Ma Si-Wei, Lai Sha, Yang Yan-Yan, Zhou Zhongliang, Yang Bin-Ting, Zheng Gu-Zheng-Yue, Gao Jianmin, Lu Li
Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.
School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China.
Front Psychiatry. 2021 Apr 27;12:648885. doi: 10.3389/fpsyt.2021.648885. eCollection 2021.
Determining the mental health status of parents who chronically care for a child with speech impairment is important for developing appropriate interventions to improve both parents' and children's health and achieve a win-win situation. Unfortunately, no study in China has explored this issue. This study investigated the differences in four aspects of mental health between maternal and paternal caregivers for the Mandarin-speaking children with speech impairment and determine whether depressive symptoms mediate the relationships between anxiety symptoms and suicidal ideation, hopelessness and suicidal ideation. This cross-sectional questionnaire survey was conducted in February 2020 by sending a link to the predesigned electronic questionnaire in WeChat. Standardized assessment tools were employed. Hierarchical multiple logistic regression was conducted to examine the associations between various factors and suicidal ideation, and two separate structural equation models were performed to evaluate the mediating effects of depressive symptoms in the relationship between anxiety symptoms and suicidal ideation as well as between hopelessness and suicidal ideation. This study included 446 parental caregivers of Mandarin-speaking children with speech impairment. Paternal caregivers had greater score than maternal caregivers on loss of motivation (one of the subdomains of hopelessness). Somatic complications of the child (OR = 2.73, 95% CI: 1.09-6.67) and depressive symptoms (OR = 3.38, 95% CI: 1.83-6.30) were positively associated with caregivers' suicidal ideation. Having speech therapy of child (OR = 0.54, 95% CI: 0.29-0.98) was negatively correlated with caregivers' suicidal ideation. There was direct effect of depressive symptoms on suicidal ideation. Depressive symptoms play mediating roles on the relationships between anxiety symptoms (β = 0.171, < 0.001) as well as between hopelessness and suicidal ideation (β = 0.187, < 0.001). Paternal and maternal caregivers of Mandarin-speaking children with speech impairment suffered from mental health problems. Preventive strategies and interventions to ameliorate parental psychological well-being, and health care policies to increase the accessibility to speech therapy care of children with speech impairment are imperative.
确定长期照料言语障碍儿童的父母的心理健康状况，对于制定适当干预措施以改善父母和儿童的健康状况并实现双赢局面至关重要。不幸的是，中国尚无研究探讨过这一问题。本研究调查了讲普通话的言语障碍儿童的母亲和父亲照料者在心理健康四个方面的差异，并确定抑郁症状是否介导焦虑症状与自杀意念、绝望与自杀意念之间的关系。这项横断面问卷调查于2020年2月进行，通过在微信上发送预先设计好的电子问卷链接。采用了标准化评估工具。进行分层多元逻辑回归以检验各种因素与自杀意念之间的关联，并进行两个独立的结构方程模型以评估抑郁症状在焦虑症状与自杀意念之间以及绝望与自杀意念之间关系中的中介作用。本研究纳入了446名讲普通话的言语障碍儿童的父母照料者。父亲照料者在动机丧失（绝望的一个子领域）方面的得分高于母亲照料者。儿童的躯体并发症（OR = 2.73，95% CI：1.09 - 6.67）和抑郁症状（OR = 3.38，95% CI：1.83 - 6.30）与照料者的自杀意念呈正相关。孩子接受言语治疗（OR = 0.54，95% CI：0.29 - 0.98）与照料者的自杀意念呈负相关。抑郁症状对自杀意念有直接影响。抑郁症状在焦虑症状与自杀意念之间（β = 0.171，< 0.001）以及绝望与自杀意念之间（β = 0.187，< 0.001）的关系中起中介作用。讲普通话的言语障碍儿童的父母照料者存在心理健康问题。改善父母心理健康的预防策略和干预措施，以及增加言语障碍儿童获得言语治疗服务机会的医疗保健政策势在必行。
