Martinez Y J, Ercikan K
Department of Educational and Counselling Psychology and Special Education, University of British Columbia, 2125 Main Mall, Vancouver, BC V6T 1Z4, Canada.
Child Care Health Dev. 2009 May;35(3):391-401. doi: 10.1111/j.1365-2214.2008.00916.x.
Survival rates of children with a chronic illness is at an all-time high. Up to 98% of children suffering from a chronic illness, which may have been considered fatal in the past, now reach early adulthood. It is estimated that as many as 30% of school-aged children are affected by a chronic illness. For this population of children, the prevalence of educational and psychological problems is nearly double in comparison with the general population.
This study investigated the educational and psychological effects of childhood chronic illness among 1512 Canadian children (ages 10-15 years). This was a retrospective analysis using data from the National Longitudinal Survey of Children and Youth, taking a cross-sectional look at the relationships between childhood chronic illnesses, performance on a Mathematics Computation Exercise (MCE) and ratings on an Anxiety and Emotional Disorder (AED) scale.
When AED ratings and educational handicaps were controlled for, children identified with chronic illnesses still had weaker performance on the MCE. Chronic illness did not appear to have a relationship with children's AED ratings. The regression analysis indicated that community type and illness were the strongest predictors of MCE scores.
The core research implications of this study concern measurement issues that need to be addressed in future large-scale studies. Clinical implications of this research concern the need for co-ordinated services between the home, hospital and school settings so that services and programmes focus on the ecology of the child who is ill.
患有慢性病的儿童生存率创历史新高。高达98%曾被认为可能致命的慢性病患儿如今已步入成年早期。据估计，多达30%的学龄儿童受慢性病影响。对于这群儿童而言，教育和心理问题的患病率几乎是普通人群的两倍。
本研究调查了1512名加拿大儿童（10至15岁）童年慢性病对其教育和心理的影响。这是一项回顾性分析，使用了来自全国儿童和青少年纵向调查的数据，横断面研究童年慢性病、数学计算练习（MCE）成绩以及焦虑和情绪障碍（AED）量表评分之间的关系。
在控制了AED评分和教育障碍因素后，被确诊患有慢性病的儿童在MCE中的表现仍然较差。慢性病似乎与儿童的AED评分没有关系。回归分析表明，社区类型和疾病是MCE分数的最强预测因素。
本研究的核心研究意义在于未来大规模研究中需要解决的测量问题。本研究的临床意义在于需要在家庭、医院和学校环境之间协调服务，以便服务和项目关注患病儿童的生态环境。
