Royal Children's Hospital Education Institute, Parkville, Victoria, Australia; Murdoch Childrens Research Institute, Parkville, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia.
Royal Children's Hospital Education Institute, Parkville, Victoria, Australia; Murdoch Childrens Research Institute, Parkville, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia.
Acad Pediatr. 2015 Jan-Feb;15(1):89-95. doi: 10.1016/j.acap.2014.08.004. Epub 2014 Nov 8.
To understand the prevalence and timing of child chronic illness at school entry; associations with child learning, behavior and health-related quality of life and parent mental health at ages 6 to 7, 8 to 9, and 10 to 11 years; and cumulative health care costs.
Data were drawn from the first 4 waves of the Longitudinal Study of Australian Children. Children were aged 4 to 5 years at wave 1, with data collection every 2 years. Parent-reported timing of child chronic illness at school entry was categorized into 4 chronic illness groups based on changes between waves 1 and 2: none, resolving, incident and persistent. Child outcomes included: parent-reported quality of life, parent- and teacher-reported behavior, teacher-reported child learning, teacher-reported child-teacher relationship, directly assessed nonverbal and verbal cognition and parent self-reported mental health. Linear regression, adjusted for gender and socioeconomic position, was used to quantify longitudinal associations between chronic illness timing at school entry with outcomes at age 6 to 7 years, 8 to 9 years and 10 to 11 years.
Of the 4983 children enrolled in the study, chronic illness data was available for 4464 children (89.6%) at both waves 1 and 2. From wave 1, 6.1% had a condition that persisted until wave 2, while 14.1% had a condition that resolved. Furthermore, 4.7% had a newly emerging condition at wave 2. Compared with the no chronic illness group, children with persistent or emerging chronic illness during school entry had the poorest outcomes (except father's mental health) at all time points, while children with resolving conditions had smaller differences.
Child chronic illness at school entry is associated with poorer longitudinal child and maternal outcomes. Therefore, future research should aim to determine the risk and protective factors that contribute to the poorer child and parent outcomes experienced in this growing population.
了解儿童在入学时慢性疾病的流行率和发病时间；研究其与儿童在 6 至 7 岁、8 至 9 岁和 10 至 11 岁时的学习、行为和健康相关生活质量以及父母心理健康之间的关系；以及累积的医疗保健费用。
数据来自澳大利亚儿童纵向研究的前 4 个波次。在第 1 波次时，儿童年龄为 4 至 5 岁，每两年进行一次数据采集。根据第 1 波次和第 2 波次之间的变化，家长报告的儿童入学时慢性疾病的发病时间分为 4 个慢性疾病组：无疾病、疾病缓解、新发病和持续性疾病。儿童的结果包括：父母报告的生活质量、父母和教师报告的行为、教师报告的儿童学习、教师报告的儿童与教师关系、直接评估的非言语和言语认知以及父母自我报告的心理健康。线性回归，调整了性别和社会经济地位，用于量化儿童入学时慢性疾病发病时间与 6 至 7 岁、8 至 9 岁和 10 至 11 岁时结果之间的纵向关联。
在 4983 名入组儿童中，有 4464 名儿童（89.6%）在第 1 波次和第 2 波次都有慢性疾病数据。从第 1 波次开始，6.1%的儿童有一种持续到第 2 波次的疾病，而 14.1%的儿童有一种疾病缓解。此外，4.7%的儿童在第 2 波次出现了新发病。与无慢性疾病组相比，入学时患有持续性或新发性慢性疾病的儿童在所有时间点的结果最差（父亲心理健康除外），而患有缓解性疾病的儿童差异较小。
儿童在入学时的慢性疾病与较差的儿童和母亲纵向结局相关。因此，未来的研究应旨在确定导致这一不断增长的人群中儿童和父母较差结局的风险和保护因素。
