School of Psychology and Counselling, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.
School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.
J Pediatr Psychol. 2019 Oct 1;44(9):1083-1096. doi: 10.1093/jpepsy/jsz048.
This study examined associations between chronic physical health conditions (identified from hospital records) that are subject to school health care plans, and children's emotional, behavioral, and social functioning during early (∼5 years of age) and middle childhood (∼11 years).
Participants were 21,304 Australian children from a representative longitudinal population cohort derived by multi-agency record linkage. Hospital presentations (admitted patients and emergency department) identified children with asthma (n = 1,573), allergies and anaphylaxis (n = 738), type 1 diabetes (n = 59), epilepsy (n = 87), and any of these conditions (n = 2,275), relative to 19,029 children without these presentations. Logistic regression analyses determined associations between these exposures and (i) emotional, behavioral, social, and overall vulnerabilities reported by teachers (early childhood) and children (middle childhood), and (ii) self-reported lack of sources of support (middle childhood).
Prevalence of any condition in hospital records was 7.5% by early childhood, and 10.7% by middle childhood. Relative to peers without these presentations, small increases in risk of overall problems, and selected emotional, behavioral, and social problems, were apparent for children with any condition, and asthma specifically, in early and middle childhood. Large and pervasive effects were apparent for epilepsy, limited small effects in middle childhood only for allergies and anaphylaxis, and no increases in risk associated with type 1 diabetes examined in middle childhood. No condition was associated with increased risk of lacking supports.
Children with hospital records of chronic conditions, particularly epilepsy and asthma, might benefit from school-based care plans that integrate their physical and mental health support needs.
本研究考察了受学校保健计划影响的慢性身体健康状况（从医院记录中确定）与儿童早期（约 5 岁）和中期（约 11 岁）情绪、行为和社会功能之间的关联。
参与者为来自多机构记录链接的代表性纵向人群队列的 21304 名澳大利亚儿童。医院就诊（住院患者和急诊室）确定了哮喘（n=1573）、过敏和过敏反应（n=738）、1 型糖尿病（n=59）、癫痫（n=87）和任何这些病症的儿童（n=2275），与没有这些病症的 19029 名儿童相对比。逻辑回归分析确定了这些暴露与（i）教师（早期儿童）和儿童（中期儿童）报告的情绪、行为、社会和整体脆弱性，以及（ii）自我报告缺乏支持来源（中期儿童）之间的关联。
在早期儿童中，任何病症在医院记录中的患病率为 7.5%，在中期儿童中为 10.7%。与没有这些病症的同龄人相比，患有任何病症（尤其是哮喘）的儿童在早期和中期儿童时期，整体问题以及特定的情绪、行为和社会问题的风险略有增加。癫痫症表现出较大且普遍的影响，过敏和过敏反应仅在中期儿童中表现出有限的小影响，而 1 型糖尿病在中期儿童中没有增加风险。没有病症与缺乏支持的风险增加相关。
患有慢性疾病（尤其是癫痫症和哮喘）的儿童可能会受益于以学校为基础的护理计划，该计划将整合他们的身心健康支持需求。
