Teyhan Alison, Galobardes Bruna, Henderson John
School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
PLoS One. 2015 Aug 12;10(8):e0135271. doi: 10.1371/journal.pone.0135271. eCollection 2015.
Eczema and asthma are common conditions in childhood that can influence children's mental health. Despite this, little is known about how these conditions affect the well-being of children in school. This study examines whether symptoms of eczema or asthma are associated with poorer social and mental well-being in school as reported by children and their teachers at age 8 years.
Participants were from the Avon Longitudinal Study of Parents and Children. Measures of child well-being in school were child-reported (n = 6626) and teacher reported (n = 4366): children reported on their enjoyment of school and relationships with peers via a self-complete questionnaire; teachers reported child mental well-being using the Strengths and Difficulties Questionnaire [binary outcomes were high 'internalizing' (anxious/depressive) and 'externalizing' (oppositional/hyperactive) problems (high was >90th percentile)]. Child rash and wheeze status were maternally reported and symptoms categorised as: 'none'; 'early onset transient' (infancy/preschool only); 'persistent' (infancy/preschool and at school age); and 'late onset' (school age only).
Children with persistent (OR 1.29, 95% CI 1.02 to 1.63) and late onset (OR 1.48, 95% CI 1.02 to 2.14) rash were more likely to report being bullied, and children with persistent wheeze to feel left out (OR 1.42, 95% CI 1.10 to 1.84). Late onset rash was associated with high teacher-reported internalising behaviours (OR 1.61, 95% CI 1.02 to 2.54), and persistent rash with high externalising behaviours (OR 1.37, 95% CI 1.02 to 1.84). Child sleep and maternal mental health explained some of the associations with teacher-reported mental well-being.
Symptoms of eczema or asthma can adversely affect a child's social and mental well-being at primary school. This suggests interventions, such as additional support or education of peers, should begin at early stages in schooling.
湿疹和哮喘是儿童期的常见病症,会影响儿童的心理健康。尽管如此,对于这些病症如何影响在校儿童的幸福状况却知之甚少。本研究调查了8岁儿童及其教师报告的湿疹或哮喘症状是否与较差的学校社交和心理健康状况相关。
参与者来自阿冯父母与儿童纵向研究。学校儿童幸福状况的测量由儿童报告(n = 6626)和教师报告(n = 4366):儿童通过自我填写问卷报告他们对学校的喜爱程度以及与同伴的关系;教师使用长处和困难问卷报告儿童的心理健康状况[二元结局为高“内化”(焦虑/抑郁)和“外化”(对立/多动)问题(高是指高于第90百分位数)]。儿童皮疹和喘息状况由母亲报告,并将症状分类为:“无”;“早发性短暂性”(仅在婴儿期/学龄前);“持续性”(婴儿期/学龄前和学龄期);以及“晚发性”(仅在学龄期)。
患有持续性(比值比1.29,95%置信区间1.02至1.63)和晚发性(比值比1.48,95%置信区间1.02至2.14)皮疹的儿童更有可能报告遭受欺凌,患有持续性喘息的儿童更有可能感到被排斥(比值比1.42,95%置信区间1.10至1.84)。晚发性皮疹与教师报告的高内化行为相关(比值比1.61,95%置信区间1.02至2.54),持续性皮疹与高外化行为相关(比值比1.37,95%置信区间1.02至1.84)。儿童睡眠和母亲心理健康解释了一些与教师报告的心理健康状况的关联。
湿疹或哮喘症状会对小学儿童的社交和心理健康产生不利影响。这表明干预措施,如额外的支持或对同伴的教育,应在学校教育的早期阶段开始。