Stransky Michelle L, Oshita Jennifer Y, Morris Megan A
From the Department of General Academic Pediatrics, Boston Medical Center, Boston, MA (MLS); Clinical and Translational Sciences Program, University of Vermont, Burlington (JYO); Rehabilitation Therapies Department, University of Vermont Medical Center, Burlington (JYO); Adult and Child Consortium for Health Outcomes Research and Delivery Science, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora (MAM).
J Am Board Fam Med. 2020 Nov-Dec;33(6):932-941. doi: 10.3122/jabfm.2020.06.200216.
Adults with communication disabilities (CDs) experience poor health and health care outcomes. Few studies have examined behavioral health outcomes among this population. We compare the behavioral health of adults with CDs to their peers without such disabilities.
Retrospective cohort study examining the 2012 National Health Interview Survey Voice, Speech, and Language Supplement. We compared adults (> 17 years old) with voice only (n = 2169), speech/language (SL) only (n = 730), and speech/language and voice (SLV; n = 450) disabilities to adults without CDs (n = 29,873). Outcomes include behavioral health diagnoses (eg, depression), substance misuse (eg, excessive alcohol or tobacco use), experiences (eg, nonspecific psychological distress), and health care utilization. Unadjusted Pearson's χ and adjusted logistic regression analyses controlling for sociodemographic, health, and other disability measures were conducted.
Adults with CDs more frequently reported diagnoses (7.1% to 35.9% vs 1.8% to 8.6%), substance misuse (SL only: 15.5% vs 5.5%), and nonspecific psychological distress (SL only: 14.7%; SLV: 22.3% vs 2.3%) compared with adults without CDs (all < .001). These findings were consistent for all outcomes and in multivariate analyses. Odds ratios ranged from 1.4 (99.7% CI, 1.1-1.7) to 5.0 (99.7% CI, 3.6-6.8). Adults with CDs more frequently endorsed visiting mental health professionals compared with adults without CDs (voice only: 11.4%; SL only: 19.1%; SLV: 23.1%; vs 6.8%, all < .001), but these differences became nonsignificant in multivariate analyses.
Adults with CDs experience poorer behavioral health and health care outcomes compared with persons without CDs. Barriers to identification and treatment related to CDs must be addressed for persons with CDs.
有沟通障碍（CDs）的成年人健康状况较差，医疗保健结果也不佳。很少有研究调查这一人群的行为健康结果。我们将有CDs的成年人的行为健康与其没有此类障碍的同龄人进行比较。
回顾性队列研究，分析2012年美国国家健康访谈调查中的语音、言语和语言补充内容。我们将仅患有语音障碍（n = 2169）、仅患有言语/语言（SL）障碍（n = 730）以及患有言语/语言和语音（SLV；n = 450）障碍的成年人（> 17岁）与没有CDs的成年人（n = 29,873）进行比较。结果包括行为健康诊断（如抑郁症）、物质滥用（如过度饮酒或吸烟）、经历（如非特异性心理困扰）以及医疗保健利用情况。进行了未调整的Pearson卡方检验以及控制社会人口统计学、健康状况和其他残疾指标的调整逻辑回归分析。
与没有CDs的成年人相比，有CDs的成年人更频繁地报告诊断结果（7.1%至35.9%对1.8%至8.6%）、物质滥用（仅SL障碍：15.5%对5.5%）和非特异性心理困扰（仅SL障碍：14.7%；SLV障碍：22.3%对2.3%）（所有P <.001）。所有结果以及多变量分析中的这些发现都是一致的。优势比范围从1.4（99.7% CI，1.1 - 1.7）到5.0（99.7% CI，3.6 - 6.8）。与没有CDs的成年人相比，有CDs的成年人更频繁地认可拜访心理健康专业人员（仅语音障碍：11.4%；仅SL障碍：19.1%；SLV障碍：23.1%；对6.8%，所有P <.001），但在多变量分析中这些差异变得不显著。
与没有CDs的人相比，有CDs的成年人行为健康和医疗保健结果更差。必须解决与CDs相关的识别和治疗障碍，以帮助患有CDs的人。
