Berntsson L T, Köhler L, Gustafsson J E
The Nordic School of Public Health, School of Education, Göteborg, Sweden.
Scand J Public Health. 2001 Mar;29(1):44-54.
This study investigates the association between psychosomatic complaints (PSC) and background factors from children in the five Nordic countries, their families, and their social context in a model using proximal (child), intermediate (family), and distal (society) levels. Similarities and differences between the countries were compared.
A questionnaire was sent to the parents of a representative sample of 3,760 Nordic children aged seven to 12 years. The relationship between PSC and background factors was analysed using structural equation modelling.
Headaches and stomach complaints were most common. The prevalence was higher in girls than in boys. A LISREL analysis showed that determinants of PSC varied little between countries. The most important factors associated with PSC were the mother's health and well-being, the child's mental stability and social competence, and the family's socioeconomic status. Families with low education, blue-collar work, low income, and unemployed fathers were found to be most vulnerable. High risk factors could be influenced by other intervening protective factors. The greatest country differences were found on the distal level, where macroeconomic, legislative, and social factors dominated.
The pattern of PSC was quite similar between the Nordic countries, although there were some small differences. The results also confirm that the determinants of PSC are multidimensional. Longitudinal studies are needed to clarify the complex reality.
本研究在一个使用近端(儿童)、中间(家庭)和远端(社会)层面的模型中,调查北欧五国儿童的心身症状(PSC)与其背景因素、家庭及社会环境之间的关联。比较了各国之间的异同。
向3760名7至12岁北欧儿童的具有代表性样本的父母发送了一份问卷。使用结构方程模型分析了PSC与背景因素之间的关系。
头痛和胃部不适最为常见。女孩中的患病率高于男孩。LISREL分析表明,各国之间PSC的决定因素差异不大。与PSC相关的最重要因素是母亲的健康和幸福、儿童的心理稳定性和社交能力,以及家庭的社会经济地位。发现受教育程度低、从事蓝领工作、收入低且父亲失业的家庭最易受影响。高风险因素可能会受到其他干预性保护因素的影响。在远端层面发现了最大的国家差异,其中宏观经济、立法和社会因素占主导地位。
北欧国家之间PSC的模式相当相似,尽管存在一些小差异。结果还证实,PSC的决定因素是多维度的。需要进行纵向研究来阐明这一复杂的现实情况。