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儿童心理健康服务利用与母亲心理健康:一种路径分析模型

CHILDREN'S MENTAL HEALTH SERVICE USE AND MATERNAL MENTAL HEALTH: A PATH ANALYTIC MODEL.

作者信息

Pfefferle Susan G, Spitznagel Edward L

机构信息

The George Warren Brown School of Social Work, Washington University in St Louis, 1 Brookings Dr. Campus Box 1093, St Louis, Mo. 63130,

出版信息

Child Youth Serv Rev. 2009 Mar;31(3):378-382. doi: 10.1016/j.childyouth.2008.09.003.

Abstract

OBJECTIVE

This observational study explores pathways towards any past year use of child mental health services. METHODS: Data from the 2002 National Survey of American Families were used to explore the relationship between past month maternal mental health and past year child mental health services use. Observations were limited to the 8072 most knowledgeable adults who were the mothers of target children aged 6-11. Logistic regressions were performed to determine the odds of any child mental health service use followed by path analyses using Maximum Likelihood estimation with robust standard errors. RESULTS: Multiple factors were associated with odds of any child mental health service use. In the path analytic model poor past month maternal mental health was associated with increased aggravation which in turn was associated with increased use of mental health visits. Negative child behaviors as reported by the mother were also associated with increased maternal aggravation and increased service use. CONCLUSIONS: Parental perception of child behaviors influences treatment seeking, both directly and indirectly through parental aggravation. Parental mental health influences tolerance for child behaviors. Findings are consistent with other studies. Interventions should address the entire family and their psychosocial circumstances through collaboration between multiple service sectors.

摘要

目的

本观察性研究探讨过去一年中使用儿童心理健康服务的途径。方法:利用2002年全国家庭调查的数据,探讨过去一个月母亲心理健康状况与过去一年儿童心理健康服务使用情况之间的关系。观察对象仅限于8072名最了解情况的成年人,他们是6至11岁目标儿童的母亲。进行逻辑回归以确定使用任何儿童心理健康服务的几率,随后使用具有稳健标准误差的最大似然估计进行路径分析。结果:多种因素与使用任何儿童心理健康服务的几率相关。在路径分析模型中,过去一个月母亲心理健康状况不佳与加剧情况增加相关,而加剧情况增加又与心理健康就诊次数增加相关。母亲报告的儿童负面行为也与母亲加剧情况增加和服务使用增加相关。结论:父母对儿童行为的认知直接或通过父母的加剧情况间接影响寻求治疗的行为。父母的心理健康影响对儿童行为的容忍度。研究结果与其他研究一致。干预措施应通过多个服务部门之间的合作,解决整个家庭及其社会心理状况。

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