Mussatto Kathleen A, Sawin Kathleen J, Schiffman Rachel, Leske Jane, Simpson Pippa, Marino Bradley S
J Pediatr Health Care. 2014 May-Jun;28(3):251-61. doi: 10.1016/j.pedhc.2013.05.006. Epub 2013 Jul 30.
This study examined the importance of self-perceptions as determinants of psychosocial adjustment reported by adolescents with heart disease and compared adolescents with heart disease to healthy norms.
Ninety-two adolescents with heart disease from a single Midwestern institution provided reports of self-perceptions (health, self-worth, competence, and importance), internalizing behavior problems (IPs; e.g., anxiety and depression) and externalizing behavior problems (EPs; e.g., attention problems and aggression), and health-related quality of life (HRQOL). Hierarchical linear regression was used to assess the impact of self-perceptions, as well as clinical factors (e.g., illness severity, time since last hospitalization, and medications) and demographic characteristics on outcomes.
Self-perceptions explained the most variance in behavioral and HRQOL outcomes (R(2)adj = 0.34 for IP, 0.24 for EP, and 0.33 for HRQOL, p < .001). Male gender and lower household income were associated with more behavior problems. Clinical variables were only related to HRQOL. Compared with healthy norms, IPs were significantly more common in male adolescents and HRQOL was lower (p < .001).
Adolescents with heart disease are at risk for internalizing behavior problems and reduced HRQOL; however, positive self-perceptions appear to be protective. Self-perceptions are critical and should be addressed by clinicians.
本研究探讨了自我认知作为心脏病青少年心理社会适应决定因素的重要性，并将心脏病青少年与健康标准进行了比较。
来自中西部一家机构的92名心脏病青少年提供了自我认知（健康、自我价值、能力和重要性）、内化行为问题（如焦虑和抑郁）、外化行为问题（如注意力问题和攻击行为）以及健康相关生活质量（HRQOL）的报告。采用分层线性回归评估自我认知以及临床因素（如疾病严重程度、上次住院后的时间和药物治疗）和人口统计学特征对结果的影响。
自我认知解释了行为和HRQOL结果中最大的变异（内化行为问题的调整R² = 0.34，外化行为问题为0.24，HRQOL为0.33，p <.001）。男性和较低的家庭收入与更多的行为问题相关。临床变量仅与HRQOL有关。与健康标准相比，内化行为问题在男性青少年中显著更常见，且HRQOL较低（p <.001）。
患有心脏病的青少年有内化行为问题和HRQOL降低的风险；然而，积极的自我认知似乎具有保护作用。自我认知至关重要，临床医生应予以关注。
