住院早产儿父亲创伤后应激障碍发生风险列线图的建立及验证  

Establishment and validation of risk nomogram of post-traumatic stress disorder in fathers with hospitalized premature infants

作　　者：赵希平[1] 李玮桐 宋贵华 江延秋[1] 向美芹[1] Zhao Xiping;Li Weitong;Song Guihua;Jiang Yanqiu;Xiang Meiqin(Neonatal Intensive Care Unit,Affiliated Hospital of Jining Medical University,Jining 272029,China)

机构地区：[1]济宁医学院附属医院新生儿监护病房,济宁272029

出　　处：《中国实用护理杂志》2022年第23期1823-1830,共8页Chinese Journal of Practical Nursing

基　　金：济宁医学院附属医院"苗圃"课题(MP-2018-026)。

摘　　要：目的了解住院早产儿父亲创伤后应激障碍(PTSD)的发生状况,并分析其风险因素。方法便利选取2021年5—8月济宁医学院附属医院NICU住院的203名早产儿父亲为研究对象,填写一般资料问卷、中文版围生期创伤后应激障碍问卷(PPQ-C)、疾病不确定感父母量表、社会支持评定量表、简明应对方式问卷等。运用Logistic回归分析发生PTSD的风险因素,并建立列线图模型,绘制ROC曲线检验模型的区分度,通过Hosmer-Lemeshow拟合优度检验和绘制校准曲线验证模型的校准度。结果203名住院早产儿父亲PPQ-C总分为(17.17±8.77)分,有81人症状阳性,PTSD发生率为39.90%(81/203)。Logistic回归分析显示,大专学历(OR=0.297,95%CI 0.116~0.763,P<0.05)、患儿极低出生体质量(OR=2.491,95%CI 1.027~6.044,P<0.05)、疾病不确定感(OR=1.038,95%CI 1.012~1.066,P<0.05)、消极应对方式(OR=1.871,95%CI 1.127~3.108,P<0.05)为早产儿父亲PTSD发生的风险因素。根据Logistic回归分析结果建立列线图模型,ROC曲线证明(曲线下面积为0.751)模型具有较好的区分度。Hosmer-Lemeshow拟合优度检验(P=0.974)和校准曲线证明预测值与实际监测值趋于一致。结论住院早产儿父亲PTSD发生率较高,与受教育程度、患儿出生体质量、疾病不确定感、应对方式有关。因此,护理人员应根据患儿父亲的个体情况,给予信息支持和心理指导,以降低PTSD的发生率。Objective To understand the incidence of post-traumatic stress disorder(PTSD)in fathers with premature infants and analyze the risk factors.Methods Conveniently,the 203 fathers of premature infants in NICU of Affiliated Hospital of Jining Medical University of Shandong Province from May to August 2021 were selected as the subjects to fill in the general data questionnaire,Perinatal Post-traumatic stress disorder Questionnaire-Chinese edition(PPQ-C),Parents,Perception of Uncertainty Scale,Social Support Rating Scale,Simplified Coping Style Questionnaire.Logistic regression was used to analyze the risk factors of PTSD and establish a nomogram model.ROC curve was used to verify the discrimination ofthe model.Hosmer-Lemeshow goodness-of-fit test and Calibration Plot were used to verify the calibration.Results PPQ-C total score of 203 fathers was 17.17±8.77,81 fathers,symptoms were positive and the incidence of PTSD was 39.90%(81/203).Logistic regression analysis showed college degree(OR=0.297,95%CI 0.116-0.763,P<0.05),very low birth weight(OR=2.491,95%CI 1.027-6.044,P<0.05),sense of disease uncertainty(OR=1.038,95%CI 1.012-1.066,P<0.05),negative coping style(OR=1.871,95%CI 1.127-3.108,P<0.05)were risk factors of PTSD in fathers with premature infants.The nomogram model was established basing on the results of the Logistic regression analysis,and the ROC curve proved(AUC=0.751)the model having a good discrimination.The Hosmer-Lemeshow goodness-of-fit test(P=0.974)and the calibration plot demonstrated that the prediction values tends to coincide with the actual monitoring values.Conclusions A higher incidence of PTSD was observed in fathers with hospitalized premature infant.It was related to education level,the infants′s birth weight,disease uncertainty and coping style.Therefore,the nurses should give information support and psychological guidance according to the individual situation of the infants′father to reduce the incidence of PTSD.

关 键 词：应激障碍 创伤后 列线图 婴儿 早产 疾病不确定感 应对方式 

分 类 号：R473.72[医药卫生—护理学]