学龄期哮喘患儿症状控制水平的影响因素及路径分析

doi:10.3761/j.issn.0254-1769.2022.24.009

摘要/Abstract

摘要：

目的分析父母教养方式、服药依从性等因素对学龄期哮喘患儿症状控制水平的影响以及影响因素间的作用路径，为制订针对性的护理干预方案提供依据。方法采用便利抽样法，选取2020年12月—2021年9月在山东省济南市3所三级甲等医院就诊或住院的学龄期哮喘患儿及其父母作为调查对象，使用一般资料调查表、简式父母教养方式问卷中文版、服药依从性问卷、儿童哮喘控制测试对其进行调查。采用单因素分析、Pearson相关性分析、多元线性回归分析数据，并构建结构方程模型。结果共纳入211例学龄期哮喘患儿，其儿童哮喘控制测试得分为（19.15±4.27）分，哮喘未控制率为43.6%。影响因素分析结果显示，父母教养方式、患儿服药依从性、一级亲属哮喘史是学龄期哮喘患儿症状控制水平的影响因素（P<0.05）。路径分析结果显示，患儿服药依从性在父母积极教养方式和患儿症状控制水平间起部分中介作用，效应值为0.395，95%CI为（0.273，0.540），占总效应的54.6%；患儿服药依从性在父母消极教养方式和其症状控制水平间起部分中介作用，效应值为-0.435，95%CI为（-0.598，-0.254），占总效应的58.8%。结论学龄期哮喘患儿症状控制较差，临床医护人员需重视父母教养方式对患儿症状控制水平的影响，应指导父母采取积极的教养方式，以提高患儿服药依从性及症状控制水平。

关键词: 哮喘, 父母教养方式, 服药依从性, 影响因素分析, 儿科护理学

Abstract:

Objective From the aspects of parenting style and medication adherence，the influencing factors of asthma symptom control level of school-age children and the impact path of influencing factors were analyzed，so as to provide a basis for the formulation of targeted nursing intervention programs. Methods Using convenient sampling method，from December 2020 to September 2021，we investigated school-age asthmatic children and their parents in pediatric respiratory outpatient departments and wards of 3 tertiary hospitals in Jinan，Shandong province，using the General Demographic Questionnaire，Short-Egna Minnen av Barndoms Uppfostran-Chinese（s-EMBU-C），Medication Adherence Questionnaire and Childhood Asthma Control Test（C-ACT）. Univariate analysis，Pearson correlation analysis and multiple linear stepwise regression analysis were used to analyze the data，and the structural equation model was established. Results A total of 211 school-age children with asthma were enrolled. The score of C-ACT was（19.15±4.27），and the uncontrolled rate was 43.6%（92 cases）. The results of influencing factor analysis showed that the parenting style，medication adherence and asthma history of first-degree relatives were the influencing factors of symptom control level in school-age children with asthma（P<0.05）. Pathway analysis results showed that medication adherence played a partially mediating role between positive parenting style and asthma symptom control level（ES=0.395），with 95%CI（0.273，0.540），accounting for 54.6% of the total effect. The medica-tion adherence played a partially mediating role between negative parenting style and asthma symptom control level（ES=-0.435），with 95%CI（-0.598，-0.254），accounting for 58.8% of the total effect. Conclusion The symptom con-trol of school-age children with asthma is poor. Clinical doctors and nurses should pay attention to the influence of parenting style on children’s symptom control level，guide parents to adopt positive parenting styles，and improve children’s medication compliance，so as to improve their symptom control level.

Key words: Asthma, Parenting Styles, Medication Adherence, Influencing Factor Analysis, Pediatric Nursing

贾元敏, 伊默, 王晶晶, 张泽懿, 王海霞, 陈欧. 学龄期哮喘患儿症状控制水平的影响因素及路径分析[J]. 中华护理杂志, 2022, 57(24): 3004-3010.

JIA Yuanmin, YI Mo, WANG Jingjing, ZHANG Zeyi, WANG Haixia, CHEN Ou. Analysis of influencing factors and impact path of asthma control in school-age children[J]. Chinese Journal of Nursing, 2022, 57(24): 3004-3010.

图/表 6

表1 调查对象的一般资料及其症状控制水平影响因素的单因素分析结果（n=211）

Table 1 The general data of subjects and the results of univariate analysis of predictors for symptom control level（n=211）

表2 父母教养方式与学龄期哮喘患儿服药依从性、症状控制水平间的相关分析（r值，n=211）

Table 2 Correlation analysis of parenting style, medication adherence and symptom control level in school-age children with asthma（r value，n=211）

表3 自变量赋值方式

Table 3 Variables assignment table

表4 学龄期哮喘患儿症状控制水平影响因素的多元线性回归分析结果

Table 4 Multivariable linear regression of predictors of symptom control level in school-age children with asthma

图1 学龄期哮喘患儿服药依从性在父母积极教养方式与患儿症状控制水平间的中介效应模型 1)p<0.001。

Figure 1 Mediating effect model of medication adherence in school-age children with asthma between positive parenting style and symptom control level

图2 学龄期哮喘患儿服药依从性在父母消极教养方式与患儿症状控制水平间的中介效应模型 1）P<0.001；2）P<0.05。

Figure 2 Mediating effect model of medication adherence in school-age children with asthma between negative parenting style and symptom control level

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