Psychosocial Department, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
Child Adolesc Psychiatry Ment Health. 2013 Apr 15;7(1):12. doi: 10.1186/1753-2000-7-12.
As the treatment of chronic or life-threatening diseased children has dramatically over recent decades, more and more paediatric patients reach adulthood. Some of these patients are successfully integrating into adult life; leaving home, developing psychosocially, and defining a role for themselves in the community through employment. However, despite careful guidance and support, many others do not succeed. A growing number of adolescents and young adults who have had a somatic disease or disability since childhood apply for disability benefits. The purpose of this study was to assess the health-related quality of life (HRQoL), anxiety and depression of young adults receiving disability benefits because of somatic conditions compared to reference groups from the general Dutch population and to explore factors related to their HRQoL, anxiety and depression.
Young adults (N = 377, 22-31 yrs, 64.3% female) claiming disability benefits completed the RAND-36 and an online version of the HADS. Differences between respondents and both reference groups were tested using analysis of variance and logistic regression analysis by group and age (and gender). Regression analyses were conducted to predict HRQoL (Mental and Physical Component Scale; RAND-36) and Anxiety and Depression (HADS) by demographic and disease-related variables.
The respondents reported worse HRQoL than the reference group (-1.76 Physical Component Scale; -0.48 Mental Component Scale), and a higher percentage were at risk for an anxiety (29.7%) and depressive (17.0%) disorder. Better HRQoL and lower levels of anxiety and depression were associated with a positive course of the illness and the use of medical devices.
This study has found worse HRQoL and feelings of anxiety and depression experienced by young adults claiming disability benefits. Healthcare providers, including paediatric healthcare providers, should pay systematic attention to the emotional functioning of patients growing up with a somatic condition in order to optimise their emotional well-being and adaptation to society during their transition to adulthood. Future research should focus on emotional functioning in more detail in order to identify those patients that are most likely to develop difficulties in emotional functioning and who would benefit from specific psychosocial support aimed at workforce participation.
近几十年来，慢性或危及生命的疾病患儿的治疗取得了显著进展，越来越多的儿科患者进入成年期。其中一些患者成功融入了成年生活；离开家，在心理社会方面发展，并通过就业在社区中为自己定义一个角色。然而，尽管经过精心指导和支持，仍有许多人未能成功。越来越多的青少年和年轻人因童年时期的躯体疾病或残疾而申请残疾福利。本研究旨在评估因躯体状况而领取残疾福利的年轻成年人的健康相关生活质量（HRQoL）、焦虑和抑郁情况，并与一般荷兰人群的参考组进行比较，并探讨与他们的 HRQoL、焦虑和抑郁相关的因素。
年轻成年人（N=377，22-31 岁，64.3%为女性）填写了 RAND-36 和 HADS 在线版。通过组间和年龄（以及性别）的方差分析和逻辑回归分析，比较了受访者与两个参考组之间的差异。通过人口统计学和疾病相关变量，进行回归分析预测 HRQoL（RAND-36 的心理和生理成分量表）和焦虑和抑郁（HADS）。
受访者报告的 HRQoL 差于参考组（生理成分量表-1.76；心理成分量表-0.48），且焦虑（29.7%）和抑郁（17.0%）障碍风险较高的比例更高。更好的 HRQoL 和较低的焦虑和抑郁水平与疾病的积极进程和使用医疗设备有关。
本研究发现，因躯体状况而领取残疾福利的年轻成年人的 HRQoL 和焦虑抑郁感更差。医疗保健提供者，包括儿科医疗保健提供者，应系统关注患有躯体疾病的患者的情绪功能，以优化他们的情绪健康和适应成年期的社会。未来的研究应更详细地关注情绪功能，以确定那些最有可能出现情绪功能困难的患者，并为那些希望参与劳动力的患者提供特定的社会心理支持。
