临床儿科杂志 ›› 2021, Vol. 39 ›› Issue (9): 677-.doi: 10.3969/j.issn.1000-3606.2021.09.009

• 综合报道 • 上一篇    下一篇

Noonan 综合征患儿照护负担对生活质量的影响

刘佐嘉 1, 王秀敏 1, 唐佳丽 2, 李辛 1   

  1. 上海交通大学医学院附属上海儿童医学中心 1. 内分泌遗传代谢科,2. 护理部(上海 200127)
  • 出版日期:2021-09-15 发布日期:2021-09-03
  • 通讯作者: 王秀敏 电子信箱:wangxium@scmc.com.cn
  • 基金资助:
    上海市儿童罕见病临床医学研究中心项目(No. 20 MC 1920400)

Impact of caregiver burden on quality of life in Noonan syndrome children

LIU Zuojia1 , WANG Xiumin1 , TANG Jiali 2 , LI Xin1   

  1. 1 .Department of Endocrinology, Genetics and Metabolism, 2 . Nursing Department, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
  • Online:2021-09-15 Published:2021-09-03

摘要: 目的 调查Noonan综合征患儿的生活质量及照护负担。方法 采用一般资料问卷、儿童生活质量普通适用核心量表以 及照护者负担问卷,调查Noonan综合征患儿的生活质量及照护负担。结果 96例Noonan综合征患儿,男40例、女56例,中位年龄 4.0(3.0~5.0)岁。患儿的生活质量总分为49.3(34.2~59.8)分,远低于全国常模(81.8±12.0)分,差异有统计学意义(P<0.001)。 患儿主要照护者照护负担量表总分为43.5(29.5~52.0)分,提示为中度负担。患儿生活质量得分与照护者负担总得分呈显著正相关 (r= 0 . 65,P<0 . 01),并与其中3个维度(时间依赖性负担、发展受限性负担以及身体性负担)呈显著正相关(P<0 . 05)。患儿是否独 生子女、照护者不同职业以及文化程度之间的生活质量得分差异有统计学意义(P<0 . 05);多元回归分析提示,时间依赖性负担、发 展受限性负担以及身体性负担对于预测其生活质量贡献度为22. 0 %。Noonan患儿家庭在照护过程中的诊疗需求主要集中在医学遗 传咨询(100 %),多学科团队综合管理(93.8%),康复训练(79.2%)以及预防接种(58.3%)。结论 Noonan综合征患儿的生活质量 严重低下,照护者负担不容乐观,早期诊断、医学遗传咨询以及Noonan综合征长期诊疗规划值得关注。

关键词: Noonan综合征, 生活质量, 照护负担, 慢病管理, 多学科管理

Abstract: Objective To explore the quality of life (QoL) and care burden of Noonan syndrome children. Methods The quality of life and care burden of children with Noonan syndrome were investigated by general data questionnaire, pediatric quality of life inventory 4.0 generic core scales (PedsQL 4.0) and caregiver burden inventory (CBI). Results The median age of 96 children (40 boys and 56 girls) with Noonan syndrome was 4.0 (3.0-5.0) years. The total score of PedsQL in children with Noonan syndrome was 49.3(34.24-59.8), which was far lower than the national norm ( 81. 81 ± 12. 03 ), and the difference was statistically significant (P<0.001). The total score of CBI of primary caregiver was 43. 5 ( 29. 5 - 52. 0 ), indicating a moderate burden. The score of life quality was significantly positively correlated with the total burden score of caregivers (r=0.65, P<0.01), and was significantly positively correlated with three dimensions (time-dependent burden, developmental constraint burden and physical burden) (P< 0. 05 ). There were statistically significant differences in PedsQL scores among families in only child, occupations and education levels of caregivers (P<0.05). Multivariate regression analysis suggested that timedependent burden, developmental constraint burden and physical burden contributed 22.0% to the prediction of life quality. Medical and genetic counseling (100%), multidisciplinary team management (93.8%), rehabilitation training (79.2%), and vaccination (58.3%) were the primary needs of Noonan families in their care. Conclusions The life quality of children with Noonan syndrome is severely low and the burden on caregivers is heavy. Early diagnosis, medical genetic counseling and long-term management planning of Noonan syndrome deserve attention.