目的 探讨特发性中枢性性早熟(ICPP)女童的生活质量受损特征及其主要影响因素,为制定以患儿心理支持为核心、家长情绪管理为重点、家庭功能优化为基础的综合干预策略提供依据。方法 选取2022年1月—2023年12月在东莞第一医院确诊为ICPP的179例女童作为病例组,按年龄匹配健康女童 178 例作为对照组。采用一般资料问卷、儿少主观生活质量问卷量表(ISLQ)、儿童用家庭功能评估量表(FFAS-C),评估两组女童的一般情况、生活质量和家庭功能。使用焦虑自评量表(SAS)和抑郁自评量表(SDS)评估家长心理状态。采用Pearson相关分析和多元线性回归模型分析ICPP女童生活质量的影响因素。结果 病例组ISLQ总分及各维度(除家庭生活和生活环境维度)评分均低于对照组(P<0.05)。病例组ISLQ总分与FFAS-C评分(r＝-0.43)、家长SAS评分(r＝-0.45)及SDS评分(r＝-0.40)呈中等程度负相关(P<0.05)。多元线性回归分析显示,家庭月收入、主要照护者文化程度与ISLQ总分呈正相关(β=0.12、0.12,P<0.05),FFAS-C评分、家长SAS评分及SDS评分与ISLQ总分呈负相关(β＝-0.17、-0.55、-0.67,P<0.05);家长心理状态对生活质量影响最为显著。结论 ICPP女童生活质量在多维程度上受损,其中学校生活、同伴交往、自我认识及情绪相关维度影响较明显。家庭功能及家长心理状态是其重要影响因素。临床应建立“患儿-家长-家庭”综合干预体系提升患儿的生活质量。
Abstract
Objective To investigate the characteristics of quality of life impairment and its influencing factors in girls with idiopathic central precocious puberty (ICPP), and to provide evidence for comprehensive clinical intervention. Methods A total of 179 girls diagnosed with ICPP in the First Dongguan Hospital Affiliated to Guangdong Medical University, from January 2022 to December 2023 were enrolled as the case group, and 178 age-matched healthy girls were included as the control group. General information questionnaires, the Inventory of Subjective Life Quality for Children (ISLQ), and the Family Functioning Assessment Scale for Children (FFAS-C) were used to assess demographic characteristics, quality of life, and family functioning. Parental psychological status was evaluated using the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS). Pearson correlation analysis and multiple linear regression analysis were performed to identify factors associated with quality of life in girls with ICPP. Results Compared with the control group, the case group had significantly lower ISLQ total scores and lower scores in the domains of school life, peer interaction, self-perception, somatic emotion, depressive experience, and anxiety experience (P<0.05), while no significant differences were found in family life or living environment (P>0.05). In the case group, ISLQ total score was moderately negatively correlated with FFAS-C score, parental SAS score, and parental SDS score (r＝-0.43,-0.45,-0.40, P<0.05). Multiple linear regression analysis showed that monthly household income and primary caregiver's educational level were positively associated with ISLQ total score (β=0.12, 0.12, P<0.05), whereas FFAS-C score, parental SAS score, and parental SDS score were negatively associated with ISLQ total score (β＝-0.17,-0.55,-0.67, P<0.05). Parental psychological status had greatest impact on the total score of ISLQ. Conclusions Girls with ICPP show multidimensional impairment in quality of life, particularly in school life, peer interaction, self-perception, and emotional domains. Family functioning and parental psychological status are important factors associated with their quality of life. Comprehensive interventions targeting the child, parents, and family should be emphasized in clinical practice.
关键词
性早熟 /
生活质量 /
家庭功能 /
父母心理健康
Key words
precocious puberty /
quality of life /
family functioning /
parental mental health
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参考文献
[1] 中华医学会儿科学分会内分泌遗传代谢学组,中华儿科杂志编辑委员会.中枢性性早熟诊断与治疗专家共识(2022)[J].中华儿科杂志,2023,61(1):16-22.
Endocrine and Genetic Metabolism Group of Pediatric Branch of Chinese Medical Association, Chinese Journal of Pediatrics Editorial Board. Expert consensus on diagnosis and treatment of central precocious puberty (2022)[J]. Chin J Pediatr, 2023, 61(1): 16-22.(in Chinese)
[2] Kang S, Park MJ, Kim JM, et al. Ongoing increasing trends in central precocious puberty incidence among Korean boys and girls from 2008 to 2020[J]. PLoS One, 2023, 18(3):e0283510.
[3] Micangeli G, Paparella R, Tarani F, et al. Clinical management and therapy of precocious puberty in the Sapienza University Pediatrics Hospital of Rome[J] , Italy. Children (Basel),2023, 10(10):1672.
[4] Shi L, Jiang Z, Zhang L. Childhood obesity and central precocious puberty[J]. Front Endocrinol (Lausanne), 2022, 13:1056871.
[5] Lin WY, Hou JW, Huang L, et al. Sleep duration transitions among children with central precocious puberty across pubertal development[J]. J Adolesc Health, 2025, 77(2):324-330.
[6] Turan AP, Akca SO. The quality of life of children with precocious puberty and healthy children in Turkey[J]. Am J Health Behav, 2021, 45(1):62-70.
[7] Kardaš B, Kardaš Ö, Demiral M, et al. Early puberty paradox: An investigation of anxiety levels of mothers and children, children's quality of life, and psychiatric diagnoses[J]. Eur J Pediatr, 2023, 182(8):3775-3783.
[8] Raafat S, Abdelaal E, Mowafi I, et al. Assessment of quality of life and behavioral problems in children with central precocious puberty[J]. Oman Med J, 2024, 39(5):e670.
[9] Yilmazer I·N, Abseyi SN, enyazar G, et al. Evaluation of quality of life in children with precocious puberty[J]. Clin Endocrinol (Oxf), 2024, 100(4):338-342.
[10] Tung VS, Thong NV, Mai NP, et al. Diagnostic value in screening severe depression of the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Beck Depression Inventory Scale, and Zung's Self-Rating Anxiety Scale among patients with recurrent depression disorder[J]. Acta Inform Med, 2023, 31(4):249-253.
[11] Yue T, Li Q, Wang R, et al. Comparison of Hospital Anxiety and Depression Scale (HADS) and Zung Self-Rating Anxiety/Depression Scale (SAS/SDS) in evaluating anxiety and depression in patients with psoriatic arthritis[J]. Dermatology, 2020, 236(2):170-178.
[12] 栾风焕.中文版女童用家庭功能评估量表(FFAS-C)的修订及应用[D].上海:上海交通大学,2018.
Luan FH. Revision and application of the Chinese version of the Family Functioning Assessment Scale for Children (FFAS-C)[D].Shanghai: Shanghai Jiao Tong University, 2018. (in Chinese)
[13] 程灶火,高北陵,彭健,等.儿少主观生活质量问卷的编制和信效度分析[J].中国临床心理学杂志,1998, 6(1):11-16.
Cheng ZH, Gao BL, Peng J, et al. The Inventory of Subjective Life Quality for Child and adolescent:Development, reliability,and validity[J]. Chin J Clin Psychol, 1998, 6(1): 11-16. (in Chinese)
[14] Koca SB, Büyükyilmaz G, Ta D. Do body esteem and quality of life scores change with puberty signs or precocious puberty treatment?[J]. J Pediatr Endocrinol Metab, 2024, 37(9):804-810.
[15] Çoban ÖG, Bedel A, Önder A, et al. Psychiatric disorders, peer-victimization, and quality of life in girls with central precocious puberty[J]. J Psychosom Res, 2021, 143:110401.
[16] Varni JW, Thompson KL, Hanson V. The Varni/Thompson Pediatric Pain Questionnaire I. Chronic musculoskeletal pain in juvenile rheumatoid arthritis[J]. Pain, 1987, 28(1):27-38.
[17] Huang H, Liu L, Su S, et al. Self-consciousness and depression in precocious pubertal children[J]. J Int Med Res, 2021, 49(5):03000605211020227.
[18] Chen J, Cao L, Chen X, et al. Therapeutic outcomes of GnRHa and rhGH in idiopathic central precocious puberty: A focus on psychological and behavioral improvements[J]. BMC Pediatr, 2025, 25(1):655.
[19] Peltz J, Zhang L, Sasser J, et al. The influence of pubertal development on early adolescent sleep and changes in family functioning[J]. J Youth Adolesc, 2024, 53(2):459-471.
[20] Hu SJ, Li Y, Yang QH, et al. Family functioning mediation in tic severity and quality of life for children with Tourette syndrome[J]. World J Psychiatry. 2024, 14(11):1641-1651.
[21] Ho YL, Mahirah D, Ho CZ, et al. The role of the family in health promotion: A scoping review of models and mechanisms[J].Health Promot Int, 2022, 37(6):daac119.
[22] Kerr ME, Bowen M. Family evaluation: An approach based on Bowen theory[M]. New York: W.W. Norton & Company, 1988.
[23] Yang H, Luo S, Liang X, et al. The association between family impact and health-related quality of life of children with idiopathic central precocious puberty in Chongqing, China[J]. Health Qual Life Outcomes, 2021, 19(1):171.
[24] Gautam N, Rahman MM, Hashmi R, et al.Socioeconomic inequalities in child and adolescent mental health in Australia: The role of parenting style and parents' relationships[J]. Child Adolesc Psychiatry Ment Health, 2024, 18(1):28.
[25] Joseph R, Etterman E. Nurses' role in caring for girls with precocious puberty[J]. Nurs Child Young People,2023.doi:10.7748/ncyp.2023.e1480.
[26] 耿跃,张立双,商然.精细心理干预改善特发性中枢性性早熟女童心理状态与生活质量的价值[J].河北医药,2023,45(18):2877-2880.
Geng Y, Zhang LS, Shang R. Value of fine psychological intervention in improving mental state and quality of life of female children with idiopathic central precocious puberty[J]. Hebei Med J, 2023, 45(18): 2877-2880. (in Chinese)
[27] Rahimi F, Mirghafourvand M, Farvareshi M,et al. The effect of cognitive behavioral therapy on stress and anxiety of mothers of girls with precocious puberty symptoms: A randomized controlled trial[J]. BMC Psychiatry, 2023, 23(1):738.
基金
东莞市社会发展科技面上项目及高水平医院建设专项(第二批)(20231800937422);广东医科大学附属东莞第一医院“攀峰100”联合培优计划(PF100-1-06);广东医科大学附属东莞第一医院院内科研培育计划(PY2023008)
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