From the Division of Plastic and Reconstructive Surgery, University of California, Los Angeles David Geffen School of Medicine; the Institute for Digital Research and Education, University of California, Los Angeles; the Cleft Palate Program, Orthopaedic Institute for Children; and the Division of Plastic and Reconstructive Surgery, Northwell Health Hofstra School of Medicine.
Plast Reconstr Surg. 2020 Mar;145(3):764-773. doi: 10.1097/PRS.0000000000006577.
Psychosocial distress in children with craniofacial anomalies is multifactorial. A known cause of childhood psychosocial distress is parental limited English proficiency; however, its role as a psychosocial stressor in the craniofacial anomaly population remains unknown. The current study aimed to understand the potential influence of parental English proficiency in children with craniofacial anomalies.
Two hundred ninety-six children were prospectively evaluated at the University of California, Los Angels and the Orthopaedic Institute for Children using the Pediatric Patient-Reported Outcomes Measurement Information System to assess anger, anxiety, depression, and peer relationships. Children were grouped by parental English proficiency based on the requirement or lack thereof for interpreting services during clinic appointments. Independent t tests, analyses of variance, and linear regressions were performed to compare groups and identify predictors for psychosocial functioning.
Although comparison children did not exhibit any differences in psychosocial scores with respect to parental English proficiency, craniofacial anomaly children with parents who have limited English proficiency demonstrated higher anger, anxiety, depression, and lower peer relationships compared with those with parents who are English proficient. Linear regression analyses demonstrated that limited English proficiency in parents was a significant predictor for anger (p = 0.005), anxiety (p = 0.002), depression (p < 0.001), and poor peer relationships (p < 0.001) in children with craniofacial anomalies.
Parental English proficiency is associated with increased psychosocial distress in children with craniofacial anomalies. Future efforts toward identification of and assistance for parents with limited English proficiency to address barriers to care may improve psychosocial function in children with craniofacial anomalies.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.
儿童颅面畸形的心理社会困扰是多因素的。已知儿童心理社会困扰的一个原因是父母英语水平有限；然而，其在颅面畸形人群中作为心理社会应激源的作用尚不清楚。本研究旨在了解父母英语水平对颅面畸形儿童的潜在影响。
296 名儿童在加利福尼亚大学洛杉矶分校和骨科研究所接受前瞻性评估，使用儿科患者报告的结果测量信息系统评估愤怒、焦虑、抑郁和同伴关系。根据就诊时是否需要口译服务，将儿童按父母的英语水平分组。采用独立 t 检验、方差分析和线性回归比较组间差异，并识别心理社会功能的预测因素。
尽管比较组儿童在父母英语水平方面的心理社会评分没有差异，但英语水平有限的父母的颅面畸形儿童表现出更高的愤怒、焦虑、抑郁和更低的同伴关系，而英语水平较高的父母的儿童则没有。线性回归分析表明，父母英语水平有限是儿童愤怒（p = 0.005）、焦虑（p = 0.002）、抑郁（p < 0.001）和同伴关系差（p < 0.001）的显著预测因素。
父母英语水平与颅面畸形儿童的心理社会困扰增加有关。未来努力识别和帮助英语水平有限的父母克服护理障碍，可能会改善颅面畸形儿童的心理社会功能。
临床问题/证据水平：风险，II 级。
