Borg Anne-Mari, Salmelin Raili, Joukamaa Matti, Tamminen Tuula
Department of Child Psychiatry, School of Medicine, University of Tampere, 33014 Tampere, Finland ; Department of Child Psychiatry, Tampere University Hospital, PL 2000, 33521 Tampere, Finland.
School of Health Sciences, University of Tampere, 33014 Tampere, Finland.
ScientificWorldJournal. 2014;2014:286939. doi: 10.1155/2014/286939. Epub 2014 Dec 31.
Assessing young children's mental health is a crucial and challenging task. The aim of the study was to evaluate the clinical relevance of asking parents, nurses, and young children themselves to identify children's mental health problems by only one or two questions.
In regular health check-ups of 4- to 9-year-old children (n = 2682), parents and public health nurses assessed by one question whether the child had any emotional or behavioral difficulties. The child completed a self-evaluation enquiry on his/her emotional well-being. A stratified proportion of the participating parents were invited to a diagnostic interview.
Sensitivities were fairly good for the parents' (68%), nurses' (65%), and their combined (79%) one-question screens. Difficulties identified by parents and nurses were major risks (OR 10-14) for any child psychiatric disorders (P < 0.001). The child's self-evaluation was related to 2-fold to 3-fold risks (P < 0.05) for any psychiatric diagnosis, for any emotional diagnosis, and for negative situational factors.
The one-question screen for parents and public health nurses together quite adequately identified the young children with mental health problems. The child's self-evaluation provided relevant and complementary information on his/her mental health and especially emotional problems.
评估幼儿心理健康是一项至关重要且具有挑战性的任务。本研究的目的是评估仅通过一两个问题让家长、护士及幼儿自身来识别儿童心理健康问题的临床相关性。
在对4至9岁儿童(n = 2682)的定期健康检查中,家长和公共卫生护士通过一个问题评估孩子是否存在任何情绪或行为问题。孩子完成了一份关于其情绪健康的自我评估询问。按分层比例邀请参与研究的家长参加诊断访谈。
家长(68%)、护士(65%)以及二者综合(79%)的单问题筛查敏感性相当不错。家长和护士识别出的问题是任何儿童精神疾病的主要风险因素(比值比10 - 14)(P < 0.001)。对于任何精神疾病诊断、任何情绪诊断以及负面情境因素,孩子的自我评估与2至3倍的风险相关(P < 0.05)。
家长和公共卫生护士共同进行的单问题筛查能相当充分地识别出有心理健康问题的幼儿。孩子的自我评估提供了关于其心理健康尤其是情绪问题的相关且补充性信息。