出院后早产儿随访与早期综合干预依从性影响因素分析
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摘要
目的探索出院后早产儿随访和早期综合干预依从性的影响因素。方法选取2012年6月—2014年9月在中国6省市17家医疗保健机构出生的2 802名早产儿作为研究对象,指导家长对早产儿实施适合月龄的早期综合干预,并进行为期2年的随访,分别采用单因素和多因素logistic回归模型分析早产儿随访和早期综合干预依从性的影响因素。结果随访依从性较好者为668人(23.8%),早期综合干预依从性较好者为724人(25.8%)。多因素logistic回归分析结果显示,母亲受教育程度较高(OR=1.341, 95%CI=1.061～1.695)、主要看护人为父母之一(OR=9.696, 95%CI=7.714～12.186)、家庭平均月收入较高(OR=1.434, 95%CI=1.145～1.796)的早产儿随访依从性较好;主要看护人为父母之一(OR=8.569, 95%CI=6.917～10.616)和家庭平均月收入较高(OR=1.301, 95%CI=1.058～1.601)的早产儿早期综合干预依从性较好。结论主要看护人和家庭经济情况与早产儿随访和早期综合干预依从性密切相关。
Objective To explore influencing factors of follow-up and early comprehensive intervention compliance among post-discharge premature infants. Methods Using cluster sampling, we selected post-discharge premature infants born between June 2012 to September 2014 in 17 hospitals in Beijing and 5 provinces and conducted a 2-year follow-up.Month age-specific early comprehensive interventions were implemented by the infants ′ parents under the guidance of professionals. Univariate and multivariate logistic regression models were used to analyze influencing factors of follow-up and early comprehensive intervention compliance. Results Of the 2 802 enrolled premature infants, 668(23.8%) and 724(25.8%) were assessed with a better follow-up and early comprehensive intervention compliance. Multivariate logistic regression analysis indicated that the premature infants with better-educated mothers(odds ratio [OR] = 1.341, 95%confidence interval [95% CI]: 1.061 – 1.695), in a family with higher household income(OR = 1.434, 95% CI: 1.145 –1.796), and mainly raised by their parents(OR = 9.696, 95% CI: 7.714 – 12.186) were more likely to have a better follow-up compliance; and those mainly raised by their parents(OR = 8.569, 95% CI: 6.917 – 10.616) and in a family with higher household income(OR = 1.301, 95% CI: 1.058 – 1.601) were more likely to have a better early comprehensive intervention compliance. Conclusion Main caregivers and household income are associated with follow-up and early comprehensive intervention compliance among post-discharge premature infants.
Objective To explore influencing factors of follow-up and early comprehensive intervention compliance among post-discharge premature infants. Methods Using cluster sampling, we selected post-discharge premature infants born between June 2012 to September 2014 in 17 hospitals in Beijing and 5 provinces and conducted a 2-year follow-up.Month age-specific early comprehensive interventions were implemented by the infants ′ parents under the guidance of professionals. Univariate and multivariate logistic regression models were used to analyze influencing factors of follow-up and early comprehensive intervention compliance. Results Of the 2 802 enrolled premature infants, 668(23.8%) and 724(25.8%) were assessed with a better follow-up and early comprehensive intervention compliance. Multivariate logistic regression analysis indicated that the premature infants with better-educated mothers(odds ratio [OR] = 1.341, 95%confidence interval [95% CI]: 1.061 – 1.695), in a family with higher household income(OR = 1.434, 95% CI: 1.145 –1.796), and mainly raised by their parents(OR = 9.696, 95% CI: 7.714 – 12.186) were more likely to have a better follow-up compliance; and those mainly raised by their parents(OR = 8.569, 95% CI: 6.917 – 10.616) and in a family with higher household income(OR = 1.301, 95% CI: 1.058 – 1.601) were more likely to have a better early comprehensive intervention compliance. Conclusion Main caregivers and household income are associated with follow-up and early comprehensive intervention compliance among post-discharge premature infants.
引文
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[14]许琪,李瑞莉,尹德卢,等.不同省市0~6岁儿童主要看护人育儿知识和行为情况调查及影响因素分析[J].中国妇幼保健,2015,30(08):1222-1225.
[15]朱瑛,刘江虹,岳莉,等.兰州市婴幼儿饮食行为问题及影响因素[J].中国公共卫生,2015,31(5):570-573.
[16]Ballantyne M,Stevens B,Guttmann A,et al.Transition to neonatal follow-up programs:is attendance a problem[J].J Perinat Neonatal Nurs,2012,26(1):90-98.
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[18]谷丽紧,罗荣,金曦,等.甘肃省会宁县贫困家庭0~6岁儿童保健服务影响因素分析[J].中国儿童保健杂志,2014,22(9):910-913.
[19]政晓果,肖峰,李瑞莉,等.0~2岁儿童家长育儿知识知晓情况及影响因素分析[J].中华疾病控制杂志,2017,21(09):950-952.
[2]Cheong JL,Doyle LW,Burnett AC,et al.Association between moderate and late preterm birth and neurodevelopment and socialemotional development at age 2 years[J].JAMA Pediatr,2017,171(4):e164805.
[3]袁欣,郝素媛,韩炳娟,等.早期早产儿和/或极低出生体重儿出院后随访及早期干预的临床研究[J].中华围产医学杂志,2015,18(4):296-299.
[4]Spittle A,Orton J,Anderson PJ,et al.Early developmental intervention programmes provided post hospital discharge to prevent motor and cognitive impairment in preterm infants[J].Cochrane Database Syst Rev,2015(11):CD005495.
[5]王伟,杨丽芳,张月芳,等.早期干预对早产儿体格及神经心理发育的影响[J].南京医科大学学报:自然科学版,2014,34(2):197-200.
[6]王雪茵,张小松,赵更力,等.早产儿早期神经心理发育的影响因素研究[J].中华疾病控制杂志,2018,22(2):187-190.
[7]国家卫生和计划生育委员会办公厅.早产儿保健工作规范[J].中华围产医学杂志,2017,20(6):401-406.
[8]Ballantyne M,Stevens B,Guttmann A,et al.Maternal and infant predictors of attendance at Neonatal Follow-Up programmes[J].Child Care Health Dev,2014,40(2):250-258.
[9]昌爱慧.早产儿随访管理模式初探[J].国际医药卫生导报,2016,22(1):116-118.
[10]封志纯,马秀伟.婴幼儿脑损伤的早期干预-神经发育促进[J].中国儿童保健杂志,2016,24(4):337-339.
[11]谢甜,郝波,周敏,等.家庭干预对早产儿早期神经心理发育效果研究[J].中国儿童保健杂志,2017,25(5):452-455.
[12]McManus BM,Rosenberg SA.Does the persistence of development delay predict receipt of early intervention services?[J].Acad Pediatr,2012,12(6):546-550.
[13]郝波,周敏,张小松,等.西部四县出院后早产儿管理模式比较研究[J].中国儿童保健杂志,2016,24(11):1145-1147.
[14]许琪,李瑞莉,尹德卢,等.不同省市0~6岁儿童主要看护人育儿知识和行为情况调查及影响因素分析[J].中国妇幼保健,2015,30(08):1222-1225.
[15]朱瑛,刘江虹,岳莉,等.兰州市婴幼儿饮食行为问题及影响因素[J].中国公共卫生,2015,31(5):570-573.
[16]Ballantyne M,Stevens B,Guttmann A,et al.Transition to neonatal follow-up programs:is attendance a problem[J].J Perinat Neonatal Nurs,2012,26(1):90-98.
[17]Verrips G,Brouwer L,Vogels T,et al.Long term follow-up of health-related quality of life in young adults born very preterm or with a very low birth weight[J].Health Qual Life Outcomes,2012,10(1):49.
[18]谷丽紧,罗荣,金曦,等.甘肃省会宁县贫困家庭0~6岁儿童保健服务影响因素分析[J].中国儿童保健杂志,2014,22(9):910-913.
[19]政晓果,肖峰,李瑞莉,等.0~2岁儿童家长育儿知识知晓情况及影响因素分析[J].中华疾病控制杂志,2017,21(09):950-952.