新生儿高胆红素血症就医延迟的影响因素分析

Medical delay in neonate with hyperbilirubinemia and its influencing factors

目的了解新生儿高胆红素血症(neonatal hyperbilirubinemia,NHB)就医延迟现状以及影响因素。方法采用目的抽样法,选取2022年12月—2023年7月于贵州医科大学附属医院治疗的176例NHB及其照护者作为调查对象,采用一般资料调查表、黄疸相关知识、态度与实践问卷、决策冲突量表进行调查,采用单因素分析和logistic回归分析探索其就医延迟的影响因素。结果共纳入NHB及其照顾者176例,其中89例(50.6%)新生儿出现就医延迟。多因素logistic回归分析结果显示,新生儿日龄、照护者民族、分娩方式、照护者文化程度、黄疸相关知识得分、决策冲突程度为影响NHB就医延迟的主要影响因素(P<0.05)。结论NHB就医延迟现象普遍,提示应重视基层医疗建设,对新生儿照护者疾病知识的科普,采用决策辅助工具降低决策冲突水平,进而减少NHB延迟就医的发生。

Objective To investigate the status and influencing factors of medical delay in neonatal hyperbilirubinemia(NHB).Methods NHB and their caregivers who were treated in a grade-A hospital in Guizhou province from December 2022 to July 2023 were selected as the investigation objects by convenient sampling method.General data scale,jaundice related knowledge,attitude,and practice questionnaire,and Decisional Conflict Scale were used to investigate the cases.Univariate analysis and logistic regression analysis were used to explore the influencing factors of medical delay.Results A total of 176 NHB were included,and the results showed that 89 cases(50.6%)had delayed treatment.The results of univariate logistic regression analysis showed that the day age of neonates,the nationality of caregivers,mode of delivery,educational level of caregivers,related knowledge score of jaundice,and degree of decision conflict were influencing factors for medical delay in hyperbilirubinemia neonates(P<0.05).Conclusion Delayed medical treatment is common in NHB,It is suggested that attention should be paid to the construction of primary medical care,the popularization of disease knowledge for newborn caregivers,and the use of decision aids to reduce the level of decision conflict,so as to reduce the occurrence of delayed medical treatment for NHB.