Thomson Joanna, Shah Samir S, Simmons Jeffrey M, Sauers-Ford Hadley S, Brunswick Stephanie, Hall David, Kahn Robert S, Beck Andrew F
Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.
Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
J Pediatr. 2016 May;172:187-193.e1. doi: 10.1016/j.jpeds.2016.01.049. Epub 2016 Feb 17.
To describe hardships experienced by families of children with medical complexity (CMC) and compare them with those experienced by families of children with asthma.
We assessed hardships in a cohort of 167 families of CMC. Surveys assessed sociodemographics and hardships (eg, financial: inability to pay bills; social: limited help from family/friends). CMC cohort hardships were compared with those of an established cohort of children hospitalized with asthma using multivariable logistic regression.
CMC had diagnoses in a median of 5 different complex chronic condition categories (most common neurologic/neuromuscular), and the majority (74%) were dependent on technology. Over 80% of families of CMC reported experiencing ≥1 hardship; 68% with financial and 46% with social hardship. Despite higher socioeconomic status than families with asthma, families of CMC often experienced more hardships. For example, families of CMC were significantly more likely to report failure to pay rent/mortgage (aOR 2.6, 95% CI 1.6, 4.3) and the expectation of little to no help from family/friends (aOR 2.9, 95% CI 1.9, 4.7).
Families of CMC frequently report financial and social hardships, often at rates higher than families with asthma who were generally of lower socioeconomic status. Identifying and acting upon hardships may be an important addition to the care of CMC.
描述患有复杂疾病的儿童(CMC)家庭所经历的困难,并将其与哮喘儿童家庭所经历的困难进行比较。
我们评估了167名CMC儿童家庭中的困难情况。调查评估了社会人口统计学特征和困难(例如,经济方面:无法支付账单;社会方面:来自家人/朋友的帮助有限)。使用多变量逻辑回归将CMC队列中的困难情况与已有的哮喘住院儿童队列中的困难情况进行比较。
CMC儿童的诊断中位数为5种不同的复杂慢性病类别(最常见的是神经/神经肌肉疾病),大多数(74%)依赖技术设备。超过80%的CMC儿童家庭报告经历过≥1种困难;68%的家庭有经济困难,46%的家庭有社会困难。尽管CMC儿童家庭的社会经济地位高于哮喘儿童家庭,但他们经常经历更多的困难。例如,CMC儿童家庭更有可能报告未能支付房租/抵押贷款(调整后的比值比[aOR]为2.6,95%置信区间[CI]为1.6至4.3),以及期望从家人/朋友那里得到很少或没有帮助(aOR为2.9,95% CI为1.9至4.7)。
CMC儿童家庭经常报告经济和社会困难,其发生率通常高于社会经济地位普遍较低的哮喘儿童家庭。识别并应对这些困难可能是CMC儿童护理的重要补充。