Chien Li-Yin, Chou Yi-Hung, Ko Yi-Li, Lee Ching-Fang
Institute of Community Health Nursing, National Yang-Ming University, Pei-Tou, Taipei, Taiwan.
J Adv Nurs. 2006 Oct;56(1):9-16. doi: 10.1111/j.1365-2648.2006.03974.x.
This paper reports a study comparing health-related quality of life at 3-4 years of age among children born with very low birthweight (<or=1500 g) to a group of non-very low birthweight controls, and to examine biological, environmental, demographic and health factors associated with quality of life of children born with very low birthweight.
Advances in modern medicine have increased the survival of infants with very low birthweight, but its impact on quality of life of children during preschool years has been less studied.
The study sample included 118 children born with very low birthweight and 170 non-very low birthweight controls in Taiwan. Primary caregivers of the study children completed structured questionnaires during the period November 2002 to April 2003. Health-related quality of life was measured using the Mandarin version of the TZO-AZL Preschool Children Quality of Life instrument. This tool has four dimensions: physical, emotional, cognitive and social functions. Higher scores indicate better quality of life.
Children born with very low birthweight had statistically significantly lower mean quality of life scores in all the four dimensions compared with controls. Among the former, those who had current physical health problems scored lower in all dimensions of quality of life. Primary caregivers with higher educational levels and increased ages of the children were associated with improved scores in the emotional and social functions. Birth gestational age was negatively associated with cognitive function. Length of stay in the neonatal intensive care unit was negatively associated with scores for the social function aspect of quality of life.
Regular monitoring of the quality of life among very low birthweight children is needed. Nurses need to assess the child's current health state, birth gestational age, and the primary caregiver's educational level in order to identify those who are at risk for low quality of life and intervene early.
本文报告一项研究，比较极低出生体重儿（出生体重≤1500克）在3至4岁时与非极低出生体重对照组儿童的健康相关生活质量，并探讨与极低出生体重儿生活质量相关的生物学、环境、人口统计学和健康因素。
现代医学的进步提高了极低出生体重儿的存活率，但对其学龄前儿童生活质量的影响研究较少。
研究样本包括台湾地区118名极低出生体重儿和170名非极低出生体重对照组儿童。研究对象的主要照顾者在2002年11月至2003年4月期间完成了结构化问卷。使用TZO-AZL中文版学龄前儿童生活质量量表测量健康相关生活质量。该工具包括四个维度：身体、情感、认知和社会功能。得分越高表明生活质量越好。
与对照组相比，极低出生体重儿在所有四个维度上的平均生活质量得分在统计学上均显著较低。在前者中，目前有身体健康问题的儿童在生活质量的所有维度上得分较低。教育水平较高的主要照顾者和年龄较大的儿童与情感和社会功能得分的提高相关。出生胎龄与认知功能呈负相关。新生儿重症监护病房的住院时间与生活质量的社会功能方面得分呈负相关。
需要定期监测极低出生体重儿的生活质量。护士需要评估儿童当前的健康状况、出生胎龄和主要照顾者的教育水平，以识别那些生活质量低风险的儿童并尽早进行干预。
