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种族主义和儿科镰状细胞病患者的健康相关生活质量:抑郁和支持的作用。

Racism and Health-Related Quality of Life in Pediatric Sickle Cell Disease: Roles of Depression and Support.

机构信息

Department of Neuropsychology, Kennedy Krieger Institute.

Department of Psychology, Georgia State University.

出版信息

J Pediatr Psychol. 2020 Sep 1;45(8):858-866. doi: 10.1093/jpepsy/jsaa035.

Abstract

INTRODUCTIONS

Sickle cell disease (SCD) is the most commonly inherited blood disorder in the United States, and it predominately affects the Black community. SCD is characterized by a number of symptoms, including unpredictable pain, which can lead to hospitalizations. Data indicate that people with SCD experience racism and ample data indicate that racism predicts depressive symptoms and impaired health-related quality of life (HRQOL). In contrast, research suggests that social support might buffer the impact of racism on depression. The aim of this study was to explore associations among perceived racism, depressive symptoms, and HRQOL in adolescents with SCD. Consistent with the literature, it was predicted that perceived racism would predict HRQOL through depression, and social support would moderate the negative impact of racism on depression.

METHODS

In a cross-sectional design, 75 inpatient adolescents with SCD completed measures of perceived racism, depressive symptoms, HRQOL, and social support.

RESULTS

This results indicated a moderated mediation model with greater perceived racism predicting more depressive symptoms, which in turn related to poorer HRQOL; greater access to social support from individuals with SCD strengthened the perceived racism-depressive symptom association.

CONCLUSIONS

Findings suggest a model for how racism, depressive symptoms, HRQOL, and social support might interact in hospitalized adolescents with SCD. Longitudinal or experimental designs are needed to substantiate directionality among these variables. Results highlight several areas for future research and clinical avenues to improve the welfare of youth with SCD.

摘要

简介

镰状细胞病(SCD)是美国最常见的遗传性血液病,主要影响黑人群体。SCD 的特征是一系列症状,包括不可预测的疼痛,这可能导致住院。数据表明,SCD 患者经历种族主义,大量数据表明种族主义预测抑郁症状和健康相关生活质量(HRQOL)受损。相比之下,研究表明,社会支持可能缓冲种族主义对抑郁的影响。本研究旨在探讨 SCD 青少年中感知到的种族主义、抑郁症状和 HRQOL 之间的关联。与文献一致,预计感知到的种族主义将通过抑郁来预测 HRQOL,社会支持将缓和种族主义对抑郁的负面影响。

方法

在横断面设计中,75 名住院 SCD 青少年完成了感知种族主义、抑郁症状、HRQOL 和社会支持的测量。

结果

该结果表明存在一个中介调节模型,即感知到的种族主义越大,抑郁症状越多,进而与 HRQOL 越差相关;从 SCD 患者那里获得更多的社会支持会加强感知种族主义与抑郁症状之间的关联。

结论

研究结果表明了一个模型,说明种族主义、抑郁症状、HRQOL 和社会支持如何在住院 SCD 青少年中相互作用。需要进行纵向或实验设计来证实这些变量之间的方向关系。研究结果强调了未来研究和改善 SCD 青少年福利的临床途径的几个领域。

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