Lach Lucyna M, Kohen Dafna E, Garner Rochelle E, Brehaut Jamie C, Miller Anton R, Klassen Anne F, Rosenbaum Peter L
School of Social Work, McGill University, Montreal, Quebec, Canada.
Disabil Rehabil. 2009;31(9):741-52. doi: 10.1080/08916930802354948.
Children with neurodevelopmental disorders (Neuro) pose complex parenting challenges, particularly if the condition co-occurs with behaviour problems. Such challenges are likely to impact caregiver health and well-being. This study explores the extent to which caregivers of children with both 'Neuro' and behaviour problems differ in their physical and psychosocial outcomes from caregivers of children with either condition or neither condition.
The first wave of data collected in the National Longitudinal Survey of Children and Youth in Canada (1994) was used to identify four groups of caregivers of 4 to 11-year-old children: caregivers of children with a 'Neuro' disorder and externalising behaviour problems (Both; n=414), caregivers of children with a 'Neuro' disorder only (Neuro Only; n=750), caregivers of children with an externalising behaviour problem only (Ext Only; n=1067), and caregivers of children with neither health condition (Neither; n=7236).
Caregivers in the 'Both' group were least likely to report excellent or very good health, and more frequently reported chronic conditions such as asthma, arthritis, back problems, migraine headaches, and limitations in activities as compared to the 'Neither' group. This group also exhibited higher depression scores, experienced more problematic family functioning, and reported lower social support than the 'Neither' group. Scores for caregivers in the 'Ext Only' and 'Neuro Only' groups tended to lie between the 'Both' and 'Neither' group scores and often did not differ from one another.
Caregivers of children with both neurodevelopmental disorders and behaviour problems exhibited a greater number of health and psychosocial problems. While addressing children's behaviour problems, health care professionals should also consider caregiver physical and psychosocial health as this may also have an impact on children's well-being.
患有神经发育障碍(Neuro)的儿童给养育带来了复杂的挑战,尤其是当这种情况与行为问题同时出现时。此类挑战可能会影响照顾者的健康和幸福。本研究探讨了患有“Neuro”且有行为问题的儿童的照顾者在身体和心理社会方面的结果与患有其中一种情况或两种情况都没有的儿童的照顾者相比存在何种程度的差异。
利用加拿大儿童和青少年全国纵向调查(1994年)收集的第一波数据,确定了四组4至11岁儿童的照顾者:患有“Neuro”障碍且有外化行为问题的儿童的照顾者(两者兼具组;n = 414)、仅患有“Neuro”障碍的儿童的照顾者(仅Neuro组;n = 750)、仅患有外化行为问题的儿童的照顾者(仅Ext组;n = 1067)以及两种健康状况都没有的儿童的照顾者(两者皆无组;n = 7236)。
“两者兼具”组的照顾者最不可能报告健康状况极佳或非常好,与“两者皆无”组相比,更频繁地报告患有慢性疾病,如哮喘、关节炎、背部问题、偏头痛以及活动受限。该组还表现出更高的抑郁得分,经历了更多有问题的家庭功能,并且报告的社会支持比“两者皆无”组更低。“仅Ext”组和“仅Neuro”组照顾者的得分往往介于“两者兼具”组和“两者皆无”组得分之间,且通常彼此没有差异。
患有神经发育障碍和行为问题的儿童的照顾者表现出更多的健康和心理社会问题。在解决儿童行为问题时,医疗保健专业人员还应考虑照顾者的身体和心理社会健康,因为这也可能会影响儿童的幸福。