A cross-sectional survey and analysis of influencing factors on the occurrence of post-burn psychological stress disorder in preschool children
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摘要:
目的 探讨学龄前儿童烧伤后心理应激障碍发生情况及其影响因素。 方法 该研究为多中心横断面调查。2022年1月—2023年2月，选择川北医学院附属医院、南充市中心医院、遂宁市中心医院、广安市人民医院、广元市中心医院收治的85例符合入选标准的1~6岁学龄前烧伤患儿为调查对象。采用自制一般信息调查表调查患儿性别、年龄段、居住地区、主要看护人及其文化程度、家庭类型等一般资料，以及致伤原因、烧伤严重程度等伤情；采用儿童应激障碍检查表调查患儿伤后3 d~1个月心理应激障碍发生情况，计算发生率。将患儿按照一般资料和伤情分类，统计患儿伤后3 d~1个月心理应激障碍发生情况，筛选学龄前儿童烧伤后发生心理应激障碍的影响因素。 结果 共发放调查问卷85份，收回有效问卷85份，有效回收率为100%。患儿中，男45例、女40例，以1~3岁年龄段患儿居多，农村地区患儿稍多于城市，主要看护人为父母和祖父母的患儿约各占1/2，主要看护人文化程度以高中/中专为主，家庭类型以核心家庭与扩大家庭为主，致伤原因以热液烫伤为主，烧伤严重程度以中度为主。该组患儿伤后3 d~1个月心理应激障碍发生率为34.12%（29/85）。不同年龄段、致伤原因、烧伤严重程度患儿伤后3 d~1个月心理应激障碍发生情况比较，差异均有统计学意义（ χ 2值分别为9.18、7.80、25.47， P<0.05）；不同性别、居住地区、主要看护人、主要看护人文化程度、家庭类型患儿伤后3 d~1个月心理应激障碍发生情况比较，差异均无统计学意义（ P>0.05）。多因素logistic回归分析显示，年龄段和烧伤严重程度均为学龄前儿童烧伤后发生心理应激障碍的独立影响因素（比值比分别为8.21、33.99，95%置信区间分别为1.57~43.04、5.55~207.93， P<0.05），患儿年龄越大、烧伤严重程度越重，发生心理应激障碍的可能性越高。 结论 学龄前儿童烧伤后心理应激障碍发生率高，年龄段和烧伤严重程度是该类患儿伤后发生心理应激障碍的独立影响因素。 Abstract:Objective To explore the occurrence and influencing factors of post-burn psychological stress disorder in preschool children. Methods This study was a multi-center cross-sectional survey. From January 2022 to February 2023, 85 preschool children (aged 1 to 6 years) with burns admitted to the Affiliated Hospital of North Sichuan Medical College, Nanchong Central Hospital, Suining Central Hospital, Guang'an People's Hospital, and Guangyuan Central Hospital who met the inclusion criteria were selected as respondents. A self-made general information questionnaire was used to investigate the children's general data including gender, age group, residential area, main caregiver and their education level, and family type, as well as the injury condition including cause of injury and burn severity. The Child Stress Disorders Checklist was used to investigate the occurrence of psychological stress disorder in children at 3 days to 1 month after injury, and the incidence rate was calculated. The children were classified according to their general data and injury condition, and the occurrence of psychological stress disorder in children at 3 days to 1 month after injury was recorded, and the influencing factors for post-burn psychological stress disorder in preschool children were screened. Results A total of 85 questionnaires were distributed and 85 valid questionnaires were recovered, with an effective recovery rate of 100%. Among the children, there were 45 boys and 40 girls, with most children aged 1 to 3 years. There were slightly more children in rural areas than in cities. About half of the children were mainly cared for by their parents and grandparents, respectively, and the education level of the main caregivers was mainly high school/technical secondary school. The family type was mainly core family and extended family. The main cause of injury was hydrothermal scald, and the severity of burns was mainly moderate. The incidence rate of psychological stress disorder in this group of children at 3 days to 1 month after injury was 34.12% (29/85). There were statistically significant differences in the occurrence of psychological stress disorder in children with different age groups, causes of injuries, and burn severity at 3 days to 1 month after injury (with χ 2 valuesof 9.18, 7.80, and 25.47, respectively, P<0.05); there were no statistically significant differences in the occurrence of psychological stress disorder in children with different genders, residential area, main caregivers, main caregivers' education levels, or family types at 3 days to 1 month after injury ( P>0.05). Multivariate logistic regression analysis showed that age group and burn severity were independent influencing factors for the occurrence of psychological stress disorder in preschool children after burns (with odds ratios of 8.21 and 33.99, respectively, and 95% confidence intervals of 1.57-43.04 and 5.55-207.93, respectively, P<0.05), the older the child and the more severe the burn, the higher the possibility of the occurrence of psychological stress disorder. Conclusions The incidence rate of psychological stress disorder is high in preschool children after burns. Age group and burn severity are independent influencing factors for the occurrence of post-burn psychological stress disorder in this type of children. -
卢学兰：研究设计、数据分析、论文撰写；刘应平、刘一伟、刁杰林：资料收集；王丰、钟方宇、何家乐：数据整理、统计分析；陈朗：研究指导、论文修改、经费支持所有作者均声明不存在利益冲突
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参考文献
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表1 85例学龄前儿童烧伤后3 d~1个月不同一般资料与伤情下心理应激障碍发生情况比较
表1. Comparison of the occurrence of psychological stress disorder in 85 preschool children at 3 days to 1 month after burns with different general data and injury condition
项目与类别 例数 构成比（%） 应激障碍（例） χ 2值 P值 无 有 性别 男 45 52.94 31 14 0.39 0.535 女 40 47.06 25 15 年龄段 1~3岁 66 77.65 49 17 9.18 0.002 4~6岁 19 22.35 7 12 居住地区 农村 48 56.47 31 17 0.08 0.774 城市 37 43.53 25 12 主要看护人 父母 42 49.41 28 14 0.02 0.880 祖父母 43 50.59 28 15 主要看护人文化程度 初中及以下 25 29.41 19 6 5.88 0.117 高中/中专 38 44.71 20 18 大学本科/专科 20 23.53 15 5 硕士研究生及以上 2 2.35 2 0 家庭类型 扩大家庭 34 40.00 21 13 0.60 0.895 核心家庭 34 40.00 24 10 留守家庭 14 16.47 9 5 单亲家庭 3 3.53 2 1 致伤原因 热液烫伤 65 76.47 48 17 7.80 0.005 火焰烧伤/其他 20 23.53 8 12 烧伤严重程度 轻度 38 44.71 36 2 25.47 <0.001 中度 42 49.41 18 24 重度 5 5.88 2 3 注：其他指接触烫伤 
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表2 影响学龄前儿童烧伤后发生心理应激障碍的多因素logistic回归分析结果
表2. Results of multivariate logistic regression analysis affecting the occurrence of psychological stress disorder in preschool children after burns
项目与分类 比值比 95%置信区间 P值 致伤原因热液烫伤（以火焰烧伤/其他为参照） 0.41 0.11~1.53 0.182 年龄段4~6岁（以1~3岁为参照） 8.21 1.57~43.04 0.013 烧伤严重程度中重度（以轻度为参照） 33.99 5.55~207.93 <0.001 注：其他指接触烫伤
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表3 2个年龄段学龄前烧伤患儿的一般资料与伤情比较（例）
表3. Comparison of general data and injuries of preschool children with burns in two age groups
年龄段 例数 性别 居住地区 主要看护人 主要看护人文化程度 男 女 农村 城市 父母 祖父母 初中及以下 高中/中专 大学本科/专科 硕士研究生及以上 1~3岁 66 34 32 36 30 34 32 20 28 16 2 4~6岁 19 11 8 12 7 8 11 5 10 4 0 χ 2值 0.24 0.45 0.52 1.06 P值 0.623 0.505 0.470 0.786 注：其他指接触烫伤
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