A Study Of Psychological And Behavioral Changes In Children Before And After Adenoidectomy In Children

Obejective:To investigate the correlation between adenoid hypertrophy(AH)and its psychobehavioral problems in school-age children and the effect of adenoidectomy on the psycho-behavioral status of children with AH.Methods:From May 2021 to March 2022,103 children with AH in the Department of Otolaryngology of Qingdao Municipal Hospital and the Department of Otolaryngology of Qingdao Huangdao District Central Hospital were randomly selected as the AH group,and 105 healthy children from a primary and secondary school in Qingdao were also selected according to the diagnostic criteria of AH with adenoids blocking the posterior nostril by nasopharyngoscopic exploration and a ratio of adenoid thickness to nasopharyngeal cavity width greater than 0.6.At the same time,105 healthy children from a primary and secondary school in Qingdao were selected as the healthy control group.The self-administered general condition questionnaire,adenoid hypertrophy-related questionnaire,Conners Parent Symptom Questionnaire(PSQ)and Social Anxiety Scale for Children(SASC)were used to evaluate the children’s social anxiety and the scores of the two groups were compared to analyze the correlation between AH and children’s psychological behavior problems.The correlation between AH and children’s psychological and behavioral problems was analyzed.To further understand the effect of adenoidectomy on the psycho-behavioral status of children with AH,the AH group was divided into 72 cases in the surgical intervention group and 31 cases in the conservative treatment group according to the treatment method selected.The scores of the two groups of children were compared before and after the intervention by using self-administered general condition questionnaires,Conners Parent Symptom Questionnaire(PSQ),Social Anxiety Scale for Children(SASC),and Attention Deficit Hyperactivity Disorder Rating Scale(SNAP-IV).The effects of adenoidectomy on the psycho-behavioral status of children with AH were analyzed.Results:1.The The total PSQ score and the scores of character disorder,learning problems,impulsivity-hyperactivity,and hyperactivity index factors were higher in the AH group than in the healthy control group(all P < 0.05);the total SASC score and the scores of fear of negativity evaluation and social avoidance distress factors were higher than in the normal control group(all P < 0.05).2.One-way ANOVA was performed to correlate different AH-related factors with the PSQ and SASC scores.The total SASC scores of children with higher age of onset,longer duration of AH and higher endoscopic grade of AH were higher than those of children with lower age of onset,shorter duration of AH and lower grade of AH(all P <0.05).3.Multiple linear analysis showed that the duration of AH,presence of AH complications,AH endoscopic grade and school age were positively associated with children’s PSQ scores(β =0.57,0.17,0.28,all P<0.05);the age of AH onset,duration of AH and school age children’s SASC scores were positively associated(β=0.38,0.49,all P<0.05).4.After The main effects of PSQ(F = 595.141),SASC(F = 595.141),and SNAP-IV(F = 595.141)scores in the surgical intervention and conservative treatment groups were statistically significant(all P < 0.05);and the main effects of PSQ(F = 388.944),SASC(F = 3.986),and SNAP-IV(F = 94.808)scores were statistically significant.94.808)scores had an interaction between measurement time* groups(all P < 0.05).5.The PSQ,SASC,and SNAP-IV scores in the surgical intervention group decreased at 4,8,and 16 weeks after the intervention compared with those before the intervention,and the differences were statistically significant(all P < 0.05);the PSQ,SASC,and SNAP-IV scores in the conservative treatment group decreased at8 and 16 weeks after the intervention compared with those before the intervention,and the differences were statistically significant(all P < 0.05),suggesting that the children with AH had psychobehavioral abnormalities after surgical intervention or conservative treatment.The differences were statistically significant(all P < 0.05),suggesting that the psycho-behavioral abnormalities of children with AH could be reduced and their psycho-behavioral status improved after surgical intervention or conservative treatment.6.The differences between the PSQ and SASC scores in the surgical intervention group were statistically significant(P < 0.05)compared with the conservative treatment group at 16 weeks after the treatment;the differences between the SASC scores in the two groups at 16 weeks after the treatment were not statistically significant(P > 0.05),suggesting that the improvement of psychological behavior in the surgical intervention group was more significant than that in the conservative treatment group,but there was no significant difference between the two groups for the improvement of social problems.Conclusions:1.There is a correlation between AH and the severity of their psychologicalbehavioral problems in school-age children,and the more adverse factors of AH in the children,the more serious the character problems,learning problems,hyperactivity problems and social problems.2.Adenoidectomy is more effective than conservative treatment in improving the psycho-behavioral problems of children with AH.