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儿童被安置照料后母亲的健康和社会结局:使用可链接行政数据的基于人群的纵向队列研究。

Maternal health and social outcomes after having a child taken into care: population-based longitudinal cohort study using linkable administrative data.

机构信息

Department of Community Health Sciences, University of Manitoba, Manitoba, Canada.

Manitoba Centre for Health Policy, University of Manitoba, Manitoba, Canada.

出版信息

J Epidemiol Community Health. 2017 Dec;71(12):1145-1151. doi: 10.1136/jech-2017-209542. Epub 2017 Oct 5.

Abstract

BACKGROUND

We investigated whether mothers experience changes to their health and social situation after having a child taken into care by child protection services, then compared these outcomes with those found in mothers whose children were not taken into care.

METHODS

The cohort includes mothers whose first child was born in Manitoba between 1 April 1998 and 31 March 2011. Mothers whose children were taken into care after age 2 (n=1591) were compared with a matched group of women whose children were not taken into care (n=1591).

RESULTS

The rates of mental illness diagnoses, treatment use and social factors were significantly higher for mother whose children were taken into care, both in the 2 years before and in the 2 years after the index date. These adjusted relative rates (ARRs) increased significantly for anxiety (before ARR=2.71, after ARR=3.55), substance use disorder (3.77-5.95), physician visits for mental illness (2.83-3.66), number of prescriptions (psychotropic: 4.35-5.86; overall: 2.34-2.94), number of different prescriptions (psychotropic: 2.70-3.27; overall: 1.62-1.70), residential mobility (1.40-1.63) and welfare use (2.07-2.30).

CONCLUSION

The health and social situation of mothers involved with child protection services deteriorates after their child is taken into care. Mothers would benefit from supports during this time period to ensure that the outcomes they experience after the loss of their child do not become another barrier to reunification.

摘要

背景

本研究旨在调查儿童保护服务机构接管儿童后,母亲的健康和社会状况是否会发生变化,并将这些结果与未被接管的儿童的母亲进行比较。

方法

该队列纳入了 1998 年 4 月 1 日至 2011 年 3 月 31 日期间在马尼托巴省首次分娩的母亲。将其子女在 2 岁后被接管的母亲(n=1591)与未被接管的子女的母亲(n=1591)进行比较。

结果

在索引日期之前的 2 年和之后的 2 年内,子女被接管的母亲的精神疾病诊断、治疗使用和社会因素的发生率明显更高。这些调整后的相对比率(ARR)显著增加,包括焦虑症(ARR 从 2.71 增加到 3.55)、物质使用障碍(3.77-5.95)、因精神疾病就诊的次数(ARR 从 2.83 增加到 3.66)、处方数量(精神类药物:ARR 从 4.35 增加到 5.86;总体:ARR 从 2.34 增加到 2.94)、不同处方数量(精神类药物:ARR 从 2.70 增加到 3.27;总体:ARR 从 1.62 增加到 1.70)、居住地迁移(ARR 从 1.40 增加到 1.63)和福利使用(ARR 从 2.07 增加到 2.30)。

结论

儿童保护服务机构接管儿童后,母亲的健康和社会状况恶化。在此期间,母亲需要得到支持,以确保她们在失去孩子后不会面临另一个团聚的障碍。

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