为适应特征分为3个潜在类别,分别为心理行为健康组(48.9%)、多动-低亲社会行为组(48.2%)、高心理行为问题组(2.9%)。将高心理行为问题组、多动-低亲社会行为组合并为心理行为问题组,进行Logistics回归分析。结果显示,年龄、疾病类型和家庭复原力是患儿心理行为适应特征潜在类别的影响因素。结论慢性病患儿的心理行为适应特征存在异质性,可分为3个潜在类别。年龄较小、患有神经系统疾病、低家庭复原力的患儿出现心理行为问题的风险更高。

Objective To explore the latent classes of the psychological behavior adaptation in children with chronic diseases,and to analyze the differences in demography and family resilience among different classes.Methods Through convenience sampling,307 parents of children with chronic diseases from outpatient clinics and wards were recruited from 4 tertiary hospitals in Shanghai Municipality and Zhejiang Province from June to September in 2019. Basic Information Questionnaire,Strengths and Difficulties Questionnaire(parent version),and Family Resilience Assessment Scale were used for investigation. Latent class analysis(LCA) was used to explore the latent classes of the psychological behavior adaption in the children. Univariate analysis and logistic regression were used to identify the predictors of the latent classes. Results The psychological behavior adaptation in children with chronic diseases could be divided into 3 latent classes,including “group with healthy psychological behavior”(48.9%), “hyperactivity and low prosocial behavior group”(48.2%),and “group with high psychological behavior problem”(2.9%). Logistic regression analysis was carried out when the latter 2 groups were combined to be marked as the group with psychological behavior problem. The results showed that age,disease type,and family resilience were predictors of chronically ill children’s latent classes of psychological behavioral adaptation. Conclusion The psychological behavior adaptation of children with chronic diseases are heterogeneous and can be divides into 3 latent classes. The children at younger age,with neurological diseases and lower family resilience had a higher risk of psychological behavior problems.