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照顾发展障碍幼儿的照料者健康影响:一项荟萃分析。

The Caregiver Health Effects of Caring for Young Children with Developmental Disabilities: A Meta-analysis.

机构信息

Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK.

Faculty of Health Studies, University of Bradford, Bradford, UK.

出版信息

Matern Child Health J. 2020 May;24(5):561-574. doi: 10.1007/s10995-020-02896-5.

Abstract

OBJECTIVES

Mothers of school age and older children with developmental disabilities experience poorer health than mothers of typically developing children. This review assesses the evidence for the effect on mothers' health of caring for young children with developmental disabilities, and the influence of different disability diagnoses and socioeconomic status.

METHODS

Medline, EMBASE, PsycINFO and CINAHL were searched. Studies measuring at least one symptom, using a quantitative scale, in mothers of preschool children (0-5 years) with and without a diagnosed developmental disability were selected. Random effects meta-analysis was performed, and predictive intervals reported due to high expected heterogeneity.

RESULTS

The meta-analysis included 23 estimates of association from 14 retrospective studies for the outcomes of stress (n = 11), depressive symptoms (n = 9), general health (n = 2) and fatigue (n = 1). Caring for a child with a developmental disability was associated with greater ill health (standardised mean difference 0.87; 95% predictive interval - 0.47, 2.22). The largest association was for mixed developmental disabilities (1.36; - 0.64, 3.36) and smallest for Down syndrome (0.38; - 2.17, 2.92). There was insufficient socioeconomic information to perform subgroup analysis. The small number of studies and data heterogeneity limited the precision of the estimates of association and generalizability of the findings.

CONCLUSIONS FOR PRACTICE

Mothers of young children with developmental disabilities may have poorer health than those with typically developing children. Research is needed to identify whether the relationship is causal and, if so, interventions that could reduce the negative effect of caregiving.

摘要

目的

与发育正常儿童的母亲相比,学龄期及以上发育障碍儿童的母亲健康状况更差。本综述评估了照顾发育障碍幼儿对母亲健康的影响,并评估了不同残疾诊断和社会经济地位的影响。

方法

检索了 Medline、EMBASE、PsycINFO 和 CINAHL。选择了至少使用定量量表测量了有和没有发育障碍诊断的学龄前儿童(0-5 岁)母亲的一种以上症状的研究。由于预期异质性较高,进行了随机效应荟萃分析,并报告了预测区间。

结果

荟萃分析包括来自 14 项回顾性研究的 23 个关联估计值,用于评估压力(n=11)、抑郁症状(n=9)、一般健康(n=2)和疲劳(n=1)的结局。照顾发育障碍儿童与健康状况较差相关(标准化均数差 0.87;95%预测区间 -0.47,2.22)。最大的关联见于混合发育障碍(1.36;-0.64,3.36),最小的见于唐氏综合征(0.38;-2.17,2.92)。由于社会经济信息不足,无法进行亚组分析。研究数量少和数据异质性限制了关联估计的准确性和研究结果的推广性。

结论

幼儿期患有发育障碍的母亲可能比发育正常的儿童的母亲健康状况更差。需要研究确定这种关系是否具有因果关系,如果是,是否有可以减轻护理负担的负面影响的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6491/7170980/9b3bd0b03bd6/10995_2020_2896_Fig1_HTML.jpg

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