The Study On The Influential Factors And Nursing Of Behavior Disorders Of Nephrotic Syndrome Children

ObjectiveTo investigate the behavior characters of 3~7years old nephrotic syndrome (NS) children, and explore the influential factors from social demography, disease, treatment, and family environment. To study the application of nursing logos of Family-Centered Care(FCC) to the psychology health education of NS children. By intervention, promote behavior changes and improve the integrative treatment effectiveness of NS cases, then achieve the real meaning of physiological and psychological health as far as possible.MethodsThe study was divided into two parts: investigation analysis stage and clinic intervention stage.1. Part 1: investigation analysis stageAccording to the method of convenient sampling, 100 NS children were chose as the research objects in a 3A hospital of Fuzhou City, simultaneously 120 cases normal children were selected as the control in two town kindergartens in Fujian District. Two groups were investigated by self-design social demography questionnaire, family environment scale and child behavior questionnaire.2. Part 2: clinic intervention stageWith similar experiment design, randomly drew off 60 cases from NS children group, then divided into two groups respectively 30 cases randomly. According to the results of the early investigation stage, experiment group adopted the psychological education scheme of"Family-Centered Care"(FCC), and control group continuously received the education method which is forthcoming.All data were analyzed by SPSS 13.0 statistical software. The statistical methods were engaged as follows: Chi square, t test, rank sum test, Spearman correlation analysis and Binary logistic regression analysis. The significance level was set at 0.05. Results1. The results of the part 1(1) The incidence rate of behavior disorder of 3-7 years old NS children was 59.8%, and the control group was 28.6%, which was much lower than the former (P<0.05). The conduct, psychosomatic disorder and hyperactivity index scores in child behavior questionnaire of two groups were significantly different (p all less than 0.01).(2) In two groups of NS children and normal children, family environment scale showed that nine factors (including sense of control, intimacy, feeling expression, contradiction, independence, knowledge, entertainment, ethics and sense of organization) scores, except success factor score, were significantly different (p all less than 0.01).(3) In family environment scale, six factors (including intimacy, feeling expression, contradiction, knowledge, entertainment and sense of organization) scores was correlated with the behavior of NS children respectively (r=-0.591, -0.202, 0.475, -0.222, -0.267, -0.311, p all less than 0.05).(4) One-way factor analysis showed that recrudescence times, hospitalization times, hospitalization days and use of total amount hormone affected the behavior of NS children significantly (p all less than 0.05); Logistic regression analysis showed that persistence time of disease, use of total amount hormone and intimacy affected the behavior of NS children significantly (p all less than 0.05).2. The result of the part 2(1) In behavior questionnaire, the scores of experiment group of each factors except anxiety degraded. The scores of conduct and multi-action index degraded significantly (p=0.019, 0.037 ) after 6 months intervention.(2) In family environment scale, the scores of experiment group of intimacy, entertainment and sense of organization all improved significantly (p all less than 0.05).(3) After 6 months intervention, the behavior scores of experiment group were lower than the control group, and the score of study factor was significant lower (P=0.010).(4) After 6 months intervention, the family environment scale factors scores of experiment group were much better than the control group, and scores of intimacy, feeling expression, knowledge and entertainment showed statistical difference in two groups (p all less than 0.05). The recrudescence times of experiment group were less than the control group(P=0.040).(5) After 6 months intervention, the recrudescence times of experiment group were less than the control group(P=0.040).ConclusionThe incidence rate of NS children is higher than that of normal children, which mainly reflect at the four sides: conduct, psychosomatic disorder and hyperactivity index. The occurrence of behavior problems of NS children not only correlate with recrudescence times of disease, hospitalization times and the side effect of hormone, but also correlate with family environment. After intervention, the family environment of NS children, especially the family atmosphere and the relations of family members are improved, and the behavior of children also changes in some extent. The result indicates that, based on correctly evaluating the behavior state of patients, paramedic staff should apply the"Family-Centered Care"principle to practice psychological health education to the NS children and their whole families. These can not only boost the combined therapy efficacy of disease, but also promote optimization of the family environment, which can improve the life quality and enhance attending ability of family members, and then achieve the real meaning health. At the same time, it also provide new theory basis and methods for pediatrics clinic nursing practice.