急性白血病患儿行为特征的潜在类别分析及影响因素

Latent class analysis of behavioral characteristics of children with acute leukemia and associated influencing factors

摘要:

目的 利用潜在类别分析法探讨急性白血病患儿行为特征的潜在类别及影响因素，为制定白血病患儿行为问题精准干预策略提出循证依据。方法 便利抽样法选取重庆医科大学附属儿童医院血液科202例急性白血病患儿及其照顾者为研究对象，使用一般资料调查表、Rutter 儿童行为问卷、一般家庭功能分量表、社会支持评定量表对其进行调查。利用潜在类别分析对急性白血病患儿行为特征进行分类，采用无序多分类logistic回归分析各因素对不同类别的影响。结果 急性白血病患儿行为特征可分为3种类型，其中冲动-不友善型占50%，情绪-躯体障碍型占33.66%，良好行为型占16.34%；无序多分类logistic回归结果显示，不健康的家庭功能、男性患儿易发展为冲动-不友善型，不健康的家庭功能、男性患儿、治疗期易发展为情绪-躯体障碍型，治疗期患儿易发展为情绪-躯体障碍型。结论 急性白血病患儿行为特征存在明显不同的分类特征，与家庭功能、性别、疾病阶段关系密切。因此应针对不同类别特征的急性白血病患儿制定个性化干预措施，预防或减少其行为问题的发生，进而提升其社会适应能力及生存质量。

Abstract:

Objective To explore the potential categories of behavioral characteristics of children with acute leukemia using latent class analysis and associated influencing factors，and to provide evidence for developing precise intervention strategies for behavioral problems in children with leukemia.Methods We selected 202 children with acute leukemia and their caregivers by convenience sampling in the Department of Hematology of Children’s Hospital of Chongqing Medical University for a survey using the General Information Questionnaire， Rutter Child Behavior Questionnaire，General Family Functioning Scale， and Social Support Rating Scale. The behavioral characteristics of children with acute leukemia were categorized using a latent class analysis， and the effects of various factors on different categories were analyzed using a multinomial logistic regression analysis.Results TThe behavioral characteristics of children with acute leukemia were classified into three types： impulsive-unfriendly type（50%），emotional-somatic disorder type （33.66%），and well-behaved type（16.34%）. The multinomial logistic regression analysis showed that unhealthy family functioning and male were more frequently associated with the impulsive-unfriendly type compared with the well-behaved type； unhealthy family functioning，male，and being in the treatment period were more frequently associated with the emotional-somatic disorder type compared with the well-behaved type；and children in the treatment period were prone to developing the impulsive-unfriendly type compared with the emotional-somatic disorder type.Conclusion Children with acute leukemia have distinct types of behavioral features， which are closely related to family functioning， sex， and disease stage. Therefore， for different behavioral types， targeted individualized interventions should be developed to prevent or reduce the occurrence of behavioral problems in children with acute leukemia， improving their social adaptability and quality of life.