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从父母的角度理解新生儿脑损伤后的儿童早期韧性:一项混合方法设计。

Understanding Early Childhood Resilience Following Neonatal Brain Injury From Parents' Perspectives Using a Mixed-Method Design.

机构信息

The Hospital for Sick Children,Division of Neurology,Department of Pediatrics,Toronto Ontario,Canada.

The Hospital for Sick Children,Department of Psychology,Toronto,Ontario,Canada.

出版信息

J Int Neuropsychol Soc. 2019 Apr;25(4):390-402. doi: 10.1017/S1355617719000079.

Abstract

OBJECTIVES

The current study used a mixed-method design to qualitatively examine parents' definitions of resilience and factors they believed optimized their child's early outcome following neonatal brain injury. This was followed by quantitative analyses of early developmental and mental health outcomes and their relation to salient biopsychosocial factors.

METHODS

Participants were parents of children diagnosed with neonatal brain injury due to stroke or hypoxic-ischemic encephalopathy (N=51; age range of children 18 months to 8 years). The Parent Experiences Questionnaire (PEQ) was used to qualitatively analyze parents' open-ended responses about their child's early experiences and outcome. The Child Behavior Checklist (CBCL) and Scales of Independent Behaviour Early Developmental Form (SIB-ED) parent ratings were used to measure child resilience from a quantitative perspective, identifying "at-risk" and "resilient" children using standard cutoffs. "Resilient" and "at-risk" children were compared on biopsychosocial variables using univariate t tests and chi-square analyses.

RESULTS

Parents provided five unique definitions of their child's positive outcomes, and many children demonstrated resilience based on parent perspectives and quantitative definitions. Supporting factors included close medical follow-up, early intervention, and intrinsic factors within the child and parent. Group comparisons of "resilient" and "at-risk" children highlighted the importance of parent mental health across these early developmental and mental health outcomes.

CONCLUSIONS

Many children were described as resilient during the early years by parents using qualitative and quantitative approaches. Findings highlighted the importance of parent well-being in promoting optimal early outcomes. (JINS, 2019, 25, 390-402.).

摘要

目的

本研究采用混合方法设计,从定性角度探讨父母对韧性的定义以及他们认为优化患有新生儿脑损伤儿童早期预后的因素。随后对早期发展和心理健康结果进行定量分析,并探讨其与重要的生物心理社会因素的关系。

方法

研究对象为患有由中风或缺氧缺血性脑病导致的新生儿脑损伤的儿童的父母(N=51;儿童年龄范围为 18 个月至 8 岁)。采用父母经历问卷(PEQ)对父母关于孩子早期经历和结果的开放性回答进行定性分析。采用儿童行为检查表(CBCL)和独立行为早期发育量表(SIB-ED)家长评定来从定量角度衡量儿童的适应力,使用标准临界值识别“高危”和“适应力强”的儿童。使用单变量 t 检验和卡方分析对生物心理变量进行“适应力强”和“高危”儿童之间的比较。

结果

父母对孩子积极结果提供了五个独特的定义,许多孩子从父母的观点和定量定义来看都表现出了适应力。支持因素包括密切的医疗随访、早期干预以及儿童和父母内在的因素。“适应力强”和“高危”儿童的组间比较强调了在这些早期发展和心理健康结果中父母心理健康的重要性。

结论

父母通过定性和定量方法将许多孩子描述为在早期具有适应力。研究结果强调了父母幸福感在促进最佳早期结果中的重要性。(JINS,2019,25,390-402)。

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