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因初级保健机构的心理健康服务前来就诊的家庭中的共同决策、污名化与儿童心理健康状况

Shared decision-making, stigma, and child mental health functioning among families referred for primary care-located mental health services.

作者信息

Butler Ashley M

机构信息

Baylor College of Medicine.

出版信息

Fam Syst Health. 2014 Mar;32(1):116-21. doi: 10.1037/fsh0000004. Epub 2014 Jan 20.

Abstract

There is growing emphasis on shared decision making (SDM) to promote family participation in care and improve the quality of child mental health care. Yet, little is known about the relationship of SDM with parental perceptions of child mental health treatment or child mental health functioning. The objectives of this preliminary study were to examine (a) the frequency of perceived SDM with providers among minority parents of children referred to colocated mental health care in a primary care clinic, (b) associations between parent-reported SDM and mental health treatment stigma and child mental health impairment, and (c) differences in SDM among parents of children with various levels of mental health problem severity. Participants were 36 Latino and African American parents of children (ages 2-7 years) who were referred to colocated mental health care for externalizing mental health problems (disruptive, hyperactive, and aggressive behaviors). Parents completed questions assessing their perceptions of SDM with providers, child mental health treatment stigma, child mental health severity, and level of child mental health impairment. Descriptive statistics demonstrated the majority of the sample reported frequent SDM with providers. Correlation coefficients indicated higher SDM was associated with lower stigma regarding mental health treatment and lower parent-perceived child mental health impairment. Analysis of variance showed no significant difference in SDM among parents of children with different parent-reported levels of child mental health severity. Future research should examine the potential of SDM for addressing child mental health treatment stigma and impairment among minority families.

摘要

为促进家庭参与儿童心理健康护理并提高护理质量,共同决策(SDM)受到越来越多的关注。然而,关于SDM与父母对儿童心理健康治疗的认知或儿童心理健康功能之间的关系,我们知之甚少。这项初步研究的目的是检验:(a)在一家初级保健诊所接受联合心理健康护理转诊的儿童的少数族裔父母中,与提供者进行共同决策的感知频率;(b)父母报告的共同决策与心理健康治疗耻辱感及儿童心理健康损害之间的关联;(c)患有不同心理健康问题严重程度的儿童的父母在共同决策方面的差异。参与者为36名拉丁裔和非裔美国儿童(2至7岁)的父母,这些儿童因外化性心理健康问题(破坏性行为、多动和攻击行为)被转诊至联合心理健康护理机构。父母完成了一些问题,评估他们对与提供者共同决策的认知、儿童心理健康治疗耻辱感、儿童心理健康严重程度以及儿童心理健康损害程度。描述性统计表明,大多数样本报告与提供者频繁进行共同决策。相关系数表明,更高程度的共同决策与较低的心理健康治疗耻辱感以及较低的父母感知到的儿童心理健康损害相关。方差分析表明,在父母报告的儿童心理健康严重程度不同的儿童的父母中,共同决策没有显著差异。未来的研究应探讨共同决策在解决少数族裔家庭中儿童心理健康治疗耻辱感和损害方面的潜力。

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