Moffat Anna K, Redmond Gerry
School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia.
School of Social and Policy Studies, Flinders University, Adelaide, South Australia, Australia.
BMJ Open. 2017 Jan 6;7(1):e013946. doi: 10.1136/bmjopen-2016-013946.
Young people's perspectives on the association between having a family member with a chronic health concern (FHC) and their own health are under-researched. This study used young people's reports to assess the prevalence of FHCs and their association with negative health outcomes, with an aim of identifying potential inequalities between marginalised and non-marginalised young people. Family cohesion was examined as a moderating factor.
Cross-sectional data from the Australian Child Wellbeing Project survey were used. Respondents were asked whether someone in their family experienced one or more FHCs (disability, mental illness or drug/alcohol addiction). In addition, their experience of different psychosomatic symptoms (headache, sleeplessness, irritability, etc), aspects of family relationships and social and economic characteristics (disability, materially disadvantaged and Indigenous) were documented.
Nationally representative Australian sample.
1531 students in school years 4 and 6 and 3846 students in year 8.
A quarter of students reported having an FHC (years 4 and 6: 23.96% (95% CI 19.30% to 28.62%); year 8: 25.35% (95% CI 22.77% to 27.94%)). Significantly, more students with FHCs than those without reported experiencing 2 or more negative health symptoms at least weekly (OR=1.78; 95% CI 1.19 to 2.65; p<0.01). However, an independent relationship between FHCs and symptom load was only found in the case of FHC-drug/alcohol addiction. Marginalised students and students reporting low family cohesion had an increased prevalence of FHCs and notably higher symptom loads where FHCs were present. Level of family cohesion did not impact the relationship between FHCs and symptom load.
The burden of FHCs is inequitably distributed between marginalised and non-marginalised groups, and between young people experiencing different levels of family cohesion. More work is required regarding appropriate targets for community and family-level interventions to support young people in the context of FHCs.
年轻人对家庭成员患有慢性健康问题（FHC）与其自身健康之间关联的看法研究不足。本研究利用年轻人的报告来评估FHC的患病率及其与负面健康结果的关联，旨在确定边缘化和非边缘化年轻人之间的潜在不平等。家庭凝聚力作为一个调节因素进行了考察。
使用了澳大利亚儿童福祉项目调查的横断面数据。受访者被问及他们家中是否有人患有一种或多种FHC（残疾、精神疾病或药物/酒精成瘾）。此外，记录了他们不同的心身症状（头痛、失眠、易怒等）经历、家庭关系方面以及社会和经济特征（残疾、物质匮乏和原住民）。
具有全国代表性的澳大利亚样本。
4年级和6年级的1531名学生以及8年级的3846名学生。
四分之一的学生报告有FHC（4年级和6年级：23.96%（95%置信区间19.30%至28.62%）；8年级：25.35%（95%置信区间22.77%至27.94%））。值得注意的是，患有FHC的学生比未患FHC的学生报告至少每周经历2种或更多负面健康症状的比例更高（比值比=1.78；95%置信区间1.19至2.65；p<0.01）。然而，仅在FHC-药物/酒精成瘾的情况下发现FHC与症状负荷之间存在独立关系。边缘化学生和报告家庭凝聚力低的学生FHC患病率增加，并且在存在FHC的情况下症状负荷明显更高。家庭凝聚力水平并未影响FHC与症状负荷之间的关系。
FHC的负担在边缘化和非边缘化群体之间以及经历不同家庭凝聚力水平的年轻人之间分配不均。在社区和家庭层面干预的适当目标方面，需要开展更多工作以在FHC背景下支持年轻人。
