双相情感障碍患儿家长心理危机风险预测模型的构建与验证

Construction and validation of a psychological crisis risk prediction model for parents of children with bipolar disorder

目的调查双相情感障碍(PBD)患儿家长的心理危机现状并建立风险预测模型,以期能为医护工作者早期筛查家长心理健康状况提供一定的参考依据。方法本研究为横断面研究,采用方便抽样法,选取2020年1月—2021年5月在浙江省温州医科大学附属第二医院治疗的478名PBD患儿的家长作为研究对象,并按2︰1的比例随机分为建模组(318名)和验证组(160名)。使用一般资料调查表和症状自评量表进行问卷调查,使用单因素分析和Logistic回归进行建模组心理危机影响因素分析,使用H-L检验和受试者工作特征曲线验证模型的预测效能。结果318名PBD患儿家长心理危机检出率为25.7%,其中建模组的检出率为26.1%,验证组的检出率为25.0%。是否首发(OR=2.337,P<0.05)、家长性别(OR=1.846,P<0.05)、自评照顾负担(OR=3.527,P<0.05)、宗教信仰(OR=3.113,P<0.05)和患儿年龄(OR=1.969,P<0.05)是PBD患儿家长心理危机发生的预测因素。结论医护工作者需善于观察患儿家长的心理状况,提前预测家长发生心理危机的风险性,并及时按风险等级进行针对性干预,以提高家长的心理适应能力,改善家长的心理健康状况。

Objective To investigate the psychological crisis status of parents of pediatric bipolar disorder(PBD)patients and establish a risk prediction model,in order to provide a reference for medical workers to screen parents'mental health status early.Methods This study was a cross-sectional study.Using the convenient sampling method,a total of 478 parents of children with PBD who were treated in the Second Affiliated Hospital of Wenzhou Medical University in Zhejiang Province from January 2020 to May 2021 were selected as the research subjects.They were randomly divided into the modeling group(n=318)and the validation group(n=160)in a ratio of 2∶1.Questionnaires were conducted using general information questionnaires and Symptom Self-rating Scale.Univariate analysis and logistic regression were used to analyze the influencing factors of psychological crisis in the modeling group,and H-L test and receiver operating characteristic curve were used to verify the predictive performance of the model.Results The detection rate of psychological crisis among the parents of 318 children with PBD was 25.7%,of which the detection rate was 26.1%in the modeling group and 25.0%in the validation group.First onset(OR=2.337,P<0.05),parental gender(OR=1.846,P<0.05),conscious care burden(OR=3.527,P<0.05),religious belief(OR=3.113,P<0.05)and children's age(OR=1.969,P<0.05)were independent predictors of psychological crisis in parents of children with PBD.Conclusions Medical workers need to be good at observing the psychological status of parents of children,predict the risk of psychological crisis in parents in advance and timely conduct targeted interventions according to the risk level,so as to improve the psychological adaptability of parents and improve their mental health.