发达地区残疾儿童生活质量现状及其影响因素分析——以上海市为例

doi:10.3969/j.issn.1006-9771.2021.10.002

Abstract

Abstract:

Objective To explore the current status of the quality of life of children with disabilities and its influencing factors.Methods From December, 2019 to January, 2020, and August to September, 2020, a total of 285 family caregivers of children with disabilities were enrolled in Shanghai. The EuroQol-5 Dimension Questionnaire Youth Version (EQ-5D-Y) was used to measure the quality of life of 285 children with disabilities. The impact of individual factors, caregiver factors, and environmental factors (family factors and social factors) on children's quality of life were analyzed using multiple linear stepwise regression analysis.Results The score of Visual Analog Scale (VAS) was (71.66±22.33). The quality of life were poorer for children with physical disabilities (B = -13.623, 95%CI -25.282 to -1.965, P = 0.022) or multiple disabilities (B = -14.911, 95%CI -27.445 to -2.377, P = 0.020), combined diseases (B = -8.995, 95%CI -14.780 to -3.210, P = 0.002), emotional instability (B = -4.414, 95%CI -7.433 to -1.395, P = 0.004), poor partnerships (B = 4.965, 95%CI 1.748 to 8.181, P = 0.003), no pre-school education (B = -7.757, 95%CI -12.954 to -2.561, P = 0.004) and grandparents as the main caregiver (B = -7.999, 95%CI -14.288 to -1.710, P = 0.013).Conclusion The quality of life for children with disabilities is relatively poor and influenced by multiple factors such as children's individual, caregivers, and environment. The main influencing factors are individual factors and caregiver factors.

Key words: children with disabilities, quality of life, influencing factors, types of disability

CLC Number:

ZHANG Shi-ya,SUN Mei,LÜ Jun,XIA Cong,ZHENG Hong-ying,CHEN Gang,TANG Lei,WANG Xiao-qian. Quality of Life and Influencing Factors for Children with Disabilities in Developed Areas in China: a Case of Shanghai[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(10): 1127-1134.

Figures/Tables 5

References 33

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维度	没有困难	一点点困难	一些困难	很多困难	完全困难
行动能力	199(69.8)	31(10.9)	24(8.4)	12(4.2)	19(6.7)
自理能力	113(39.6)	60(21.1)	54(18.9)	28(9.8)	30(10.5)
日常活动	130(45.6)	55(19.3)	47(16.5)	28(9.8)	25(8.8)
疼痛/不适	209(73.3)	39(13.7)	23(8.1)	7(2.5)	7(2.5)
焦虑/抑郁	128(44.9)	93(32.6)	44(15.4)	15(5.3)	5(1.8)

变量	分组	n	VAS评分	t/F/H值	P值
性别	男	175	72.20±22.18	0.511^a	0.610
	女	110	70.81±22.63
年龄	3~< 6岁	162	73.73±22.20	6.656^b	0.001
	6~< 12岁	101	71.84±20.79
	12~18岁	22	55.59±24.47
残疾类型	视力残疾	14	88.14±10.03	69.151^b	< 0.001
	听力残疾	47	87.72±12.72
	言语残疾	14	83.57±10.99
	肢体残疾	51	60.49±21.20
	智力残疾	32	64.63±26.42
	精神残疾	46	70.04±21.97
	多重残疾	27	61.22±26.36
	未定残	54	71.65±18.64
残疾等级	重度残疾	70	68.64±24.92	0.943^b	0.391
	中度残疾	19	70.53±21.14
	未定级	196	72.85±21.45
并发疾病	无	233	74.55±20.96	-4.803^a	< 0.001
	有	52	58.71±23.83
睡眠质量	无睡眠问题	206	74.88±20.72	-3.765^a	< 0.001
	有睡眠问题	79	63.27±24.24
情绪稳定性	稳定	175	76.69±19.43	27.474^b	< 0.001
	一般	60	69.12±21.91
	不稳定	50	57.12±25.61
伙伴关系	不好	107	60.53±26.48	33.214^b	< 0.001
	一般	102	76.76±16.75
	很好	76	80.49±15.10
学前教育^c	是	198	76.53±19.95	5.286^a	< 0.001
	否	83	61.07±23.58
接受当地救助服务	是	209	70.13±23.78	-2.235^a	0.027
	否	76	75.87±17.17

变量	分组	n	VAS评分	t/F/H值	P值
性别	男	69	73.42±21.84	0.750^a	0.454
	女	216	71.00±22.50
年龄(岁)^c	< 35	62	78.02±20.72	6.422^b	< 0.001
	35~< 50	139	73.24±20.98
	50~< 65	52	60.92±24.71
	≥ 65	31	69.00±21.30
家庭角色	父亲	44	76.30±19.65	17.351^b	0.001
	母亲	155	74.76±21.29
	祖辈	80	64.18±22.60
	保姆	6	57.50±36.57
文化程度	初中及以下	58	63.95±22.93	16.656^b	0.001
	高中或中专	62	67.60±25.23
	大专	53	73.57±20.52
	本科及以上	112	77.01±19.68
就业状态	无业	154	67.84±22.24	5.842^b	0.003
	非全职工作	22	70.91±25.38
	全职工作	109	77.22±20.79
自评健康状况	差	18	53.89±22.53	5.800^b	< 0.001
	一般	94	67.30±21.79
	好	84	74.68±20.98
	很好	68	77.37±22.08
	非常好	21	75.90±20.96
宗教信仰^d	无	240	72.11±21.81	0.687^a	0.495
	有	43	69.26±25.60
是否抑郁	否	183	75.34±19.35	3.528^a	0.001
	是	102	65.06±25.66
应对方式	积极应对	225	73.52±22.24	2.757^a	0.006
	消极应对	60	64.68±21.43

变量	分组	n	VAS评分	t/F/H值	P值
家庭氛围^c	和睦	59	70.50±23.10	-2.267^a	0.025
	不和睦	225	76.81±17.84
家庭人均月收入(元)	< 5000	92	70.02±21.07	2.135^b	0.120
	5000~< 10000	87	69.13±22.09
	≥ 10000	106	75.17±23.32
家庭规模^d	≤ 4人	150	71.92±22.34	0.716^b	0.490
	5~6人	122	71.78±21.73
	> 6人	11	63.64±29.16
住房性质^c	租住房屋	54	72.44±22.00	1.055^b	0.350
	自有房屋	217	72.18±21.99
	其他	13	63.08±26.89
公共政策^d	不满意	29	67.00±23.24	0.839^b	0.502
	较少满意	42	70.40±20.93
	一般满意	140	71.94±21.50
	较多满意	59	73.61±23.79
	很满意	13	79.23±24.99
社会融入^d	严重阻碍	27	58.74±24.96	3.219^b	0.013
	部分阻碍	96	70.90±19.88
	没有帮助	48	75.83±18.29
	较少帮助	80	73.77±23.33
	很大帮助	32	75.31±25.84
总体无障碍建设^d	很差	18	60.00±28.49	4.327^b	0.364
	较差	53	70.55±22.71
	一般	144	72.09±22.19
	较好	62	75.55±19.31
	很好	6	76.67±19.66

维度	变量(参照变量)	B	S.E.	95%CI	β	t值	P值
儿童因素	残疾类型(视力残疾)
	听力残疾	0.077	5.560	-10.871~11.024	0.001	0.014	0.989
	言语残疾	2.059	7.164	-12.047~16.164	0.019	0.287	0.774
	肢体残疾	-13.623	5.921	-25.282~-1.965	-0.237	-2.301	0.022
	智力残疾	-10.499	6.150	-22.607~1.610	-0.148	-1.707	0.089
	精神残疾	-8.521	5.893	-20.124~3.082	-0.141	-1.446	0.149
	多重残疾	-14.911	6.366	-27.445~-2.377	-0.198	-2.342	0.020
	未定残	-7.963	5.693	-19.173~3.246	-0.141	-1.399	0.163
	并发疾病(无)	-8.995	2.938	-14.780~-3.210	-0.157	-3.061	0.002
	情绪稳定性	-4.414	1.533	-7.433~-1.395	-0.154	-2.879	0.004
	伙伴关系	4.965	1.634	1.748~8.181	0.178	3.039	0.003
	学前教育(是)	-7.757	2.639	-12.954~-2.561	-0.161	-2.939	0.004
照护者因素	家庭角色(母亲)
	父亲	-0.785	3.177	-7.040~5.471	-0.013	-0.247	0.805
	祖辈	-7.999	3.194	-14.288~-1.710	-0.163	-2.504	0.013
	保姆	-4.970	8.110	-20.938~10.997	-0.032	-0.613	0.540
	文化程度	1.608	1.255	-0.863~4.079	0.085	1.281	0.201
常量		86.868	9.239	68.677~105.058		9.403	< 0.001

Quality of Life and Influencing Factors for Children with Disabilities in Developed Areas in China: a Case of Shanghai

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