不同出生体重儿童的生命质量研究
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摘要
目的探讨不同出生体重學龄期儿童生命質量及影响因素。
     方法採用Achendach兒童行為量表、兒少主觀生命质量问卷及自製儿童生命質量影響因素问卷,對台湾基隆市8-11歲兒童的生命質量及其影響因素進行调查。回收有效问卷共350份,男、女各175份。對研究物件按照不同的出生体重分组,分析生命質量及影響因素。
     结果在所调查的350名兒童中,出现行為问题的兒童有21.14%(74/350);男孩行為问题的檢出率為20.00%(35/175);女孩行为问题的檢出率为22.29%(39/175)。兒童是否出现行为问题與出生体重的統計结果不顯著,但卻與父母年龄、父母及主要教養人的社经地位與教育程度、父親每週與孩子的相處時间長短、该兒童是否對家庭造成心理負擔與經濟負擔、孕週、主觀生命质量的優劣有關。取以上有意義的部份,使用Logistic回歸檢驗行为问题與生命质量影響因素可知行為问题與父親教育程度(P=0.016)、主要養育人的教育程度(P=0.017)、受試兒童是否對家庭造成心理負擔(P=0.000)及经济負擔(P=0.009)四個方面有密切關係。
     在受試兒童中,對其生命质量總體满意度的结果“不满意”的有19.71%(69/350),为“一般水準”的占39.71%(139/350),認為结果“满意”的為40.57%(142/350)。男孩的認知成份满意度與其年龄有關,且男、女孩在躯体情感維度與情感成份方面有顯著性差異。對不同出生体重兒童主觀生命質量满意度的分析结果提示:低出生體重兒與正常出生體重兒相比,在生命質量中的情感成份满意度较低,结果具統計学意義(F=2.601;P=0.028);而巨大兒在認知成份满意度较正常出生体重兒差(F=3.189;P=0.012)。多元相关分析发现:有無行為问题、孩子的主要养育人、主要養育人的教育程度與社經地位、孩子添加辅食的時間、對子女的经济投入状況、該兒童是否为家庭带来心理負擔與經濟負擔、父母親的教育程度與社經地位父母每週與孩子相處時间的畏短是影響兒童主觀生命質量满意度的因素。
     結論低出生体重兒生命質量的情感成份满意度较低,而巨大兒生命質量的認知成份满意度较差,出生体重是影響兒童生命質量的因素。
Objective:To explore the birth weight specific quality of life and related influencing factors of children.
     Methods:The study subjects included 350 children aged from eight years to eleven years chosen from KeeLung City and the ratio of boy and girl is the same. Achendach's Child behavior checklist, ISLQ and self-made questionnaire were conducted to study their quality of life and related influencing factors. The subjects were divided into different groups according to their birth weight. Statistical method such as chi-square test, analysis of variance and multivariate analysis were conducted for data analysis.
     Results:74 of the 350 children studied had behavioral problems and the ratio was 21.14%(74/350), among which the ratio of boys was 20.00% (35/175) and that of girls was 22.29% (39/175). Children's behavioral problem wasn't statistically related to birth weight but was related to ages of parents, education level and socioeconomic status of parents and chief caregivers, the time of father spent with his child every week whether the child brought psychological and economic burdens to their family, gestational period and the subjective quality of life. Logistic regression analysis indicated that education level of the father (P=0.016), education level of chief caregivers (P=0.017), whether the child brought psychological and economic burdens to their family (P=0.000, P= 0.009) were risk factors for children having behavior problems. Ratio of children who were not satisfied with the perceptional content of life quality was 19.71% (69/350), average level was 39.71% (139/350) and that of children who were satisfied with the perceptional content of life quality was 40.57%(142/350). The satisfaction towards cognitive component of quality of life for boys was, related to their ages, and there were significant difference in physical and emotional dimension and affective components of quality of life between boys and girls. Analysis of subjective quality of life in children of different birth weight showed that the satisfaction towards affective components of quality of life in underweight children is lower (F=2.601; P=0.028) and the satisfaction towards cognitive component of quality of life in overweight children is lower (F= 3.189; P=0.012)
     By multiple correlation analysis it have been found that whether the child had behavior problem, chief caregivers of the child, education level and socioeconomic status of chief caregivers, the time of instruction of solid food, money spent on the child, whether the child brought psychological and economic burdens to their family, education level and socioeconomic status of their parents, the time spent with their parents every week could affect children's subjective satisfaction level towards quality of life.
     Conclusion:The satisfaction towards affective components of quality of life in underweight children is lower while for overweight children the satisfaction towards cognitive component of quality of life is lower. Birth weight is related to children's quality of life.
引文
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