基于聚类分析的恶性肿瘤患儿家庭管理类型研究

Cluster analysis on types of family management for children with malignant tumor

摘要:

目的： 探讨恶性肿瘤患儿家庭管理的分型，为制定更有针对性的家庭管理干预策略提供依据。方法： 采用一般资料问卷和家庭管理量表对重庆市某三级甲等儿童医院的176例恶性肿瘤患儿及主要照顾者进行调查，通过聚类分析对患儿家庭管理进行分型，采用方差分析比较不同家庭管理类型患儿的一般特征。结果： 恶性肿瘤患儿家庭管理可分为乐观实践型（Ⅰ类）、焦虑适应型（Ⅱ类）、能力欠缺型（Ⅲ类）和管理困难型（Ⅳ类），其中Ⅲ类和Ⅳ类患儿家庭管理水平较低。4类患儿的确诊时长（F=1.855，P=0.039）、最近半年住院次数（F=1.787，P=0.003）、居住地类型（χ²=16.218，P=0.001）和主要照顾者文化水平（χ²=16.319，P=0.012）差异具有统计学意义。结论： 通过聚类分析可将恶性肿瘤患儿家庭管理分成不同类型，有利于临床医护人员制定更精准的疾病管理策略，实现医疗资源的优化利用。

Abstract:

Objective: To explore the types of family management for children with malignant tumor，and to provide evidence for formulating more targeted intervention strategies of family management. Methods: Totally 176 children with malignant tumor and their main caregivers were investigated by using general information questionnaire and family management measure in a tertiary grade A children’s hospital of Chongqing. Cluster analysis was conducted to classify the family management of children，and analysis of variance was used to compare the general characteristics of children with different family management types. Results: Family management of children with malignant tumor could be divided into Ⅰ-Ⅳ categories：optimistic practical type，anxiety adaptation type，ability deficiency type and management difficulty type，in which Ⅲ and Ⅳ children’s family management level is low. There were statistically significant differences in the length of diagnosis（F=1.855，P=0.039），hospitalization times in the recent half year（F=1.787，P=0.003），type of residence（χ²=16.218，P=0.001）and education level of primary caregivers（χ²=16.319，P=0.012） among the four types of children. Conclusion: The family management of children with malignant tumor can be divided into different types by cluster analysis，which is conducive to the development of more precise disease management strategies for clinical medical staff and the optimal utilization of medical resources.