Abstract:

Objective: To analyze the categories of dynamic development trajectories of supportive care needs and their independent influencing factors in children with upper respiratory tract infection (URTI), so as to provide evidence for implementing precise and staged supportive care in clinical practice. Methods: A prospective cohort study was conducted. A total of 200 children with URTI admitted to the Emergency Department of Putian Children’s Hospital from January 2022 to January 2025 were enrolled. The Supportive Care Needs Scale was used to assess their care needs on days 1, 3, 5, and 7 after treatment. Meanwhile, data including baseline characteristics of children, clinical symptom recovery indicators, caregivers’ health information literacy, children’s quality of life, and caregivers’ burden were collected. Latent class analysis (LCA) was performed to identify the development trajectories of needs, and univariate analysis and multivariate logistic regression were used to explore the influencing factors of trajectory categories. Results: Three distinct development trajectories of supportive care needs in children with URTI were identified:moderate need with rapid decline group (30 cases, 15.00%), moderate need with fluctuating decline group (58 cases, 29.00%), and high need with gradual decline group (112 cases, 56.00%). Univariate analysis showed that there were statistically significant differences in the disappearance time of lung rales, body temperature recovery time, health information literacy score, quality of life score, and caregiver burden score among the three groups (all P<0.001). Taking the high need with gradual decline group as the reference, multivariate logistic regression analysis showed that for each additional day of body temperature recovery time, the probability of being classified into the moderate need with rapid decline group decreased by 99.7% (OR=0.003), and the probability of being classified into the moderate need with fluctuating decline group decreased by 97.1% (OR=0.029). For each additional day of lung rales disappearance time, the above probabilities decreased by 99.2% (OR=0.008) and 83.1% (OR=0.169), respectively. For each 1-point increase in health information literacy, the above probabilities increased by 32.7% (OR=1.327) and 16.0% (OR=1.160), respectively. For each 1-point increase in quality of life, the above probabilities decreased by 21.3% (OR=0.787) and 22.4% (OR=0.776), respectively. For each 1-point increase in caregiver burden, the above probabilities decreased by 41.6% (OR=0.584) and 31.1% (OR=0.689), respectively. Conclusion: There are three heterogeneous development trajectories of supportive care needs in children with URTI. The high need with gradual decline group accounts for the highest proportion and is the key population for clinical care. Clinically, a rapid identification system for need trajectories should be established, and differentiated interventions should be implemented for different trajectory categories. Priority should be given to controlling core clinical symptoms, improving health information literacy, and alleviating caregiver burden, so as to enhance the precision and effectiveness of supportive care.

Key words: Respiratory tract infections, Child, Pediatric nursing, Health services needs and demand, Factor analysis, statistical