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哮喘儿童和青少年的疾病严重程度、心理健康及生活质量

Disease severity, mental health, and quality of life of children and adolescents with asthma.

作者信息

Goldbeck Lutz, Koffmane Katja, Lecheler Josef, Thiessen Kai, Fegert Jörg M

机构信息

Department for Child and Adolescent Psychiatry/Psychotherapy, University Clinic, Ulm, Germany.

出版信息

Pediatr Pulmonol. 2007 Jan;42(1):15-22. doi: 10.1002/ppul.20509.

Abstract

Asthma has been found related to a higher risk of psychological problems. Inconsistent results have been reported with respect to the quality of life of children with asthma. So there may be a complex relationship between asthma severity, quality of life, and psychological factors. The aim of this study was to examine the impact of asthma severity and emotional/behavioral problems on the quality of life of children and adolescents and on their need for support. Eighty-one children and adolescents (7-18 years old, 62 boys, 19 girls) with asthma participating in different intervention and rehabilitation programs completed the Ulm Inventory for Children, an instrument for assessing health-related quality of life. Psychological problems were rated using the Child Behavior Checklist (CBCL). Caregivers judged the patients' need for support due to asthma and due to psychosocial problems. Asthma severity was rated according to the GINA classification. The participants showed elevated caregiver-reported emotional and behavioral symptoms compared with the normative sample (mean CBCL total score T=63). Quality of life and the need for social support were significantly correlated with psychological symptoms. Asthma severity was neither correlated with quality of life nor with emotional/behavioral symptoms, but it was associated with the need for support due to asthma. Therefore, in our study, comorbid emotional and behavioral symptoms rather than disease severity predicted quality of life of children and adolescents with asthma. Treatment should be adjusted to the special needs of children with asthma and comorbid mental health problems.

摘要

研究发现哮喘与心理问题风险较高有关。关于哮喘患儿的生活质量,已有不一致的研究结果报道。因此,哮喘严重程度、生活质量和心理因素之间可能存在复杂的关系。本研究的目的是探讨哮喘严重程度以及情绪/行为问题对儿童和青少年生活质量及其支持需求的影响。81名患有哮喘的儿童和青少年(7 - 18岁,62名男孩,19名女孩)参与了不同的干预和康复项目,他们完成了乌尔姆儿童量表,这是一种用于评估与健康相关生活质量的工具。使用儿童行为检查表(CBCL)对心理问题进行评分。照顾者判断患者因哮喘和心理社会问题而产生的支持需求。根据全球哮喘防治创议(GINA)分类对哮喘严重程度进行评分。与正常样本相比,参与者的照顾者报告的情绪和行为症状有所升高(CBCL总分平均值T = 63)。生活质量和社会支持需求与心理症状显著相关。哮喘严重程度既与生活质量无关,也与情绪/行为症状无关,但与因哮喘产生的支持需求有关。因此,在我们的研究中,合并的情绪和行为症状而非疾病严重程度预测了哮喘儿童和青少年的生活质量。治疗应根据哮喘儿童和合并心理健康问题儿童的特殊需求进行调整。

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