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儿童心理健康问题及其对家庭造成的相关负担。

PEDIATRIC MENTAL HEALTH PROBLEMS AND ASSOCIATED BURDEN ON FAMILIES.

作者信息

Houtrow Amy J, Okumura Megumi J

机构信息

Department of Pediatrics, University of California at San Francisco.

出版信息

Vulnerable Child Youth Stud. 2011 Sep;6(3):222-233. doi: 10.1080/17450128.2011.580144.

Abstract

Approximately 20% of children in the United States have mental health problems. The factors associated with childhood mental health problems and the associated burdens on families are not well understood. Therefore, our goals were to profile mental health problems in children to identify disparities, and to quantify and identify correlates of family burden. We used the National Survey of Children's Health, 2003 (N=85,116 children aged 3-17 years) for this analysis. The prevalence, unadjusted and adjusted odds ratios of mental health problems and family burden were calculated for children by child-, family- and health systems- level characteristics. The prevalence of mental health problems among children aged 3-17 years was 18%. The odds of mental health problems were higher for boys, older children, children living in or near relative poverty, those covered by public insurance, children of mothers with fair or poor mental health, children living in homes without two parents, children without a personal doctor or nurse, and children with unmet health care needs. Among families with children with mental health problems, 28% reported family burden. Correlates of family burden included White race, severity, older age, higher income, non-two parent family structure, and having a mother with mental health problems. In conclusion, childhood mental health problems are common and disproportionally affect children with fewer family and health care resources. Families frequently report burden, especially if the mental health problem is moderate to severe, but the correlates of family burden are not the same correlates associated with mental health problems. Understanding those highest at risk for mental health problems and family burden will help assist clinicians and policy makers to ensure appropriate support systems for children and families.

摘要

在美国,约20%的儿童存在心理健康问题。与儿童心理健康问题相关的因素以及家庭由此承受的负担尚未得到充分了解。因此,我们的目标是剖析儿童心理健康问题,以识别差异,并量化和确定家庭负担的相关因素。我们使用2003年全国儿童健康调查(样本为85116名3至17岁儿童)进行此项分析。根据儿童、家庭和卫生系统层面的特征,计算了儿童心理健康问题和家庭负担的患病率、未调整及调整后的比值比。3至17岁儿童心理健康问题的患病率为18%。男孩、年龄较大的儿童、生活在相对贫困地区或附近的儿童、参加公共保险的儿童、母亲心理健康状况一般或较差的儿童、生活在单亲家庭的儿童、没有私人医生或护士的儿童以及有未满足的医疗需求的儿童,出现心理健康问题的几率更高。在有心理健康问题儿童的家庭中,28%报告有家庭负担。家庭负担的相关因素包括白人种族、问题严重程度、年龄较大、收入较高、非双亲家庭结构以及母亲有心理健康问题。总之,儿童心理健康问题很常见,且对家庭和医疗资源较少的儿童影响尤甚。家庭经常报告有负担,尤其是在心理健康问题为中度至重度的情况下,但家庭负担的相关因素与心理健康问题的相关因素并不相同。了解那些心理健康问题和家庭负担风险最高的人群,将有助于临床医生和政策制定者确保为儿童及其家庭提供适当的支持系统。

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