Abstract:

 Objective　To investigate the status and influencing factors of family function in preschool children with type 1 diabetes mellitus. Methods　One hundred and twenty-four preschool children with type 1 diabetes mellitus who were 3-6 years old and were treated at Department of Endocrinology, Genetics, and Metabolism, Children's Hospital, Zhengzhou University from February 2017 to February 2020, including 66 boys and 58 girls, and their main caregivers were selected. According to the family function, they were divided into a good family function group and a poor family function group. The demographic data, clinical indicators, and related scale scores of the family members of the two groups were collected. The children's status quo of family function was analyzed. Univariate and multivariate logistic regression analyses were conducted to analyze the factors affecting family function. t and χ² tests were applied. Results　The overall score of Family Assessment Device (FAD) in the 124 preschool children was (108.24±10.23); 84 children's FAD score ≤ 120; the other 40 children's >120; 67.74% (84/124) had good family function. There were no statistical differences in gender, age, residential address, and family genetic history but were in education level, marital status, family monthly income, medical insurance, fasting blood glucose (FBG), two hours postprandial blood glucose (2hPBG), glycosylated hemoglobin (HbA1c), Family Adaptability and Cohesion Evaluation Scale (FACS Ⅱ-CV), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS) between the two groups (χ²=5.560, 9.804, 2.698, and 6.483; t=5.048, 7.469, 3.495, 5.386, 7.482, and 7.220; all P<0.05). Logistic regression model showed that marital status, family monthly income, HbA1c, FACS Ⅱ-CV, SAS, and SDS were independent influencing factors of family function in the preschool children. Conclusions　The status quo of family function of preschool children with type 1 diabetes mellitus is relatively weak and needs to be improved. The influencing factors are mainly attributed to marital relationship, family monthly income, blood glucose control, parent-child intimacy and adaptability, and the degrees of anxiety and depression of the family members. Efforts can be made to solve the psychological problems of the children's family members, strengthen blood glucose control and other aspects to improve family function, so that the children can be better cared for.

Key words:

Type 1 diabetes mellitus, Preschool age, Family function, Influencing factors

摘要：

目的　探讨学龄前1型糖尿病儿童家庭功能的现状及影响因素。方法　选取郑州大学附属儿童医院内分泌遗传代谢科于2017年2月至2020年2月收治的124例学龄前（3～6岁，男66例，女58例）1型糖尿病患儿及其主要照顾者，按家庭功能程度差异分为家庭功能较佳组和家庭功能较差组，收集两组患儿家属人口学资料、临床指标及相关量表评分，分析1型糖尿病儿童家庭功能现状，行单因素、多因素logistic回归分析家庭功能影响因素。统计学方法采用t检验、χ²检验。结果　124例学龄前1型糖尿病儿童整体家庭功能评定量表（FAD）评分为（108.24±10.23）分，其中，≤120分84例，>120分40例，家庭功能较佳占比达67.74%（84/124）；除性别、年龄、居住地址、家族遗传史外，两组文化程度、婚姻状况、家庭月收入、医保情况、空腹血糖（FBG）、餐后2 h血糖（2 h PBG）及糖化血红蛋白（HbA1c）、家庭亲密度和适应性量表（FACSⅡ-CV）、焦虑自评量表（SAS）、抑郁自评量表（SDS）比较，差异均有统计学意义（χ²=5.560、9.804、2.698、6.483，t=5.048、7.469、3.495、5.386、7.482、7.220，均P<0.05）；经logistic回归模型多因素分析，婚姻状况、家庭月收入、HbA1c、FACSⅡ-CV、SAS、SDS均为学龄前1型糖尿病儿童家庭功能独立影响因素。结论　学龄前1型糖尿病儿童家庭功能现状较为薄弱，尚有待改进，而影响因素主要归咎于婚姻关系、家庭月收入、血糖控制情况、亲子间亲密度与适应性以及家属焦虑、抑郁程度，可着力于患儿家属心理问题解决、血糖控制强化等方面提升家庭功能，以使患儿得到更好的照顾。

关键词:

1型糖尿病, 学龄前, 家庭功能, 影响因素