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儿科非心因性胸痛的医疗保健利用与心理社会因素。

Health care utilization and psychosocial factors in pediatric noncardiac chest pain.

机构信息

Department of Psychology, University of Georgia, Athens, GA 30602, USA.

出版信息

Health Psychol. 2013 Mar;32(3):320-7. doi: 10.1037/a0027806. Epub 2012 Apr 9.

Abstract

OBJECTIVE

This study investigated factors related to health care utilization (HCU) among patients presenting to pediatric cardiologists with symptoms of chest pain later diagnosed as noncardiac chest pain (NCCP).

METHODS

Participants included 67 children and adolescents diagnosed with NCCP and their parent. Measures of HCU, pain severity, and child self-report and parent self-report of anxiety and depression were collected at the cardiologist's office. The child's sex was examined as a moderator of HCU.

RESULTS

Pain severity and maternal and child depression were significant contributors to the variance in child HCU. The relationship between depression and HCU was moderated by the child's sex, with boys higher in levels of maternal or child depression reporting greater HCU.

CONCLUSIONS

Psychological factors are related to HCU for children with NCCP, with depression positively associated with HCU. The child's sex plays an important role in depression and HCU. Family-focused psychological screening of pediatric patients with NCCP may aid in identifying families who may benefit from referrals for psychological assessment and treatment.

摘要

目的

本研究调查了在儿科心脏病专家就诊时出现胸痛症状但后来被诊断为非心源性胸痛(NCCP)的患者中与医疗保健利用(HCU)相关的因素。

方法

参与者包括 67 名被诊断为 NCCP 的儿童和青少年及其家长。在心脏病专家办公室收集了 HCU、疼痛严重程度以及儿童自我报告和父母自我报告的焦虑和抑郁等测量指标。研究还检查了儿童的性别是否作为 HCU 的调节因素。

结果

疼痛严重程度以及母亲和孩子的抑郁是儿童 HCU 差异的重要因素。抑郁与 HCU 的关系受到孩子性别的调节,即母亲或孩子的抑郁程度较高的男孩报告的 HCU 更高。

结论

心理因素与 NCCP 儿童的 HCU 有关,抑郁与 HCU 呈正相关。孩子的性别在抑郁和 HCU 中起着重要作用。对患有 NCCP 的儿科患者进行以家庭为中心的心理筛查,可能有助于确定哪些家庭可能受益于心理评估和治疗的转介。

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