Butler Ashley M, Weller Bridget, Titus Courtney
Department of Pediatrics, Baylor College of Medicine, 1102 Bates St., Suite 940, Houston, TX, 77030, USA.
Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA.
Adm Policy Ment Health. 2015 Nov;42(6):767-74. doi: 10.1007/s10488-014-0612-y.
Experts encourage parents and practitioners to engage in shared decision making (SDM) to provide high quality child mental health care. However, little is known regarding SDM among families of children with common mental health conditions. The objectives of this study were to examine associations between parental report of SDM and parental perceptions of (a) receiving child mental health care and (b) child mental health functioning. We analyzed cross-sectional data on children with a common mental health condition (attention-deficit hyperactivity disorder, oppositional-defiant or conduct disorder, anxiety, or depression) from the 2009/2010 National Survey of Children with Special Healthcare Needs (N = 9,434). The primary independent variable was parent-reported SDM, and the dependent variables were parental perception of (a) their child receiving all needed mental health care (b) their children's impairment in school attendance and extracurricular activity participation, and (c) severity of their children's mental health condition. Multivariate logistic and multinomial regression analyses were conducted. Greater parent-reported SDM was associated with parental perceptions of receiving all needed child mental health care and children not having school or extracurricular impairment. Greater SDM was also associated with perceptions of children having a mild mental health condition compared to children having a moderate or severe condition. Findings provide a basis for future longitudinal and intervention studies to examine the benefit of SDM for improving parental perceptions of the quality of child mental health care and mental health functioning among children with common mental health conditions.
专家鼓励家长和从业者参与共同决策(SDM),以提供高质量的儿童心理健康护理。然而,对于患有常见心理健康问题的儿童家庭中的共同决策情况,我们知之甚少。本研究的目的是检验家长报告的共同决策与家长对以下两方面的看法之间的关联:(a)接受儿童心理健康护理的情况,以及(b)儿童的心理健康功能。我们分析了来自2009/2010年全国特殊医疗需求儿童调查的患有常见心理健康问题(注意力缺陷多动障碍、对立违抗或品行障碍、焦虑或抑郁)儿童的横断面数据(N = 9434)。主要自变量是家长报告的共同决策,因变量是家长对以下方面的看法:(a)他们的孩子接受了所有必要的心理健康护理;(b)他们的孩子在上学出勤和参与课外活动方面的受损情况;(c)他们孩子心理健康问题的严重程度。进行了多变量逻辑回归和多项回归分析。家长报告的共同决策程度越高,与家长认为孩子接受了所有必要的儿童心理健康护理以及孩子没有学业或课外活动受损的看法相关。与认为孩子患有中度或重度心理健康问题的家长相比,共同决策程度越高,也与认为孩子患有轻度心理健康问题的看法相关。研究结果为未来的纵向研究和干预研究提供了基础,以检验共同决策对于改善家长对患有常见心理健康问题儿童的心理健康护理质量和心理健康功能的看法的益处。