Correlation Study On The Pediatric Self-reported Health Outcomes And Family Management Among Children With Leukemia

ObjectiveTo understand the health outcomes of children with leukemia: the outcome of emotional health,the outcome of the disease,the social health outcome,the status of the physical function of the outcome,analyze their influencing factors,To understand the current situation of family management;to explore the relationship between self-reported health outcomes and family management.To understand the factors affecting the decline of children's health status,in order to improve the level of daily care for children with leukemia,and help health care workers developing individualized clinical decision-making of leukemia.MethodUsing the convenience sampling method,we respectively selected 280 cases of children aged8-17 years and their parents in the Department of Hematology of Zhengzhou City from three hospitals of three first class hospital during September 2015 to March 2016.The research tools were as follows:(1)the self-designed general situation questionnaire;(2)Chinese Version of Child-Reported Cancer Related Pediatric Patient-Reported Outcomes Measure Information System(3)Chinese version of the family management measurement scale.Statistical methods: t test,ANOVA,Pearson correlation analysis,Binary Logistic regression analysis.Result1.Health-related outcomes of self-report scores:The total score of emotional health outcomes(48.31±8.12)was at the critical value,and the depression score(49.82±9.98)was the highest in it.Symptomsscore(50.89±9.27)was slightly higher than standard threshold,the symptom of Pain score was the highest(51.67±11.25).The total score of social health outcomes(42.83±6.77)and Physical function(43.02±6.42)all were lower than standard threshold,the upper limb function score(42.43±7.48)was the lowest.2.Family management style scores:The scores of disease-related concerns(33.66±4.79),disease management difficulties(46.95±7.75),energy consumption(15.03±2.95)were higher.The scores of children's daily life(15.07±3.64),disease management capacity(39.72±4.63)and parents' support with each other(24.85±8.14)were in the middle of the range.The total score on Family management measure was in the median.3.The results of univariate analysis for C-C-Pediatrics PROMIS was showed as follows: The score on emotional health outcomes could distinguish the significant exist among children's age,hospitalization and household income(P <0.05).The scores of emotional health outcomes and depression scores were higher for children aged 13-17 than children aged 8-12(P<0.05).The score on symptoms outcomes could distinguish the exist between different grades of fathers,pediatric different stages of treatment(P<0.05).The scores on fatigue symptoms and pain symptoms of children with leukemia were significantly higher than those without progression-free survival(P<0.05).The score on social health outcomes could distinguish the exist between different gender,different stages of treatment,different occupations state of their mothers(P<0.05);the score of peer relationship in male Patients was higher than female patients(P<0.05).The score on physical function could distinguish the exist of the different treatment stages and the period of disease process(P<0.05).The physical mobility of children whose disease process was more than 2 years was better than the the children whose disease process was less than2 years.4.The results of univariate analysis of family management measure patterns in children with leukemia:The results of univariate analysis showed that the difference of hospitalization,father's education,family income and cost payment method were Statistically significant(P<0.05).There were significant differences in children's daily living condition(P<0.05)between the different sick time,family monthly income,mother's professional status.when the mother was in a non-working state(leaving or housewife),the child 's daily life status score was higher than when the mother was on daily work status(P<0.05).There were significant differences in the scores of parents' disease management difficulties for different residence areas and whether they were only children(P<0.055.The results of pearson correlation analysis analysis:The physical function of children with leukemia had significant respectively positive correlation with the daily life status of the children,management ability of the parents and the mutual support of the parents(P<0.05),and had negative correlation with parental disease management,parental disease worry and parental disease energy consumption(P<0.05).The emotional health outcomes were negatively correlated with children's daily life,parents' disease management ability and Parental support status(P<0.05).The difficult of disease management was showed the positive correlation with emotional health outcomes and symptoms outcomes(P<0.05).6.The results of Binary Logistic regression analysis of self-reported healthy outcomes in children with leukemia: the factors that family income,disease management difficulties are predictors of the emotion outcome.The factors that the daily life status of children,father's educational level are predictors of the symptom outcome.The factors that children's daily life is the predictor of social health outcomes.The factors that time of illness is the predictor of the body function outcomes.Results1.Leukemia children self-reported emotional health outcomes at a critical level,children with negative emotional tendencies,and the most obvious tendency to depression.Children with pain,fatigue symptoms are more prominent,lower levels of social health outcomes,physical function damage due to disease,children with poor health status.Family income,daily life status of children,parental disease management capacity status,parental disease fears and family management methods have an impact on self-reported emotional health outcomes.Mothers 'occupational status,mothers' cultural level,disease treatment stage,children's daily living conditions,disease energy consumption,disease management difficulties,and disease worry status have an impact on self-reported symptoms.Whether the children are the only child,gender,mother's occupational status,treatment stage,family management method,parents worry about the situation,parents support each other,parental energy consumption,children's daily living conditions for self-reported social health outcomes The The duration of illness,the stage of treatment,the status of parental support,the state of energy consumption,the status of disease management and the daily living conditions of children have an impact on the outcome of self-reported physical function.2.The family management mode of leukemia children is patient type,and the disease management is in the middle level,and the family management status is not optimistic.3.The emotional health outcomes and social health outcomes of leukemia children were positively related to the family management style.The improvement of parental disease management ability in children with leukemia is helpful for children to reduce depression,anxiety and negative emotions,and parents think that the more difficult the disease is managed,the more energy is consumed,The worse negative emotional outcome and fatigue symptoms outcome.Therefore,the promotion of family management to a positive and optimistic direction,helps to reduce the incidence of adverse Resultsoutcomes,to help children relieve symptoms of disease,thereby improving the quality of life of children and promote good health.