Lu X L, Liu Y P, Liu Y W, Diao J L, Wang F, Zhong F Y, He J L, Chen L
Department of Plastic Surgery and Burn Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong 637002, China.
Department of Burns and Plastic Surgery, Suining Central Hospital, Suining 629099, China.
Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2024 Apr 20;40(4):373-379. doi: 10.3760/cma.j.cn501225-20230731-00028.
To explore the occurrence and influencing factors of post-burn psychological stress disorder in preschool children. 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. 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 valuesof 9.18, 7.80, and 25.47, respectively, <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 (>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, <0.05), the older the child and the more severe the burn, the higher the possibility of the occurrence of psychological stress disorder. 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.
探讨学龄前儿童烧伤后心理应激障碍的发生情况及影响因素。本研究为多中心横断面调查。选取2022年1月至2023年2月期间,入住川北医学院附属医院、南充市中心医院、遂宁市中心医院、广安市人民医院和广元市中心医院且符合纳入标准的85例1至6岁烧伤学龄前儿童作为研究对象。采用自制的一般资料问卷,调查患儿的一般资料,包括性别、年龄组、居住地区、主要照顾者及其文化程度、家庭类型,以及损伤情况,包括致伤原因和烧伤严重程度。采用儿童应激障碍检查表,调查患儿伤后3天至1个月心理应激障碍的发生情况,并计算发生率。根据患儿的一般资料和损伤情况进行分组,记录患儿伤后3天至1个月心理应激障碍的发生情况,筛选学龄前儿童烧伤后心理应激障碍的影响因素。共发放问卷85份,回收有效问卷85份,有效回收率为100%。患儿中,男45例,女40例,以1至3岁儿童居多。农村患儿略多于城市患儿。约半数患儿分别主要由父母和祖父母照顾,主要照顾者文化程度以高中/中专为主。家庭类型以核心家庭和大家庭为主。主要致伤原因是热液烫伤,烧伤严重程度以中度为主。该组患儿伤后3天至1个月心理应激障碍发生率为34.12%(29/85)。不同年龄组、致伤原因、烧伤严重程度的患儿伤后3天至1个月心理应激障碍的发生情况差异有统计学意义( 值分别为9.18、7.80、25.47,均<0.05);不同性别、居住地区、主要照顾者、主要照顾者文化程度、家庭类型的患儿伤后3天至1个月心理应激障碍的发生情况差异无统计学意义(>0.05)。多因素logistic回归分析显示,年龄组和烧伤严重程度是学龄前儿童烧伤后心理应激障碍发生的独立影响因素(比值比分别为8.21和33.99,95%置信区间分别为1.57 - 43.04和5.55 - 207.93,均<0.05),年龄越大、烧伤越严重,心理应激障碍发生的可能性越高。学龄前儿童烧伤后心理应激障碍发生率较高。年龄组和烧伤严重程度是此类患儿烧伤后心理应激障碍发生的独立影响因素。
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