Ritzema A M, Lach L M, Nicholas D, Sladeczek I E
Child Development Program, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.
Faculty of Arts, School of Social Work, Department of Paediatrics, Neurology & Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada.
Child Care Health Dev. 2018 Mar;44(2):240-248. doi: 10.1111/cch.12541. Epub 2017 Dec 18.
Both child function and supports and services have been found to impact the well-being of parents of children with neurodevelopmental disorders (NDD). The relationship between function and services and the well-being of children with NDD is less well-understood and is important to clarify in order to effect program and service change.
The current project assessed whether child function as well as the adequacy of formal supports and services provided to children and their families were predictive of child well-being. Well-being was assessed using a measure of quality of life developed for use with children with NDD. Data from 234 parents were analysed using structural equation modelling.
Each predictor was found to load significantly on the overall outcome variable of well-being. Parent concerns about child function were significantly related to child well-being; parents who reported more concerns about their children's functioning reported lower levels of child well-being. Unmet needs for formal supports and services were also significantly related to child well-being; parents who reported that more of their children's and family's service needs were unmet reported lower child well-being. An indirect relationship was also found between child function and child well-being. When parents reported that their formal support needs were adequately met, their children's functional difficulties had a lower impact on parent perceptions of their children's overall well-being.
Taken together, the results of the current study enrich our understanding of well-being for children with NDD. Discussion focuses on the service implications for children with NDD and their families.
研究发现,儿童功能以及支持与服务均会影响神经发育障碍(NDD)患儿父母的幸福感。功能与服务和NDD患儿幸福感之间的关系尚鲜为人知,为实现项目与服务变革,厘清这一关系十分重要。
本项目评估了儿童功能以及为儿童及其家庭提供的正式支持与服务的充足程度是否能预测儿童的幸福感。幸福感通过一种专为NDD患儿开发的生活质量测量工具进行评估。使用结构方程模型对来自234位家长的数据进行了分析。
研究发现,每个预测因素均在幸福感这一总体结果变量上有显著载荷。家长对儿童功能的担忧与儿童幸福感显著相关;报告对孩子功能更为担忧的家长,其孩子的幸福感水平较低。正式支持与服务的未满足需求也与儿童幸福感显著相关;报告孩子及其家庭更多服务需求未得到满足的家长,其孩子的幸福感较低。研究还发现儿童功能与儿童幸福感之间存在间接关系。当家长报告其正式支持需求得到充分满足时,孩子的功能困难对家长对孩子总体幸福感的认知影响较小。
总体而言,本研究结果丰富了我们对NDD患儿幸福感的理解。讨论聚焦于对NDD患儿及其家庭的服务启示。