残疾儿童照护者焦虑状态及影响因素分析

doi:10.3969/j.issn.1006-9771.2021.10.005

《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (10): 1152-1158.doi: 10.3969/j.issn.1006-9771.2021.10.005

• 专题残疾儿童康复与照护研究 • 上一篇下一篇

残疾儿童照护者焦虑状态及影响因素分析

夏聪^1,²,孙梅^1,^2,³(),吕军^1,^2,³,邱服冰⁴,邱芬⁵,郑红颖^1,²

1.复旦大学公共卫生学院,上海市 200032
2.复旦大学中国残疾问题研究中心,上海市 200032
3.国家卫生健康委员会卫生技术评估重点实验室（复旦大学）,上海市 200032
4.深圳大学体育部体育与健康科学研究中心,广东深圳市 518060
5.武汉理工大学体育部体育科学研究所,湖北武汉市 430070

收稿日期:2021-08-20 修回日期:2021-08-30 出版日期:2021-10-25 发布日期:2021-10-29
通讯作者: 孙梅 E-mail:sunmei@fudan.edu.cn
作者简介:夏聪(1993-),女,汉族,安徽宿州市人,博士研究生,主要研究方向：健康服务政策与治理。
基金资助:
国家社会科学基金重大项目(17ZDA078);国家自然科学基金面上项目(71774030);上海市哲学社会科学规划一般课题(2018BGL005)

Anxiety and Its Influencing Factors of Caregivers for Children with Disabilities

XIA Cong^1,²,SUN Mei^1,^2,³(),LÜ Jun^1,^2,³,QIU Fu-bing⁴,QIU Fen⁵,ZHENG Hong-ying^1,²

1. School of Public Health, Fudan University, Shanghai 200032, China
2. China Research Center on Disability, Fudan University, Shanghai 200032, China
3. National Health Commission Key Laboratory of Health Technology Assessment (Fudan University), Shanghai 200032, China
4. Research Center of Physical Education, Sport and Health of Department of Physical Education, Shenzhen University, Shenzhen, Guangdong 518060, China
5. Institute for Sport Science/Department of Physical Education of Wuhan University of Technology, Wuhan, Hubei 430070, China

Received:2021-08-20 Revised:2021-08-30 Published:2021-10-25 Online:2021-10-29
Contact: SUN Mei E-mail:sunmei@fudan.edu.cn
Supported by:
National Social Science Foundation of China (Major)(17ZDA078);National Natural Science Foundation of China (General)(71774030);Shanghai Philosophy and Social Science Project(2018BGL005)

摘要/Abstract

摘要：

目的调查残疾儿童照护者焦虑状态并分析相关影响因素。方法 2019年12月至2020年1月以及2020年8月至9月,方便抽样方法选取在上海市残疾儿童家庭照护者496例。应用交叉列联表分析照护者的焦虑状态,应用二分类Logistic回归分析照护者焦虑状态的相关影响因素。结果 496例照护者中,父母占73.2%,祖父母占26.8%。被照护残疾儿童中肢体残疾最多(26.0%)。照护者中35.1%存在焦虑,超过10%存在中重度焦虑。Logistic回归分析显示,照护者个人因素中,(外)祖父报告的焦虑比例是母亲的0.318倍(OR = 0.318, 95%CI 0.113~0.900, P = 0.031)。被照护对象因素中,有睡眠问题(OR = 1.713, 95%CI 1.046~2.805, P = 0.032)和情绪稳定性(OR_一般 = 0.057, 95%CI 0.009~0.340, P = 0.002; OR_稳定 = 0.031, 95%CI 0.005~0.205, P < 0.001)对照护者报告的焦虑比例有明显影响。家庭环境因素中,家庭人均月收入(OR_{5000~< 10000元} = 0.463, 95%CI 0.236~0.909, P = 0.025; OR_≥10000元 = 0.325, 95%CI 0.160~0.660, P = 0.002)和住房性质(OR = 0.356, 95%CI 0.208~0.608, P < 0.001)对照护者报告的焦虑比例有影响。社会环境因素中,对当前无障碍环境建设满意的照护者报告的焦虑比例更低(OR_满意= 0.136, 95%CI 0.031~0.602, P = 0.009)。结论残疾儿童照护者的焦虑状态明显高于普通人群。当被照护残疾儿童存在睡眠问题或情绪不稳定、家庭月收入低以及对社会无障碍环境不满意时,照护者的焦虑水平会更高。

关键词: 残疾儿童, 照护者, 焦虑, 影响因素

Abstract:

Objective To investigate the anxiety state and its influencing factors for caregivers of children with disabilities.Methods From December, 2019 to January, 2020, and August to September, 2020, a total of 496 family caregivers of children with disabilities were surveyed in Shanghai. Crosstab was used to analyze the anxiety state and binary logistic regression analysis was used for identifying key factors.Results There were 73.2% parents and 26.8% grandparents among 496 caregivers. Physical disabilities accounted most (26.0%) in the children. About 35.1% caregivers reported their anxiety state, and more than 10% reported moderate to severe anxiety. The results of logistic regression analysis showed that grandfather reported 0.318 times anxiety to mother (OR = 0.318, 95%CI 0.113 to 0.900, P = 0.031). Sleep problems (OR = 1.713, 95%CI 1.046 to 2.805, P = 0.032) and emotional functioning (OR_generally = 0.057, 95%CI 0.009 to 0.340, P = 0.002; OR_stable = 0.031, 95%CI 0.005 to 0.205, P < 0.001) of children were associated with the rate of caregiver-reported anxiety. Among family environment factors, monthly per capita household income (OR_{5000-< 10000 Yuan} = 0.463, 95%CI 0.236 to 0.909, P = 0.025; OR_{≥ 10,000 Yuan} = 0.325, 95%CI 0.160 to 0.660, P = 0.002) and housing status (OR = 0.356, 95%CI 0.208 to 0.608, P < 0.001) were associated with the rate of caregiver-reported anxiety. Among social environment factors, caregivers who were satisfied with current accessibility reported lower rate of anxiety (OR_satisfied = 0.136, 95%CI 0.031 to 0.602, P = 0.009).Conclusion The anxiety state of caregivers of children with disabilities is higher than that of the general population. When caregivers are caring for a child with sleep problem or emotional issue, have low household income, or dissatisfied with the barrier-free environment, they may face higher risk of anxiety.

Key words: children with disabilities, caregivers, anxiety, influencing factors

中图分类号:

夏聪,孙梅,吕军,邱服冰,邱芬,郑红颖. 残疾儿童照护者焦虑状态及影响因素分析[J]. 《中国康复理论与实践》, 2021, 27(10): 1152-1158.

XIA Cong,SUN Mei,LÜ Jun,QIU Fu-bing,QIU Fen,ZHENG Hong-ying. Anxiety and Its Influencing Factors of Caregivers for Children with Disabilities[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(10): 1152-1158.

图/表 3

表1

表2

表3

影响残疾儿童照护者焦虑状态相关因素的Logistic回归分析"

维度	变量(参照变量)	B	S.E.	χ²值	P值	OR	95%CI
照护者	家庭角色(母亲)			5.895	0.117
	父亲	-0.372	0.298	1.556	0.212	0.689	0.384~1.237
	(外)祖母	-0.061	0.324	0.036	0.850	0.941	0.499~1.774
	(外)祖父	-1.145	0.530	4.663	0.031	0.318	0.113~0.900
	患病状况(无疾病)	0.339	0.264	1.650	0.199	1.404	0.837~2.357
	应对方式(消极应对)	0.482	0.286	2.842	0.092	1.620	0.925~2.838
被照护对象	年龄(< 6岁)	0.006	0.247	0.001	0.979	1.006	0.621~1.632
	性别(男)	-0.116	0.232	0.248	0.619	0.891	0.565~1.404
	残疾类型(未定残)			10.738	0.150
	视力	-0.968	0.660	2.149	0.143	0.380	0.104~1.385
	听力	-0.844	0.463	3.329	0.068	0.430	0.174~1.065
	言语	-0.610	0.581	1.101	0.294	0.543	0.174~1.698
	肢体	0.194	0.382	0.259	0.611	1.215	0.575~2.566
	智力	0.123	0.461	0.072	0.789	1.131	0.459~2.791
	精神	-0.130	0.442	0.087	0.769	0.878	0.370~2.087
	多重	0.209	0.473	0.196	0.658	1.232	0.488~3.112
	睡眠质量(无睡眠问题)	0.538	0.252	4.581	0.032	1.713	1.046~2.805
	情绪稳定性(不稳定)			13.297	0.001
	一般	-2.870	0.913	9.876	0.002	0.057	0.009~0.340
	稳定	-3.470	0.961	13.038	< 0.001	0.031	0.005~0.205
家庭环境	家庭人均月收入(< 3000元)			9.976	0.019
	3000~< 5000元	-0.583	0.353	2.739	0.098	0.558	0.280~1.113
	5000~< 10000元	-0.769	0.344	4.998	0.025	0.463	0.236~0.909
	≥ 10000元	-1.124	0.362	9.654	0.002	0.325	0.160~0.660
	住房性质(租住房屋)	-1.033	0.273	14.262	< 0.001	0.356	0.208~0.608
	家庭氛围(和睦)	0.444	0.244	3.319	0.068	1.559	0.967~2.514
社会环境	公共政策(不满意)			3.569	0.168
	一般	-0.726	0.388	3.496	0.062	0.484	0.226~1.036
	满意	-0.836	0.708	1.396	0.237	0.433	0.108~1.735
	社会态度(不友好)			1.305	0.521
	一般	-0.475	0.426	1.245	0.265	0.622	0.270~1.432
	友好	-0.543	0.553	0.965	0.326	0.581	0.197~1.717
	总体无障碍建设(不满意)			6.906	0.032
	一般	-0.959	0.550	3.044	0.081	0.383	0.130~1.126
	满意	-1.998	0.761	6.896	0.009	0.136	0.031~0.602
常量		5.194	1.238	17.614	< 0.001	180.199

表3

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家庭角色	被照护对象残疾类型								合计
家庭角色	视力	听力	言语	肢体	智力	精神	多重	未定残	合计
母亲	12(4.5)	40(15.1)	20(7.5)	61(23.0)	28(10.6)	40(15.1)	36(13.6)	28(10.6)	265(100.0)
父亲	12(12.2)	17(17.3)	5(5.1)	22(22.4)	8(8.2)	13(13.3)	10(10.2)	11(11.2)	98(100.0)
(外)祖母	4(4.4)	9(10.0)	4(4.4)	36(40.0)	11(12.2)	7(7.8)	4(4.4)	15(16.7)	90(100.0)
(外)祖父	4(9.3)	6(14.0)	3(7.0)	10(23.3)	7(16.3)	1(2.3)	4(9.3)	8(18.6)	43(100.0)
合计	32(6.5)	72(14.5)	32(6.5)	129(26.0)	54(10.9)	61(12.3)	54(10.9)	62(12.5)	496(100.0)

维度	变量		是否焦虑
维度	变量		无焦虑	焦虑
照护者	家庭角色	母亲	160(60.4)	105(39.6)
		父亲	73(74.5)	25(25.5)
		(外)祖母	53(58.9)	37(41.1)
		(外)祖父	36(83.7)	7(16.3)
	患病状况	有疾病	87(56.1)	68(43.9)
		无疾病	235(68.9)	106(31.1)
	应对方式^a	积极应对	247(65.7)	129(34.3)
		消极应对	75(66.4)	38(33.6)
被照护对象	年龄	0 ~< 6岁	188(67.4)	91(32.6)
		6~18岁	134(61.8)	83(38.2)
	性别	男	194(63.4)	112(36.6)
		女	128(67.4)	62(32.6)
	残疾类型	视力	27(84.4)	5(15.6)
		听力	58(80.6)	14(19.4)
		言语	25(78.1)	7(21.9)
		肢体	77(59.7)	52(40.3)
		智力	29(53.7)	25(46.3)
		精神	36(59.0)	25(41.0)
		多重	28(51.9)	26(48.1)
		未定残	42(67.7)	20(32.3)
	睡眠质量	有睡眠问题	66(50.0)	66(50.0)
		无睡眠问题	256(70.3)	108(29.7)
	情绪稳定性	不稳定	2(16.7)	10(83.3)
		一般	254(63.2)	148(36.8)
		稳定	66(80.5)	16(19.5)
家庭环境	家庭人均	< 3000元	35(46.7)	40(53.3)
	月收入^b	3000~< 5000元	73(61.9)	45(38.1)
		5000~< 10000元	105(68.2)	49(31.8)
		≥ 10000元	106(73.1)	39(26.9)
	住房性质^c	租住房屋	49(50.5)	48(49.5)
		自有房屋	273(68.6)	125(31.4)
	家庭氛围^c	不和睦	186(59.4)	127(40.6)
		和睦	136(74.7)	46(25.3)
社会环境	公共政策^d	不满意	20(43.5)	26(56.5)
		一般	283(66.7)	141(33.3)
		满意	19(79.2)	5(20.8)
	社会态度^d	不友好	16(39.0)	25(61.0)
		一般	254(66.3)	129(33.7)
		友好	52(74.3)	18(25.7)
	总体无障	不满意	7(28.0)	18(72.0)
	碍建设^d	一般	284(66.0)	146(34.0)
		满意	31(79.5)	8(20.5)

残疾儿童照护者焦虑状态及影响因素分析

Anxiety and Its Influencing Factors of Caregivers for Children with Disabilities

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