Center for Applied Research and Evaluation, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Pediatrics. 2013 Aug;132(2):e476-83. doi: 10.1542/peds.2013-0644. Epub 2013 Jul 29.
The purpose of this study was to empirically test if siblings of children with disability had higher levels of parent-reported behavioral and emotional functional impairment compared with a peer group of siblings residing with only typically developing children.
This was a retrospective secondary analysis of data from the Medical Expenditure Panel Survey. We included only households with at least 2 children to ensure sibling relationships. Two groups of siblings were formed: 245 siblings resided in households with a child with disability and 6564 siblings resided in households with typically developing children. Parents responded to questions from the Columbia Impairment Scale to identify functional impairment in their children.
On the basis of parent reports and after adjusting for sibling demographic characteristics and household background, siblings of children with disability were more likely than siblings residing with typically developing children to have problems with interpersonal relationships, psychopathological functioning, functioning at school, and use of leisure time (P < .05). The percentage of siblings of children with disability classified with significant functional impairment was 16.0% at the first measurement period and 24.2% at the second (P < .001). For siblings of typically developing children there was a smaller percentage increase from 9.5% to 10.3% (P < .001).
Functional impairment is a key indicator for the need of mental health services and, as such, early assessment and interventions to limit increasing severity and short- to long-term consequences need to be addressed. Health care professionals need to consider a family-based health care approach for families raising children with disability.
本研究旨在通过实证检验,比较残疾儿童的兄弟姐妹与仅与正常发育儿童同住的兄弟姐妹的父母报告的行为和情绪功能障碍水平,是否存在差异。
这是对医疗支出面板调查数据的回顾性二次分析。我们只纳入至少有 2 个孩子的家庭,以确保兄弟姐妹关系。形成了两组兄弟姐妹:245 名兄弟姐妹居住在有残疾儿童的家庭中,6564 名兄弟姐妹居住在有正常发育儿童的家庭中。父母回答哥伦比亚障碍量表中的问题,以确定子女的功能障碍。
根据父母的报告,并在调整了兄弟姐妹的人口统计学特征和家庭背景后,与与正常发育儿童同住的兄弟姐妹相比,残疾儿童的兄弟姐妹更有可能在人际关系、心理病理功能、学校功能和休闲时间利用方面存在问题(P<0.05)。残疾儿童兄弟姐妹中被归类为存在显著功能障碍的比例,在第一个测量期为 16.0%,在第二个测量期为 24.2%(P<0.001)。而正常发育儿童的兄弟姐妹中,从 9.5%到 10.3%的比例增加较小(P<0.001)。
功能障碍是需要心理健康服务的一个关键指标,因此需要进行早期评估和干预,以限制严重程度的增加和短期到长期的后果。卫生保健专业人员需要考虑为残疾儿童家庭提供以家庭为基础的卫生保健方法。