| Objective:In this study,the quality of life of children with chronic cough aged 6～14 years was investigated,and the influencing factors were analyzed in depth,with special focus on the analysis of the distribution characteristics of etiology,so as to provide empirical evidence for the formulation of clinical etiological diagnosis and treatment plan for the disease,evaluation of treatment effect,and formulation of accurate health management plan to improve the quality of life of children.Methods:1、Literature review method: PUBMED English Abstract database,Chinese biomedical Database and Wanfang Chinese database were used for online searching."Chronic cough in children,children’s health management,life quality assessment and cough score" were used as keywords to search relevant literature,and various assessment methods were summarized and summarized.2、Scale evaluation method: using system(mechanical)sampling method,the selection of 6 ～ 9 months in 2018 in one secondary hospital pediatric clinic of 110 cases of children with chronic cough as the research object,using the general condition of scale "to collect demographic information,children use" Mr Setser cough scale(LCQ)and cough symptoms scale(VCD)for children with the comprehensive assessment of the quality of life.3、Data analysis: SPSS17.0 statistical software was used to analyze the data.T-test and one-way an OVA were used for the influence of general conditions on the quality of life of the children;multiple linear regression and Logistic regression were used for the influence factors of the quality of life of the children;chi-square test and rank sum test were used for the distribution of causes.4、Focus interview method: 10 representative children and caregivers were selected as interview subjects,and interviews were conducted by self-made semi-structured interview questionnaire,so as to understand the impact of chronic cough on the quality of life and family function of children.Results:1、The quality of life of the children was low: the average LCQ score was 13.314±2.185,and the average VCD score was 3.25±1.07,which was in a poor state overall.2、Analysis of influencing factors of children’s quality of life: LCQ assessment results showed that there was no statistical difference in quality of life between "gender and BMI"(P>0.05).In the "age,etiology,course,caregivers,medical insurance,school performance,whether smoking exposure environment and contact allergy source" on statistical differences: low age group(6 ～ 9 years old)with high age group(10 ～ 14 years of age)in the field of psychology,social life quality score was statistically difference(P < 0.05),higher age groups poorer quality of life;There were statistically significant differences in the quality of life scores of "variable asthma(CVA),respiratory infection,post-infection cough(PIC),and upper airway syndrome(UACS)" among different causes(P <0.05),with CVA having the greatest impact on quality of life.With the progression of the disease,the quality of life of the children decreased progressively,among which the psychological function damage was the most obvious.The main caregivers are the parents with a higher quality of life than the children with intergenerational care.There was a correlation between the level of medical care and school performance and the quality of life of the children,and the deterioration of the quality of life of the children was related to the exposure to allergens and the environment of smoking.VCD evaluation results showed that cough severity in the cause,course,whether the contact allergens and exposure to smoke environment was statistically difference,by Logistic regression analysis found that the course of the disease severity and cough were positively correlated,the causes are the influence factors of cough severity,children with different etiologies cough severity is different(CVA > UACS > PIC),exposure to smoke environment and contact allergens can worsen symptoms of cough.3、Analysis of pathogenetic distribution composition: PIC had the shortest disease course and CVA had the lowest quality of life.Comparison of pathogenetic distribution by age group showed that CVA accounted for the most in the lower age group and UACS accounted for the most in the higher age group.There were no significant differences in quality of life between sexes and body mass index(BMI)under the same etiology(P>0.05).There were statistically significant differences among different ages and course of disease(P<0.05).4、Results of the focus interview: It was found that chronic cough led to psychological problems such as "anxiety,depression,pessimism,withdrawal and inferiority",as well as the fear that cough would affect companions and people around,resulting in social avoidance and social function decline.The caregivers’ worry about the illness and treatment of the children,as well as long-term care,leads to energy fatigue,anxiety,tension and other emotions.At the same time,the prolonged illness brings great economic pressure to the family.Conclusion:1、The quality of life of the children was poor.LCQ scale assessment showed that chronic cough not only affected its physiological function,but also had a certain impact on its psychological,family and social functions.VCD assessment results showed that 68% of the children had scores above 3,indicating that more than half of the children’s sleep quality was affected.The interview results also suggest that cough has a serious impact on the psychological,social and family functions of children.Therefore,we should pay attention to the psychological and social impact of cough on children and take active intervention measures to improve the quality of life of children.2、There are many factors affecting the quality of life of children.These included "age,etiology,course of illness,school performance,identity of primary caregiver,participation in health insurance,exposure to smoking environment and exposure to allergens".Accordingly,we should establish a systematic andaccurate health management plan to guide the whole rehabilitation process of children: information-based management based on big data information;Supported by the collaboration of medical consortium,we should do a good job in the "level-3-level-2-Community hospital" referral docking step bystep.Take family care as the starting point and promote the "family health management mode" to achieve sustained rehabilitation;The four-level network management mode of "hospital-community-family-school" was constructed to improve the cognition and management level of school health personnel.To pay attention to the "biological,psychological and social" functions of children in a comprehensive way as the goal,set up a team to provide integrated health management;Efforts will also be made to increase the coverage of medical insurance for children and reduce the burden of medical treatment on families.Exposure to allergens and smoking environment are risk factors for cough severity.Therefore,attention should be paid to the living and living environment of children,and individualized health management plan should be adopted for accurate intervention.3、Focus on etiological composition.The main etiologies of children in different age groups are different,and the course of disease caused by different etiologies is also different.In clinical practice,targeted treatment means should be adopted.The combination of Traditional Chinese and western medicine,especially the traditional Chinese medicine treatment,has been neglected for a long time,and should be included in the standard treatment plan. |
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