Carona Carlos, Moreira Helena, Silva Neuza, Crespo Carla, Canavarro Maria Cristina
Faculty of Psychology and Education Sciences, The University of Coimbra , Coimbra , Portugal.
Disabil Rehabil. 2014;36(7):584-92. doi: 10.3109/09638288.2013.804596. Epub 2013 Jun 20.
This study had two main objectives: first, to describe the social support and psychological maladjustment of children and adolescents with cerebral palsy (CP); and second, to test a mediation model where psychological maladjustment was hypothesized to mediate the link between social support and health-related quality of life (HRQL). In addition, the moderating role of gender and age was examined for this mediation model.
Self- and proxy-report questionnaires on the aforementioned variables were administered to a sample of 96 children/adolescents with CP and 118 healthy controls, as well as one of their parents. Univariate and multivariate analyses of covariance were conducted to examine differences in social support and psychological maladjustment, respectively. PROCESS computational tool was used for path analysis-based mediation, moderation and moderated mediation analyses.
Children/adolescents with CP reported lower levels of social support than their healthy peers, but no significant differences emerged in terms of their psychological maladjustment. For children/adolescents with CP, internalizing and externalizing problems were found to mediate the link between social support and HRQL, and these indirect effects were not conditional upon age or gender.
Children and adolescents with CP are likely have more negative perceptions of social support, but not necessarily more psychological adjustment problems than their healthy, able-bodied peers. Results further suggest that interventions targeting social support perceptions may positively affect HRQL outcomes in children/adolescents with CP, through the improvement of internalizing and externalizing dimensions of their psychological adjustment.
Social support perceptions are important intervention targets in psychosocial rehabilitation with children and adolescents with CP. Children and adolescents with CP do not necessarily present increased psychological maladjustment. Interventions targeting these children and adolescents' social support may promote their psychological adjustment and health-related quality of life. Developmental specificities, such as age and gender differences, should be considered when planning and implementing psychosocial interventions.
本研究有两个主要目的：第一，描述脑瘫（CP）儿童和青少年的社会支持与心理失调情况；第二，检验一个中介模型，其中假设心理失调在社会支持与健康相关生活质量（HRQL）之间起中介作用。此外，还考察了性别和年龄对该中介模型的调节作用。
对96名CP儿童/青少年及其118名健康对照者以及他们的一位家长进行了关于上述变量的自评和代理报告问卷调查。分别进行单因素和多因素协方差分析，以检验社会支持和心理失调方面的差异。使用PROCESS计算工具进行基于路径分析的中介、调节和调节中介分析。
CP儿童/青少年报告的社会支持水平低于其健康同龄人，但在心理失调方面未发现显著差异。对于CP儿童/青少年，发现内化和外化问题在社会支持与HRQL之间起中介作用，且这些间接效应不受年龄或性别的影响。
CP儿童和青少年可能对社会支持有更多负面认知，但不一定比健康的同龄人有更多心理调适问题。结果进一步表明，针对社会支持认知的干预可能通过改善心理调适的内化和外化维度，对CP儿童/青少年的HRQL结果产生积极影响。
社会支持认知是CP儿童和青少年心理社会康复的重要干预目标。CP儿童和青少年不一定存在心理失调增加的情况。针对这些儿童和青少年社会支持的干预可能促进他们的心理调适和健康相关生活质量。在规划和实施心理社会干预时，应考虑年龄和性别差异等发育特异性因素。
