远程管理下儿童膀胱功能障碍基础行为治疗依从性现况调查及其影响因素分析

目的 基于微信平台远程管理模式，探讨儿童膀胱功能障碍基础行为治疗依从性及其影响因素，为制定提高治疗依从性的干预措施提供参考依据。 方法 采用自制问卷对2021年9月至2022年2月在成都市妇女儿童中心医院就诊的膀胱功能障碍患儿及其家长开展问卷调查，并基于微信平台进行基础行为治疗远程管理和随访。调查内容包括患儿的一般情况、疾病相关情况、治疗预期目标、患儿家长对儿童膀胱功能障碍相关知识的知晓情况，以及对治疗实施满4周后患儿治疗依从性的评价。采用SPSS 22.0软件，分析儿童膀胱功能障碍基础行为治疗依从性现状及其影响因素，检验水准为α=0.05。 结果 研究最终纳入174例膀胱功能障碍患儿，平均年龄5.87±2.02岁，其中男性113例，女性61例，治疗依从率为59.20%（103/174）。t检验显示，患儿家长的首诊知识问卷得分与患儿治疗依从性有关（t=8.105，P＜0.001）；多因素logistic回归分析显示，首诊知识问卷得分（与＞10分相比，≤10分:OR=6.432，95%CI:3.150~13.135，P<0.001）、儿童日常主要照顾人类型（与日常照顾人为父母相比，日常照顾人为祖辈或保姆:OR=2.897，95%CI:1.283~6.543，P=0.011）是影响治疗依从性的危险因素。 结论 基于微信平台远程管理，可获得较好的儿童膀胱功能障碍基础行为治疗依从性。在管理各阶段应持续创新健康教育形式，加强健康教育力度，提高患儿及其照顾者对疾病相关知识的掌握程度。

Compliance status and influencing factors analysis of urotherapy of bladder dysfunction in children under remote management

Objective To assess current status of urotherapy treatment compliance of bladder dysfunction in children and its influencing factors based on wechat platform remote management, and to provide a reference basis for developing interventions to improve treatment compliance. Methods A self-made questionnaire was used to investigate the children with bladder dysfunction and their parents who were treated in Chengdu Women’s and Children’s Central Hospital from September 2021 to February 2022, and remote management and follow-up were carried out based on wechat platform. The survey contents included pediatric patients’ general information, disease-related information, treatment experience and expected objectives, guardians’ awareness of disease relevant knowledge, and compliance evaluation after 4 weeks of treatment. SPSS 22.0 software was used to analyze the current situation and influencing factors of urotherapy treatment compliance of children with bladder dysfunction. Setting α=0.05. Results Among 174 children with bladder dysfunction, 113 were male, with an average age of 5.87±2.02 years. The treatment compliance rate was 59.20% (103/174). T-test showed that parents’ scores on the first diagnosis knowledge questionnaire were associated with child treatment adherence (t=8.105, P<0.001). Multivariate logistic regression analysis showed that the first diagnosis knowledge questionnaire score (compared with >10 points, ≤10 points: OR=6.432，95%CI:3.150-13.135，P<0.001) and the main caregiver type（compared with parents，grandparents or nannies:OR=2.897，95%CI:1.283-6.543，P=0.011）were the risk factors of poor treatment compliance. Conclusion Through remote management, we can obtain better urotherapy treatment compliance of bladder dysfunction in children. In the management, health education should be further strengthened, innovative forms, to improve the mastery of disease-related knowledge of children and their caregivers.