目的 调查学龄期支气管哮喘患儿自我管理行为,并分析其影响因素,为儿童支气管哮喘的预防干预提供科学依据。方法 选取平顶山市妇幼保健院2020年1月—2021年5月诊治的132例学龄期支气管哮喘患儿作为研究对象,采用哮喘儿童自我管理量表对其自我管理行为进行调查,并采用多因素Logistic回归分析法分析学龄期支气管哮喘患儿自我管理行为的影响因素。结果 132例学龄期支气管哮喘患儿自我管理行为总得分为(119.76±19.32)分,日常生活管理行为得分为(23.13±3.51)分,疾病医学管理行为得分为(62.88±10.27)分,社会心理管理行为得分为(33.75±5.54)分。年龄11~14岁、病程＞4年、监护人大专及以上文化程度患儿的日常生活、疾病医学、社会心理得分及自我管理行为总分均高于年龄7~10岁、病程＜2年或2~4年与监护人初中及以下和高中/中专文化程度的患儿(日常生活:t=4.838,F=8.928、8.764;疾病医学:t=3.507,F=9.205、6.514;社会心理:t=3.901,F=12.028、9.635;自我管理行为总分:t=3.865,F=9.939、7.791,P＜0.01);有家族史患儿的疾病医学得分及自我管理行为总分高于无家族史的患儿(t=2.876、2.088,P＜0.05);不同教育方式患儿的疾病医学、社会心理得分及自我管理行为总分比较,差异有统计学意义(F=3.469、73.525、8.410,P＜0.05或＜0.01)。多因素Logistic回归分析发现,年龄11~14岁(OR=0.297,96%CI:0.139~0.541)、有家族史(OR=0.600,96%CI:0.327~0.852)、教育方式为说服教育(OR=0.484,96%CI:0.206~0.713)是学龄期支气管哮喘患儿整体自我管理行为的保护因素(P＜0.05),病程2~4年(OR=1.837,95%CI:1.237~2.549)、病程＜2年(OR=2.881,95%CI:2.175~3.624)、监护人文化程度高中/中专(OR=1.782,95%CI:1.266~2.582)、监护人文化程度初中及以下(OR=3.019,95%CI:2.352~3.607)、教育方式为打骂教育(OR=1.322,95%CI:1.017~1.823)是其危险因素(P＜0.05)。结论 学龄期支气管哮喘患儿的自我管理行为仍有一定的上升空间,其受患儿年龄、病程、监护人文化程度、家族史及教育方式的影响,行自我管理教育时需从多个角度去分析、考虑,以提高支气管哮喘患儿的自我管理能力。

Objective To investigate the self-management behavior of school-age children with bronchial asthma, and to analyze its influencing factors, so as to provide scientific reference for the prevention and intervention of bronchial asthma in children. Methods A total of 132 school-age children with bronchial asthma treated in Pingdingshan Maternal and Child Health Hospital from January 2020 to May 2021 were selected as the study subjects. The self-management behavior of asthmatic children was investigated by questionnaire, and the influencing factors of self-management behavior of school-age children with bronchial asthma were determined by multivariate Logistic regression analysis. Results The total score of self-management behavior of 132 school-age children with bronchial asthma was(119.76±19.32) points. The average score of daily life management behavior, disease medical management behavior and social psychological management behavior was(23.13±3.51) points,(62.88±10.27) points and(33.75±5.54) points, respectively. The scores of daily life, disease medicine, social psychology and total score of self-management behavior in children aged 11 to 14 years, with a course of more than 4 years and guardian's education level of college or above were higher than those in children aged 7 to 10 years, with a course of less than 2 years or 2 - 4 years and guardian's education level of junior middle school/below and senior high school/technical secondary school(daily life: t=4.838, F=8.928, 8.764; disease medicine:t=3.507, F=9.205, 6.514; social psychology: t=3.901, F=12.028, 9.635; total score of self-management behavior: t=3.865, F=9.939, 7.791, P<0.01). The scores of disease medicine and total score of self-management behavior of children with family history were higher than those without family history(t=2.876, 2.088, P<0.05). There were significant differences in the scores of disease medicine, social psychology and total score of self-management behavior in children with different education methods(F=3.469, 73.525, 8.410, P<0.05 or <0.01). Multivariate Logistic regression analysis showed that 11 to 14 years old(OR=0.297,95%CI:0.139 - 0.541), family history(OR=0.600,95%CI:0.327 - 0.852) and persuasion education(OR=0.484,95%CI:0.206 - 713) were protective factors for the better self-management behavior of school-age children with bronchial asthma(P＜0.05), but the disease course of 2 to 4 years(OR=1.837, 95%CI:1.237 - 2.549) and less than 2 years(OR=2.881,95%CI:2.175 - 3.624), guardian education degree of senior school or secondary specialized school(OR=1.782,95%CI:1.266 - 2.582)and junior high school or below(OR=3.019,95%CI:2.352 - 3.607), beating and scolding parenting style(OR=1.322, 95%CI:1.017 - 1.823) were risk factors(P＜0.05). Conclusions The self-management behavior of school-age children with bronchial asthma still needs to be improved, which is affected by the children's age, course of disease, guardian's education level, family history and parenting style. Self-management education should be considered and conducted from multiple perspectives to improve the self-management ability of children with bronchial asthma.