Assessment of stress disorders status of children with limb fracture and analysis of its influence factors

Objective To assess the stress disorders status and its influencing factors of children with limb fractures, to provide clinical evidence for laying down the post-fractured nursing mode. Methods From April to August 2016, a total of 81 cases of children with limb fractures who were treated in Department of Pediatric Orthopedics, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were recruited as research objects by accidental sampling method. The self-designed Basic Information Survey of Children With Limb Fractures and Fracture Knowledge Questionnaire for Parents, and the Child Stress Disorders Checklist (CSDC) which was used to investigate children′s post-traumatic psychological status were conducted among children and their parents, to get the data about limb fractured children′s immediate response scores and post-traumatic response scores, and fracture knowledge that the parents grasped. Through statistical analysis, finding out the influencing factors of limb fractured children′s stress disorders status. Informed consent was obtained from the guardians of each children. Results ①A total of 81 sets of questionnaires were handed out and 81 sets of valid questionnaires were collected, the feedback rate of valid questionnaires was 100%. ②According to the survey results of CDSC, the median score of CDSC was 7 scores (0-28 scores), and the median scores of immediate and post-traumatic response were 4 scores (1-9 scores) and 2 scores (0-23 scores), respectively. ③According to the survey results of self-designed Fracture Knowledge Questionnaire for Parents, 50.6% (41/81) parents could answer 3-4 questions correctly among 7 questions. However, only 3.7% (3/81) parents could answer all the fracture knowledge correctly. ④ Among those 81 cases of children with limb fracture, the immediate response score of limb fractured children who were >7-14 years old was lower than that of children who were 2-7 years old, and the difference was statistically significant (Z=-2.668, P=0.008). The immediate response score of children with siblings was lower than that of only-child children, meanwhile the score of re-experiencing of post-traumatic response was higher than that of only-child children, and both the differences were statistically significant (Z=-2.049, P=0.040; Z=-2.295, P=0.022). There were no statistical differences in the scores of immediate response, post-traumatic response, CSDC and scores of re-experience, avoidance, numbness and separation, increased alertness and functional lesion of post-traumatic response between the children whose parents could at least answer 4 questions correctly and the children whose parents could only answer less than 4 questions correctly (P>0.05). Conclusions The children′s age and only-child could influence the stress disorders status of children with limb fractures. As the sample size in this study is relatively small, the influences of fracture knowledge that the parents have grasped on stress disorders status of children with limb fractures still need large sample, multi-center randomized controlled study to confirm. Key words: Stress, psychological; Extremities fracture; Influencing factors; Child