Study On The Delay Of Medical Treatment And The Quality Of Life In Children With Congenital Heart Disease In Northern Guizhou And Its Influencing Factors

Objective: To investigate the delay of medical treatment and postoperative quality of life in children with congenital heart disease in northern Guizhou area,and to analyze the related factors.It provides a theoretical basis for promoting early detection,early diagnosis and early treatment of congenital heart disease in children in northern Guizhou,and improving the postoperative quality of life of children with congenital heart disease.Methods: From July 2019 to January 2020,a total of 259 children with congenital heart disease and their main caregivers in two tertiary general hospitals in northern Guizhou were selected by convenience sampling method.he general information questionnaire,was used to investigate the status of medical treatment delay for children with congenital heart disease in northern Guizhou,and the related influencing factors were analyzed.A total of 106 surgical children who met the research criteria in the investigation of medical status were selected as the research objects.The general information questionnaire was used,including the sociodemographic and clinical data of children,and the Chinese version of Peds QLTM3.0 cardiac module was followed up by telephone at 3,6 and 12 months after discharge to determine the quality of life of children.SPSS18.0 software was used for statistical analysis of the data.Results:1.Survey results of medical treatment delay status : A total of 292 children were investigated,and 33 cases of parents and / or children who were unwilling to cooperate or combined with trisomy 21 syndrome were excluded.Finally,259 children were included.The results of 259 children with congenital heart disease showed that 219 children(84.56%)had medical delay,and 40 children(15.44%)had no medical delay,The longest is 168 months,the shortest is 1 month.2.The influencing factors of medical delay in children with congenital heart disease(1)Objective factors : family residence,family economic status and the number of children in the family are the main influencing factors of medical treatment delay for children with congenital heart disease(P< 0.05).(2)Subjective factors : do not understand the disease(P < 0.05),doctors recommend followup,family economic difficulties,family members do not pay attention to,young children,etc.3.Follow-up results of postoperative quality of life in children with congenital heart disease:According to the research standards,a total of 106 subjects were included.During the 1-year follow-up period,11 people were lost,and the loss rate was 10.38 %.4.The scores of quality of life of children with congenital heart disease at different time points after operation : parents reported that the total score of quality of life at 3 months after operation was 53.08 ± 9.66,the total score of quality of life at 6 months was 61.34 ± 9.66,and the total score of quality of life at 12 months was 63.14 ± 8.35.The total score of quality of life at 3 months after operation was 55.88 ± 11.19,the total score of quality of life at 6 months was 60.94 ± 10.21,and the total score of quality of life at 12 months was 63.10 ± 7.89.The overall quality of life of children was at a medium level at 3 months after operation,and at a medium level at 6 months and 12 months after operation.5.The change trend of quality of life score: The results of parents report and children report showed that the overall quality of life of children with congenital heart disease was on the rise,and the scores at three time points were statistically significant(P< 0.05).The scores of cardiac symptoms and treatment-related problems,treatment II-related problems,treatment anxiety-related problems and communication-related problems in parents ’ reports showed an upward trend,and the score difference was statistically significant(P<0.05).In the report results of children,the scores of cardiac symptoms and their treatment-related problems,treatment II-related problems,and communication-related problems increased first and then decreased,and the difference was statistically significant(P<0.05).6 months after operation was higher than 3 months after operation,but 12 months after operation showed a downward trend,the difference was statistically significant(P<0.05).6.Factors influencing the quality of life of children at different time points after operation(1)3 months after operation: delay in medical treatment,number of children in the family,awareness of disease among primary caregivers Family economic status is the main influencing factor of quality of life in children with congenital heart disease(P<0.05);(2)6 months after operation : the occupation of the main caregivers,the education level of the main caregivers,the number of children in the family,and the place of residence of the family were the main factors affecting the quality of life of children with congenital heart disease(P<0.05);(3)12 months after operation : family residence and economic status were the main factors affecting the quality of life of children with congenital heart disease(P<0.05).Conclusion:(1)The incidence of delay in medical treatment of children with congenital heart disease is high in northern Guizhou,which is a common phenomenon.(2)The overall quality of life of children with congenital heart disease within 12 months after surgery was at a medium level,and showed an increasing trend with the passage of time.(3)children with congenital heart disease factors affecting postoperative survival quality score more,each point in time is different.