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儿童轻度创伤性脑损伤后影响亲子互动质量的因素。

Factors contributing to parent-child interaction quality following mild traumatic brain injury in early childhood.

机构信息

Ste-Justine Research Center, Montreal, Quebec, Canada.

Department of Psychology, University of Montreal, Quebec, Canada.

出版信息

J Neuropsychol. 2020 Mar;14(1):98-120. doi: 10.1111/jnp.12179. Epub 2019 Feb 19.

Abstract

There is emerging evidence that parent-child interactions are affected by early childhood traumatic brain injury (TBI). These findings are of functional importance when considering the high prevalence of TBI in early childhood alongside evidence that young children exposed to positive relationships with their parents early in life exhibit better social functioning concurrently and longitudinally. Given that the overall quality of parent-child interactions is the result of both parent and child emotional and behavioural dispositions, it remains unclear which parental or child-related factors contribute to the quality of interactions post-TBI. The aim of this study was to investigate the factors that contribute to the quality of parent-child interactions following early childhood TBI. The sample included 68 children (18-60 months at recruitment) with accidental, uncomplicated mild TBI (mTBI). The quality of parent-child interactions was assessed 6 months post-injury using the Mutually Responsive Orientation scale, an observational measure of the dyadic quality of parent-child exchanges. Potential contributing factors were assessed among parental factors (e.g., age, socioeconomic status, family burden, parental stress, marital satisfaction) and child-related factors (e.g., age, sex, symptoms, fatigue, adaptive/behavioural skills). Socioeconomic status, child post-concussive symptoms, and child sleep problems were found to be significant independent contributing factors to parent-child interactions six months post-injury. This study provides the first evidence that both parental and child factors relate to the quality of parent-child interactions following mTBI, thus contributing to a better understanding of the scope and complexity of factors that play a role in childrens' recovery.

摘要

越来越多的证据表明,亲子互动受到儿童早期创伤性脑损伤 (TBI) 的影响。这些发现具有重要的功能意义,因为儿童早期 TBI 的患病率很高,而且有证据表明,年幼的孩子如果在生命早期与父母建立积极的关系,那么他们在同时期和长期内的社会功能会更好。鉴于亲子互动的整体质量是父母和孩子的情感和行为倾向的结果,目前尚不清楚哪些父母或孩子相关因素会影响 TBI 后的互动质量。本研究旨在调查导致儿童早期 TBI 后亲子互动质量的因素。该样本包括 68 名儿童(招募时年龄为 18-60 个月),他们患有意外、无并发症的轻度 TBI (mTBI)。亲子互动质量在受伤后 6 个月使用相互响应取向量表进行评估,这是一种评估亲子互动质量的观察性测量方法。潜在的影响因素包括父母因素(如年龄、社会经济地位、家庭负担、父母压力、婚姻满意度)和儿童相关因素(如年龄、性别、症状、疲劳、适应/行为技能)。研究发现,社会经济地位、儿童脑震荡后症状和儿童睡眠问题是影响受伤后 6 个月亲子互动的重要独立影响因素。这项研究首次证明,父母和孩子的因素都与 mTBI 后亲子互动的质量有关,从而更好地理解了影响儿童康复的因素的范围和复杂性。

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