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特殊需求儿童多诊断组中父母精神困扰症状的关联和成本。

Associations and costs of parental symptoms of psychiatric distress in a multi-diagnosis group of children with special needs.

机构信息

Children's Treatment Network of Simcoe York, Richmond Hill, Ontario, Canada.

出版信息

J Intellect Disabil Res. 2011 Mar;55(3):263-80. doi: 10.1111/j.1365-2788.2010.01356.x. Epub 2011 Jan 4.

Abstract

BACKGROUND

Families supporting children with complex needs are significantly more distressed and economically disadvantaged than families of children without disability and delay. What is not known is the associations and costs of parental psychiatric distress within a multi-diagnosis group of special needs children.

METHODS

In this cross-sectional survey, families were identified from the Children's Treatment Network. Families were eligible if the child was aged 0-19 years, resided in Simcoe/York, and if there were multiple family needs (n = 429).

RESULTS

Some 42% of surveyed parents exhibited symptoms (mild to severe) of psychiatric distress. The presence of these symptoms was associated with reports of poorer social support, family dysfunction, greater adverse impact of the child's situation on the family, poorer child behaviour, unfavourable parenting styles and poorer child psychosocial functioning. The severity of the child's physical dysfunction was not related to parents/guardians most knowledgeable symptoms of psychiatric distress. Total parent costs were higher and children's uses of primary care services were higher in parents with symptoms of psychiatric distress.

CONCLUSION

Parent symptoms of psychiatric distress are a significant societal concern in families with complex needs children. Children's rehabilitation efforts need to incorporate parental mental health assessment and treatment into existing programmes. This could lead to decreases in direct and indirect healthcare utilisation costs.

摘要

背景

有复杂需求的儿童的家庭,其痛苦程度和经济劣势明显大于没有残疾和发育迟缓儿童的家庭。目前尚不清楚在患有多种特殊需要疾病的儿童群体中,父母精神疾病困扰的关联和成本是怎样的。

方法

在这项横断面调查中,研究人员从儿童治疗网络中确定了家庭。如果孩子年龄在 0-19 岁之间、居住在 Simcoe/York 地区且存在多种家庭需求,则符合入组条件(n=429)。

结果

接受调查的父母中,约有 42%表现出(轻度到重度)精神疾病困扰的症状。这些症状的存在与较差的社会支持、家庭功能障碍、孩子的状况对家庭造成的更大负面影响、较差的孩子行为、不利的育儿方式以及较差的孩子心理社会功能相关。孩子身体功能障碍的严重程度与父母/监护人最了解的精神疾病困扰症状无关。有精神疾病困扰症状的父母的总花费更高,孩子对初级保健服务的使用也更高。

结论

有复杂需求的儿童家庭中,父母精神疾病困扰的症状是一个重大的社会问题。儿童康复工作需要将父母的心理健康评估和治疗纳入现有方案。这可能会降低直接和间接的医疗保健利用成本。

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