哮喘儿童生命质量的影响因素

Influencing factors of quality of life in asthma children

目的调查哮喘儿童生命质量现状,分析自我效能感、心理弹性、哮喘控制水平等变量对哮喘儿童生命质量的影响,以期为提高哮喘儿童生命质量及拓展哮喘防治思路提供参考。方法选取2022年2—12月在西安交通大学第二附属医院儿童哮喘专病门诊就诊的244例7~14岁支气管哮喘儿童为研究对象,使用一般情况问卷、一般自我效能感量表(GSES)、哮喘控制问卷(ACT)和哮喘儿童生命质量问卷(PAQLQ)调查统计,采用SPSS 27.0统计分析。结果哮喘儿童生命质量总分为5.92±0.99,自我效能感得分2.69±0.55、心理弹性中人际协助得分3.50±0.87、积极认知维度得分3.81±0.89,哮喘控制水平测试均分为21.87±3.67。多元逐步线性回归分析结果显示:是否联合奥马珠单抗(OMA)治疗、是否伴有多种共患病、是否有积极认知是PAQLQ总均分的重要影响因素(β=0.18、0.18、0.17,P<0.05);心理弹性中积极认知和人际协助维度、是否伴有多种共患病及是否联合OMA治疗是哮喘儿童生命质量症状得分的影响因素(β=0.14、0.13、0.18、0.15,P<0.05);是否有积极认知、是否伴有多种共患病、是否联合OMA治疗是PAQLQ活动受限维度的重要影响因素(β=0.20、0.18、0.17,P<0.05);是否联合OMA治疗、是否伴有多种共患病、是否有积极认知是PAQLQ情感功能均分的重要影响因素(β=0.21、0.18、0.14,P<0.05)。结论本次调查研究中哮喘儿童生命质量处于中高水平。儿童拥有积极认知、良好的人际协助、不同的诊断类型、给予OMA治疗均有助于提高哮喘儿童生命质量。临床中经吸入激素联合长效β激动剂(ICS-LABA)治疗至少3个月以上,仍不能有效控制症状的中重度过敏性哮喘儿童,可在符合用药指征的情况下积极开展以OMA为代表的生物制剂免疫治疗,还应关注健康知识宣教与心理弹性培养,从而提高哮喘儿童的生命质量。

Objective To investigate the current status of quality of life in children with asthma and explore the impact of variables such as self-efficacy,psychological resilience,and asthma control level on the quality of life of these children,so as to provide insights for improving the quality of life of children with asthma and expanding asthma prevention and treatment strategies.Methods A total of 244 children aged 7 to 14 years with bronchial asthma who visited the Children's Asthma Clinic at the Second Affiliated Hospital of Xi'an Jiaotong University from February to December 2022 were selected as the study subjects.General information questionnaires,the General Self-Efficacy Scale(GSES),the Asthma Control Test(ACT),and the Pediatric Asthma Quality of Life Questionnaire(PAQLQ)were used for data collection,and statistical analysis was performed using SPSS 27.0.Results The total score of quality of life in children with asthma was 5.92±0.99,the score of self-efficacy was 2.69±0.55,and the scores for the interpersonal assistance dimension and positive cognition dimension of psychological resilience were 3.50±0.87 and 3.81±0.89,the score on the asthma control level test was 21.87±3.67.The results of multiple stepwise linear regression analysis showed that whether combined withomalizumab(OMA)treatment,multiple comorbidities,and positive cognition were important influencing factors for the overall average score of PAQLQ(β=0.18,0.18,0.17,P<0.05).Positive cognition and interpersonal assistance dimensions in psychological resilience,multiple comorbidities,and combined OMA treatment were influencing factors for the symptom score of quality of life in children with asthma(β=0.14,0.13,0.18,0.15,P<0.05).Positive cognition,multiple comorbidities,and combined OMA treatment were important influencing factors for the activity limitation dimension of PAQLQ(β=0.20,0.18,0.17,P<0.05).Whether combined with OMA treatment,multiple comorbidities,and positive cognition were important influencing factors for the emotional function score of PAQLQ(β=0.21,0.18,0.14,P<0.05).Conclusions The quality of life in asthmatic children in this study is at a moderate to high level.Having positive cognition,good interpersonal assistance,different types of diagnosis,and receiving OMA treatment all contribute to the quality of life of asthmatic children.Immunotherapy with biologic agents represented by OMA should be actively carried out in the clinic,and attention should also be paid to health education and psychological resilience development to enhance the quality of life of asthmatic children.