南京市8~15岁儿童青少年健康相关生命质量影响因素

梁君妍; 尤华; 赵仕奇; 刘黎

doi:10.16835/j.cnki.1000-9817.2023.07.010

南京市8~15岁儿童青少年健康相关生命质量影响因素

doi: 10.16835/j.cnki.1000-9817.2023.07.010

梁君妍¹,
尤华^1, ,,
赵仕奇¹,
刘黎²

1.
南京医科大学公共卫生学院，江苏 211166
2.
南京市疾病预防控制中心学校卫生科

基金项目:

国家自然科学基金项目 72074122

详细信息

作者简介:
梁君妍(1999-)，女，四川绵阳人，在读硕士，主要研究方向为社区医学与健康教育

通讯作者:
尤华，E-mail：youhua98@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 G479
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出版历程
- 收稿日期: 2023-05-24
- 修回日期: 2023-06-10
- 网络出版日期: 2023-07-25
- 刊出日期: 2023-07-25

The impact of health-related quality of life for children and adolescents aged 8-15 years in Nanjing

1.
School of Public Health, Nanjing Medical University, Nanjing(211166), China

摘要

摘要: 目的探究南京市8~15岁儿童青少年的健康相关生命质量(HRQoL)受新冠病毒感染和健康相关行为的影响情况，为改善儿童青少年HRQoL提供理论依据。方法于2022年12月—2023年1月，采用多阶段随机整群抽样方法选取南京市2 398名8~15岁小学三年级至初中三年级学生，由学生自主完成HRQoL的中文版儿童版三水平欧洲五维生命质量测定量表(EQ-5D-Y-3L)，家长协助完成其余部分的调查。结果新冠病毒正感染者的欧洲生命质量(EQ)-指数和视觉模拟量表(VAS)得分均低于未感染者和曾感染者(P值均 < 0.05)。正感染者报告存在“疼痛或不舒服”的比例大于未感染者和曾感染者，正感染者和曾感染者报告“行动能力”有困难的比例均高于未感染者(P值均 < 0.05)。缺少父母陪伴(OR=10.19，95%CI=3.12~33.22)、不规律早餐摄入(OR=10.63，95%CI=3.20~35.25)、屏幕时间过长(OR=8.24，95%CI=3.02~22.51)使正感染者存在“行动能力”有困难的风险增加(P值均 < 0.05)。不规律早餐摄入(OR=1.93，95%CI=1.31~2.84)和含糖饮料及零食摄入(OR=1.56，95%CI=1.17~2.10)加大曾感染者EQ-指数低于未感染者的风险；含糖饮料及零食摄入(OR=1.57，95%CI=1.21~2.05)和屏幕时间过长(OR=1.49，95%CI=1.12~1.98)使曾感染者VAS得分低于未感染者的风险增加(P值均 < 0.05)。结论新冠病毒感染会损害儿童青少年的HRQoL，不良健康行为会加重其负面影响。应提倡保持健康的行为和生活方式，减少新冠病毒感染对HRQoL的影响。
- 健康行为 /
- 健康相关生命质量 /
- 回归分析 /
- 学生
Abstract: Objective To investigate the impact of COVID-19 infection and health-related behaviors on the health-related quality of life of children and adolescents aged 8-15 years in Nanjing, so as to provide a theoretical basis for improving HRQoL in children and adolescents. Methods From December 2022 to January 2023, a total of 2 398 students aged 8-15 years from the third grade of primary school to junior middle school in Nanjing were selected by multistage random cluster sampling. The 3-level EuroQol 5-dimension Questionnaire Youth Vension (EQ-5D-Y-3L) was completed by the respondents on their own, and the parents assisted in completing the rest of the questionnaire. Results The EuroQol-index(EQ-index) and Visual Analogue Scale (VAS) scores of being infected individuals were lower than those of uninfected and previously infected (P < 0.05). The proportion of being infected individuals reporting difficulty on "Pain/Discomfort" was higher than that of uninfected and previously infected individuals, and the proportion of reporting difficulty on "Mobility" was also higher than that of uninfected individuals (P < 0.05). Lack of parental companionship(OR=10.19, 95%CI=3.12-33.22), irregular breakfast consumption (OR=10.63, 95%CI=3.20-35.25), and excessive screen time (OR=8.24, 95%CI=3.02-22.51) increased the risk of difficulty on "Mobility" in being infected individuals (P < 0.05). Irregular breakfast consumption (OR=1.93, 95%CI=1.31-2.84) and consumption of sweetened beverages and snacks (OR=1.56, 95%CI=1.17-2.10) increased the risk of having lower EQ-index in previously infected individuals compared to uninfected individuals. Furthermore, consumption of sweetened beverages and snacks (OR=1.57, 95%CI=1.21-2.05) and excessive screen time (OR=1.49, 95%CI=1.12-1.98) also increased the risk of VAS scores being lower in previously infected individuals compared to uninfected individuals (P < 0.05). Conclusion The COVID-19 infection impairs HRQoL, and unhealthy behaviors deteriorate its negative impact. Healthy behaviors and lifestyles should be advocated to reduce the impact of COVID-19 infection on HRQoL.
- Health behavior /
- Health-related quality of life /
- Regression analysis /
- Students
注释:

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表 1 不同新冠病毒感染状态儿童青少年健康相关行为分布

Table 1. Distribution of HRB among children and adolescent with different COVID-19 infections status

组别	人数	吃早餐		每周快餐摄入次数		每周含糖饮料和零食摄入次数		中高等强度身体活动时长/(h·d^-1)		屏幕时间/(h·d^-1)		每周户外运动次数
组别	人数	每天	非每天	< 1次	≥1次	< 1次	≥1次	≥1	< 1	< 2	≥2	>3次	≤3次
未感染	1 073	917(85.46)	156(14.54)	917(85.46)	156(14.54)	405(37.74)	668(62.26)	68(6.34)	1 005(93.66)	725(67.57)	348(32.43)	912(85.00)	161(15.00)
曾感染	1 053	910(86.42)	143(13.58)	941(89.36)	112(10.64)	468(44.44)	585(55.56)	72(6.84)	981(93.16)	742(70.47)	311(29.53)	857(81.39)	196(18.61)
正感染	272	237(87.13)	35(12.87)	233(85.66)	39(14.34)	102(37.50)	170(62.50)	17(6.25)	255(93.75)	177(65.07)	95(34.93)	219(80.51)	53(19.49)
合计	2 398	2 064(86.07)	334(13.93)	2 091(87.20)	307(12.80)	975(40.66)	1 423(59.34)	157(6.55)	2 241(93.45)	1 644(68.56)	754(31.44)	1 988(82.90)	410(17.10)
注： ()内数字为构成比/%。

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表 2 不同新冠病毒感染状态儿童青少年健康相关生命质量表现分布

Table 2. Distribution of HRQoL among children and adolescents with different COVID-19 infectious status

组别	人数	MO			SC			UA			PD			AD
组别	人数	没有困难	有些困难	有很大困难	没有困难	有些困难	有很大困难	没有困难	有些困难	有很大困难	没有困难	有些困难	有很大困难	没有困难	有些困难	有很大困难
未感染	1 073	1 058(98.60)	14(1.30)	1(0.10)	1 046(97.48)	26(2.42)	1(0.10)	986(91.89)	83(7.74)	4(0.37)	948(88.35)	123(11.46)	2(0.19)	938(87.42)	126(11.74)	9(0.84)
曾感染	1 053	1 020(96.87)	28(2.66)	5(0.47)	1 025(97.34)	26(2.47)	2(0.19)	960(91.17)	91(8.64)	2(0.19)	926(87.94)	123(11.68)	4(0.38)	900(85.47)	150(14.25)	3(0.28)
正感染	272	260(95.59)	11(4.04)	1(0.37)	261(95.96)	10(3.67)	1(0.37)	250(91.91)	21(7.72)	1(0.37)	222(81.62)	49(18.01)	1(0.37)	227(83.46)	40(14.70)	5(1.84)
合计	2 398	2 338(97.50)	53(2.21)	7(0.29)	2 332(97.25)	62(2.59)	4(0.16)	2 196(91.58)	195(8.13)	7(0.29)	2 096(87.41)	295(12.30)	7(0.29)	2 065(86.11)	316(13.18)	17(0.71)
注： ()内数字为构成比/%。

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表 3 健康相关行为对是否感染新冠病毒儿童青少年生命质量影响的Logistic回归分析[OR值(95%CI)]

Table 3. Logistic regression analysis of the impact of HRB on HRQoL of children and adolescents controlled by COVID-19 infectious status[OR(95%CI)]

自变量	选项	EQ-指数		VAS得分
自变量	选项	曾感染	正感染	曾感染	正感染
早餐摄入	每天	1.00	1.00	1.00	1.00
	非每天	1.93(1.31~2.84)^**	2.52(1.13~5.61)^*	1.32(0.90~1.93)	1.64(0.75~3.59)
每周快餐摄入次数/次	＜1	1.00	1.00	1.00	1.00
	≥1	1.14(0.73~1.78)	1.23(0.56~2.69)	1.33(0.88~2.00)	1.00(0.47~2.13)
每周含糖饮料及零食摄入次数/次	＜1	1.00	1.00	1.00	1.00
	≥1	1.56(1.17~2.10)^**	0.75(0.42~1.36)	1.57(1.21~2.05)^**	1.70(0.97~2.96)
中到高等强度身体活动/(h·d^-1)	≥1	1.00	1.00	1.00	1.00
	＜1	1.53(0.83~2.84)	1.84(0.54~6.24)	1.31(0.77~2.27)	1.12(0.34~3.40)
屏幕时间/(h·d^-1)	＜2	1.00	1.00	1.00	1.00
	≥2	1.18(0.86~1.61)	0.88(0.47~1.63)	1.49 (1.12~1.98)^**	1.79(1.00~3.14)
每周户外活动次数/次	＞3	1.00	1.00	1.00	1.00
	≤3	0.77(0.53~1.12)	0.70(0.34~1.43)	0.93(0.66~1.30)	0.56(0.29~1.11)
注：调整了社会人口学因素(性别、年级、是否为独生子女、BMI、父母户籍、父母教育水平、父母婚姻状态、家庭平均月收入、常陪伴成员及其就业状态)；P < 0.05，*P < 0.01。

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