儿童肝移植术前患儿父母睡眠质量与心理社会问题的相关性研究

Study on the relationship between sleep quality and psychosocial problem of parents before liver transplantation in children

目的:对儿童肝移植术前患儿父亲或母亲的社会支持、亲职压力、焦虑、身心健康与睡眠质量进行调研,并进行相关性分析。方法:选取355例拟在上海交通大学医学院附属仁济医院行活体肝移植患儿的父亲或母亲作为研究对象。采用一般资料调查表、社会支持评定量表(SSRS)、亲职压力量表(PSI-SF)、匹兹堡睡眠质量指数(PSQI)量表、广泛性焦虑(GAD-7)量表及世界卫生组织五项身心健康指标(WHO-5)进行问卷调查并分析。采用Pearson相关性分析进行相关性检验,采用Kruskal-Wallis秩和检验对不同特征患儿父母睡眠质量影响因素进行分析。P<0.05为差异有统计学意义。结果:355例拟行肝移植患儿父亲或母亲SSRS平均得分为(43.9±9.0)分,PSI-SF平均得分为(81.2±27.5)分,GAD-7量表平均得分为(7.8±5.3)分,WHO-5平均得分为(12.4±6.5)分,PSQI量表中位得分为7.0(4.0,11.0)分。不同睡眠类型患儿父母PSQI量表分值差异有统计学意义(Z=4.759,P<0.05),明确晚睡晚起型患儿父母PSQI量表分值最高,明确早睡早起型分值最低,分别为10.0(5.0,13.5)和4.0(1.0,6.5)分。不同婚姻状况患儿父母PSQI量表分值差异有统计学意义(Z=2.732,P<0.05),最高为丧偶,其次是未婚。患儿父亲或母亲睡眠质量与焦虑成正相关(r=0.541),与身心健康呈负相关(r=-0.584);焦虑与身心健康呈负相关(r=-0.584),亲职压力与社会支持呈负相关(r=-0.380)。结论:大部分拟行肝移植患儿父母存在睡眠障碍、轻度抑郁和焦虑,亲职压力大且社会支持低。应采取有效措施来改善其身心健康状态,为后续患儿肝移植提供有效且长久的支持。

Objective A survey was conducted on the social support,parenting stress,anxiety,physical and mental health,and sleep quality of the fathers or mothers of children undergoing liver transplantation before the operation,and a correlation analysis was conducted.Methods A total of 355 fathers or mothers of children who were scheduled to undergo living liver transplantation at the Renji Hospital,Shanghai Jiao Tong University School of Medicine were selected as the research subjects.A general information questionnaire,the social support rating scale(SSRS),the parenting stress index-short form(PSI-SF),the Pittsburgh sleep quality index(PSQI)scale,the generalized anxiety disorder-7(GAD-7)scale,and the World Health Organization five-item well-being index(WHO-5)were used for questionnaire survey and analysis.Pearson correlation analysis was used for correlation test,and Kruskal-Wallis rank sum test was used to analyze the factors affecting the sleep quality of parents with different characteristics of their children.P<0.05 was considered statistically significant.Results The average SSRS score of 355 children who needed liver transplantation was(43.9±9.0).The average PSI-SF score was(81.2±27.5),the average GAD-7 score was(7.8±5.3),the average WHO-5 score was(12.4±6.5),and the median PSQI score was 7.0(4.0,11.0).The difference in PSQI scores between parents of children with different sleep durations was statistically significant(Z=4.759,P<0.05).Children with a clear to sleep late and wake up late had the highest PSQI score,while those with a clear early to bed and wake up early had the lowest score,with scores of 10.0(5.0,13.5)and 4.0(1.0,6.5),respectively.The difference in PSQI scores between parents of children with different marital statuses was statistically significant(Z=2.732,P<0.05),with the highest being widowhood and the second being unmarried.The sleep quality of the father or mother of the patient was positively correlated with anxiety(r=0.541)and negatively correlated with physical and mental health(r=-0.584).Anxiety was negatively correlated with physical and mental health(r=-0.584),while parental stress was negatively correlated with social support(r=-0.380).Conclusions Most parents of children who plan to undergo liver transplantation have sleep disorders,mild depression and anxiety,high parental pressure,and low social support.Overall,effective measures should be taken to improve poor physical and mental health to provide effective and long-term support for subsequent pediatric liver transplantation.