感染新冠肺炎後兒童的生活品質、執行功能與焦慮之相關研究：以執行功能為調節變項

Abstract

本研究探討確診新冠肺炎（COVID-19）一年內兒童之生活品質、執行功能和焦慮間的關係，特別檢視執行功能在焦慮和生活品質之間的潛在調節作用。研究回顧了130位一年內曾確診COVID-19的兒童 （56.9%為男性；平均年齡為9.18歲，標準差為3.32歲）的醫療記錄。研究採用臺灣版世界衛生組織生活品質問卷簡明版評估生活品質、中文版第二版執行功能行為評量表評估執行功能以及台灣版多向度兒童青少年焦慮量表評估焦慮程度。研究發現，相較未確診常模樣本，曾確診COVID-19的兒童具有較差的執行功能表現，尤其是在情緒調節方面；另一方面，在曾確診COVID-19的兒童中，較好的執行功能預測較佳的生活品質。此外，研究結果顯示部分焦慮向度較高的兒童，反而呈現較佳的整體生活品質。焦慮程度與大多執行功能表現沒有顯著關係，但執行功能的表現會改變焦慮與生活品質之間的關係。當執行功能較佳的兒童經歷較高焦慮時，其生活品質反而提升；但對執行功能較差的兒童而言，此關係則相反或不顯著。因此，本研究結果顯示執行功能在焦慮和生活品質關係中的潛在保護作用，強調支持曾確診COVID-19兒童之執行功能發展之重要性。This study investigated the relationships between quality of life (QOL), anxiety and executive function (EF) in children who were diagnosed with COVID-19 within the past year. It specifically examined EF as a potential moderator between anxiety and QOL. Medical records were reviewed for 130 children (56.9% male; M age = 9.18 years, SD = 3.32 years) who had been diagnosed with COVID-19 within a year. QOL was evaluated using the Taiwanese version of World Health Organization Quality of Life Scale Brief Version (WHOQOL-BREF), EF was assessed using The Behavior Rating Inventory of Executive Function, Second Edition (BRIEF-2) Chinese Version and anxiety was measured with the Taiwanese version of the Multidimensional Anxiety Scale for Children (MASC).Our findings revealed that children who were diagnosed with COVID-19 demonstrated weaker EF abilities compared to children without COVID-19, with particular difficulties in emotional control. Among children with COVID-19, better EF was consistently associated with improved QOL across various life domains. Children who reported higher levels of some domains of anxiety showed better overall QOL. Additionally, anxiety levels showed no significant relationship with most aspects of EF performance, but the performance of EF changed the relationships between anxiety and QOL. Children with better EF showed improved QOL when experiencing higher anxiety, while this relationship was reversed or non-significantfor those with poorer EF. These findings highlight the potential protective role of EF in the relationship between anxiety and QOL and suggest the importance of supporting EF in children who were diagnosed with COVID-19.