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有破坏性行为的儿童I:服务利用情况

Children with disruptive behaviours I: service utilization.

作者信息

Hazell P L, Tarren-Sweeney M, Vimpani G V, Keatinge D, Callan K

机构信息

Discipline of Psychiatry, Faculty of Medicine and Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia.

出版信息

J Paediatr Child Health. 2002 Feb;38(1):27-31. doi: 10.1046/j.1440-1754.2002.00714.x.

Abstract

OBJECTIVE

To describe the demographic characteristics and patterns of service utilization in the Hunter region (NSW, Australia) of families caring for a child manifesting disruptive behaviour.

METHODOLOGY

Families were eligible to participate in the survey if they had at least one child known to have one of the DSM-IV disruptive behaviour disorders, autistic spectrum disorders, behaviour problems associated with rarer forms of brain disease, brain injury or mild intellectual disability, or identified by school personnel as having significant behaviour problems. Families were recruited to the survey via schools, early education centres and clinical services. Parents completed a mail survey about demographic details and service utilization.

RESULTS

In total, 1412 families responded to the survey, a participation rate of approximately 65%. The demographic characteristics of respondent families were similar to those of the regional population. A high proportion (85%) of children from respondent families were receiving treatment. Nearly half those children attending clinical services were attending two or more services. Approximately one-third each of the sample was attending public clinics, private clinics or a combination of both. Children were more likely to be treated by a paediatrician (64%) than a child psychiatrist (39%) or a psychologist (23%). Compared with a normative Australian sample, parents of children manifesting disruptive behaviour reported a high level of family stress.

CONCLUSIONS

Families of children manifesting disruptive behaviour are a highly stressed group who often access several clinical services. Paediatricians make a significant contribution to the management of children with disruptive behaviours and need to be considered in service planning.

摘要

目的

描述在澳大利亚新南威尔士州猎人地区,照顾有破坏性行为儿童的家庭的人口统计学特征及服务利用模式。

方法

如果家庭中至少有一个孩子被确诊患有《精神疾病诊断与统计手册》第四版中的破坏性行为障碍、自闭症谱系障碍、与罕见形式的脑部疾病、脑损伤或轻度智力残疾相关的行为问题,或者被学校工作人员认定有严重行为问题,则该家庭有资格参与调查。通过学校、早教中心和临床服务机构招募家庭参与调查。家长完成一份关于人口统计学细节和服务利用情况的邮件调查问卷。

结果

共有1412个家庭回复了调查,参与率约为65%。回复调查的家庭的人口统计学特征与该地区人口相似。回复调查家庭中的儿童有很大比例(85%)正在接受治疗。在接受临床服务的儿童中,近一半的儿童使用两种或更多服务。样本中约三分之一的儿童分别前往公立诊所、私立诊所或两者结合的诊所就诊。与儿童精神科医生(39%)或心理学家(23%)相比,儿童更有可能由儿科医生治疗(64%)。与澳大利亚的一个标准样本相比,有破坏性行为儿童的家长报告称家庭压力水平较高。

结论

有破坏性行为儿童的家庭是压力很大的群体,他们经常使用多种临床服务。儿科医生在管理有破坏性行为的儿童方面做出了重大贡献,在服务规划中需要考虑到这一点。

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