脑性瘫痪儿童睡眠问题与情绪行为问题的关联

杨杰文; 黄绍逸; 黄闪; 邓浩荣; 康涛; 陈亚军

doi:10.16835/j.cnki.1000-9817.2025056

脑性瘫痪儿童睡眠问题与情绪行为问题的关联

doi: 10.16835/j.cnki.1000-9817.2025056

1.
广东省广州市社会福利院，510000
2.
中山大学公共卫生学院妇幼卫生学系
3.
广州航海学院体育学院

基金项目:

广州市“岭南英杰工程”第二梯队后备人才项目穗人社函928号

教育部人文社会科学研究项目 19JD710025

详细信息

作者简介:
杨杰文(1972-)，男，广东广州人，博士，研究员，主要研究方向为儿童青少年健康教育

通讯作者:
陈亚军，E-mail：chenyj68@mail.sysu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R651.1⁺⁵ R748 B844.1 Q428
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出版历程
- 收稿日期: 2024-05-24
- 修回日期: 2024-07-21
- 网络出版日期: 2025-03-05
- 刊出日期: 2025-02-25

Correlation of sleep problems with emotional and behavioral problems among children with cerebral palsy

1.
Guangzhou Social Welfare Institute, Guangzhou (510000), Guangdong Province, China

摘要

摘要: 目的了解脑性瘫痪(简称脑瘫)儿童睡眠问题和情绪行为问题现况及两者的关联，为制定脑瘫儿童情绪行为问题相关干预措施提供参考。方法采用横断面调查的方法，选取2023年1月至2024年1月广州市社会福利院的402名6~18岁脑瘫儿童，对其专职护理人员进行调查。通过父母版长处和困难问卷(SDQ)评估脑瘫儿童情绪行为问题情况，通过儿童睡眠习惯问卷(CSHQ)评估脑瘫儿童睡眠问题情况。采用多重线性回归分析脑瘫儿童睡眠问题与情结行为问题的关联性。结果脑瘫儿童情绪行为问题检出率为15.7%。有情绪行为问题脑瘫儿童睡眠问题得分[37.0(36.0, 41.0)]高于无情绪行为问题者[35.0(34.0, 36.0)](Z=-5.74，P < 0.01)。多重线性回归分析结果显示，调整年龄、性别、脑瘫分型分级、语言发育迟缓情况、视力障碍情况、癫痫情况等协变量后，脑瘫儿童睡眠问题总分与困难总评分呈正相关(β=0.28，95%CI=0.17~0.34，P < 0.05)。结论脑瘫儿童睡眠问题与情绪行为问题呈正相关；应提高对脑瘫儿童睡眠问题管理的认识，以降低脑瘫儿童情绪行为问题的发生率。
- 睡眠 /
- 情绪 /
- 精神卫生 /
- 回归分析 /
- 儿童 /
- 脑性瘫痪
Abstract: Objective To investigate the correlation of emotional and behavioral problems with sleep problems in children with cerebral palsy, so as to provide reference for intervention of emotional and behavioral problems in children. Methods A cross-sectional survey was conducted, and 402 children aged 6-18 with cerebral palsy who were adopted by social welfare institutions in Guangzhou City from January 2023 to January 2024 were selected to investigate their full-time nurses. The Parents' Strengths and Difficulties Questionnaire (SDQ) was used to assess the emotional and behavioral problems of children with cerebral palsy, and the Children's Sleep Habits Questionnaire (CSHQ) was used to assess sleep problems. Multiple linear regression analysis was used to analyze the correlation between the sleep problem of children with cerebral palsy and the emotional and behavioral problems. Results The prevalence of emotional and behavioral difficulties among children with cerebral palsy was 15.7%. The median sleep problem score of children with emotional and behavioral problems [37.0(36.0, 41.0)] was significantly higher than that of children without emotional and behavioral [35.0(34.0, 36.0)] (Z=-5.74, P < 0.01). The results of multiple linear regression analysis showed that after adjusting covariables such as age, gender, cerebral palsy classification, language retardation, visual impairment and epilepsy, the total sleep problem score of children with cerebral palsy was positively correlated with the total difficulty score (β=0.28, 95%CI=0.17-0.34, P < 0.05). Conclusions Sleep problems in children with cerebral palsy are associated with emotional and behavioral difficulties. Understanding of the management of sleep problems in children with cerebral palsy should be enhanced to reduce the incidence of emotional and behavioral problems in children with cerebral palsy.
- Sleep /
- Emotions /
- Mental health /
- Regression analysis /
- Child /
- Cerebral palsy
注释:

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表 1 有无情绪行为问题脑瘫儿童的睡眠问题及各维度得分比较[M(P₂₅, P₇₅)]

Table 1. Comparison of sleep problem scores and dimensions scores among cerebral palsy children with or without emotional and behavioral problems[M(P₂₅, P₇₅)]

情绪行为问题	人数	睡眠问题总分	就寝习惯不良	入睡潜伏期延长	睡眠持续时间不规律	睡眠焦虑	夜醒问题	异态睡眠	睡眠呼吸障碍	白天嗜睡
无	339	35.0(34.0, 36.0)	6.0(6.0, 6.0)	1.0(1.0, 2.0)	3.0(3.0, 3.0)	4.0(4.0, 4.0)	3.0(3.0, 4.0)	7.0(7.0, 8.0)	3.0(3.0, 3.0)	8.0(8.0, 10.0)
有	63	37.0(36.0, 41.0)	6.0(6.0, 7.0)	2.0(1.0, 2.0)	3.0(3.0, 3.0)	4.0(4.0, 4.0)	3.0(3.0, 4.0)	8.0(7.0, 9.0)	3.0(3.0, 3.0)	9.0(8.0, 11.0)
Z值		-5.74	-5.58	-4.06	-3.41	-2.69	-1.78	-4.51	-2.42	-2.23
P值		< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	0.08	< 0.01	0.02	0.03

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表 2 不同组别脑瘫儿童情绪行为问题检出率比较

Table 2. Comparison of the detection rates of emotional and behavioral problems among children with cerebral palsy of different groups

组别	选项	人数	情绪行为问题	χ²值	P值
年龄/岁	6~12	214	23(10.7)	8.39	< 0.01
	13~18	188	40(21.3)
性别	男	243	50(20.6)	11.18	< 0.01
	女	159	13(8.2)
脑瘫分型	痉挛型	323	47(14.6)	15.10	< 0.01
	非痉挛型	45	15(33.3)
	混合型	34	1(2.9)
GMFCS分级	轻度	42	21(50.0)	41.82	< 0.01
	中重度	360	42(11.7)
语言发育迟缓	是	377	49(13.0)	29.63	< 0.01
	否	25	14(56.0)
视力障碍	是	17	2(11.8)	0.01	0.92
	否	385	61(15.8)
癫痫	是	88	14(15.9)	0.01	0.95
	否	314	49(15.6)
注：()内数字为检出率/%。

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表 3 脑瘫儿童睡眠问题与情绪行为问题关联性的多重线性回归分层分析

Table 3. Multiple linear regression hierarchical analysis of correlation of sleep problems with emotional and behavioral problems in children with cerebral palsy

自变量	人数	模型1		模型2
自变量	人数	β值(95%CI)	P值	β值(95%CI)	P值
年龄/岁
6~12	214	0.23(0.08~0.29)	< 0.01	0.21(0.07~0.26)	< 0.01
13~18	188	0.39(0.26~0.52)	< 0.01	0.30(0.16~0.43)	< 0.01
性别
男	243	0.37(0.21~0.41)	< 0.01	0.28(0.14~0.34)	< 0.01
< 0.01女	159	0.27(0.13~0.47)	< 0.01	0.28(0.16~0.47)	< 0.01
脑瘫分型
痉挛型	323	0.29(0.16~0.34)	< 0.01	0.26(0.13~0.30)	< 0.01
非痉挛型	45	0.42(0.16~0.78)	< 0.01	0.29(-0.00~0.65)	0.05
混合型	34	0.45(0.11~0.67)	< 0.01	0.47(0.10~0.73)	0.01
GMFCS分级
轻度	42	0.23(-0.10~0.61)	0.15	0.26(-0.11~0.72)	0.15
中重度	360	0.32(0.18~0.34)	< 0.01	0.34(0.20~0.35)	< 0.01
语言发育迟缓
是	377	0.37(0.24~0.41)	< 0.01	0.30(0.18~0.34)	< 0.01
否	25	0.15(-0.31~0.66)	0.46	0.09(-0.43~0.63)	0.69
视力障碍
是	17	0.44(-0.08~1.33)	0.08	0.52(-0.19~1.66)	0.11
否	385	0.34(0.22~0.39)	< 0.01	0.28(0.17~0.33)	< 0.01
癫痫
是	88	0.38(0.14~0.45)	< 0.01	0.31(0.09~0.38)	< 0.01
否	314	0.34(0.23~0.45)	< 0.01	0.26(0.16~0.37)	< 0.01
注：模型1为粗模型；模型2调整了性别、年龄、脑瘫分型、GMFCS分级、语言发育迟缓、视力障碍和癫痫情况协变量；分层分析时，相应分层变量默认不作为协变量进行调整。

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