Weber Sabine, Jud Andreas, Landolt Markus A, Goldbeck Lutz
Child Protection Group, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.
School of Social Work, Lucerne University of Applied Sciences and Arts, Lucerne, Switzerland.
Qual Life Res. 2017 Oct;26(10):2717-2727. doi: 10.1007/s11136-017-1615-4. Epub 2017 Jun 15.
Research on the consequences of child maltreatment has primarily focused on behavior and mental health; the children's overall well-being has not received the same attention. A number of studies have investigated health-related quality of life (HRQoL) among victims of child maltreatment, but there is still a lack of knowledge about predictors of HRQoL in maltreated children and adolescents. This study seeks to bridge the gap by drawing data from the German multi-site study Child Abuse and Neglect Case-Management (CANMANAGE).
Parents or caregivers of 350 children and adolescents completed a proxy version of the Kidscreen-10-Index, a multidimensional instrument measuring child HRQoL. An additional 249 children age 8 years and older completed a self-report version. Multiple regression analyses were performed to identify potential predictors for both self- and proxy-rated HRQoL.
Comparisons with the reference group revealed a significantly lower mean proxy-rated HRQoL, the self-rated HRQoL of the study sample was not significantly impaired. Predictors of impaired self-reported HRQoL were older age, self-reported posttraumatic stress symptoms (PTSS), and self-reported emotional and behavioral symptoms. Predictors of impaired proxy-reported HRQoL again were older age, self-reported PTSS, and emotional and behavioral symptoms in the child/adolescent, as reported by the caregiver, as well as low socioeconomic status. Multivariate analysis explained 20% and 38% of the variability in self-reported and proxy-rated HRQoL, respectively.
It is important to treat PTSS and emotional and behavioral symptoms in maltreated children, as these two phenomena are strong cross-sectional predictors of a child's HRQoL. Trauma-focused cognitive behavioral therapies are one possible option to address the needs of such children.
对儿童虐待后果的研究主要集中在行为和心理健康方面；儿童的整体幸福感并未受到同等关注。一些研究调查了受虐待儿童的健康相关生活质量（HRQoL），但对于受虐待儿童和青少年HRQoL的预测因素仍缺乏了解。本研究旨在通过从德国多地点研究“儿童虐待与忽视病例管理（CANMANAGE）”中提取数据来填补这一空白。
350名儿童和青少年的父母或照料者完成了儿童生活质量量表10项指标（Kidscreen - 10 - Index）的代理版本，这是一种测量儿童HRQoL的多维工具。另外249名8岁及以上儿童完成了自我报告版本。进行多元回归分析以确定自我评定和代理评定的HRQoL的潜在预测因素。
与参照组相比，代理评定的HRQoL平均得分显著更低，而研究样本的自我评定HRQoL未受到显著损害。自我报告的HRQoL受损的预测因素包括年龄较大、自我报告的创伤后应激症状（PTSS）以及自我报告的情绪和行为症状。代理报告的HRQoL受损的预测因素再次包括年龄较大、自我报告的PTSS、照料者报告的儿童/青少年的情绪和行为症状以及社会经济地位较低。多变量分析分别解释了自我报告和代理评定的HRQoL变异性的20%和38%。
治疗受虐待儿童的PTSS以及情绪和行为症状很重要，因为这两种现象是儿童HRQoL的强有力的横断面预测因素。以创伤为重点的认知行为疗法是满足此类儿童需求的一种可能选择。
