Department of Pediatrics, Golisano Children's Hospital, University of Rochester, Rochester, New York
Department of Pediatrics, Golisano Children's Hospital, University of Rochester, Rochester, New York.
Pediatrics. 2021 Aug;148(2). doi: 10.1542/peds.2020-023358. Epub 2021 Jun 21.
The mental health of parents of children with medical complexity (CMC) is poorly understood, yet it drives child and family health outcomes. For parents of CMC, compared with parents of noncomplex children with special health care needs (CSHCN) and children without special health care needs (non-CSHCN), we examined self-reported mental health, knowledge of community sources for help, and emotional support.
Using parent-reported data from the combined 2016-2017 National Survey of Children's Health, we divided the population into 3 groups: households with CMC, noncomplex CSHCN, and non-CSHCN. We compared these groups regarding the following: (1) parents' risks for poor or fair mental health and knowledge of where to go for community help and (2) parent-reported sources of emotional support.
Of 63 955 588 parent-child dyads (weighted from a sample of 65 204), parents of CMC had greater adjusted odds of reporting poor or fair mental health compared with parents of noncomplex CSHCN (adjusted odds ratio [aOR] 2.0; 95% confidence interval [CI] 1.1-3.8) and non-CSHCN (aOR 4.6; 95% CI 2.5-8.6). Parents of CMC had greater odds of not knowing where to find community help compared with parents of noncomplex CSHCN (aOR 2.1; 95% CI 1.4-3.1) and non-CSHCN (aOR 2.9; 95% CI 2.0-4.3). However, parents of CMC were most likely to report receiving emotional support from health care providers and advocacy groups ( < .001).
Among all parents, those with CMC were at the highest risk to report suboptimal mental health. They more often reported that they do not know where to find community help, but they did say that they receive emotional support from health care providers and advocacy groups. Future researchers should identify ways to directly support the emotional wellness of parents of CMC.
患有复杂疾病儿童（CMC）父母的心理健康状况尚未得到充分了解，但它会影响儿童和家庭的健康状况。与患有特殊医疗需求（CSHCN）的非复杂儿童的父母和无特殊医疗需求的儿童（非 CSHCN）的父母相比，我们检查了他们的自我报告心理健康状况、了解社区援助资源的程度以及情绪支持情况。
利用 2016-2017 年全国儿童健康调查的家长报告数据，我们将人群分为 3 组：CMC 家庭、非复杂 CSHCN 家庭和非 CSHCN 家庭。我们比较了这些群体之间的以下情况：（1）父母心理健康状况不佳或一般的风险以及了解社区援助资源的情况；（2）父母报告的情绪支持来源。
在 63955588 对父母-子女对（从样本中加权得出的 65204 对）中，与非复杂 CSHCN 的父母（调整后的优势比 [aOR]2.0；95%置信区间 [CI]1.1-3.8）和非 CSHCN 的父母相比，CMC 儿童的父母报告心理健康状况不佳或一般的调整后比值比（aOR）更高（2.0；95%CI1.1-3.8）和非 CSHCN（aOR4.6；95%CI2.5-8.6）。与非复杂 CSHCN 的父母（aOR2.1；95%CI1.4-3.1）和非 CSHCN 的父母（aOR2.9；95%CI2.0-4.3）相比，CMC 儿童的父母更有可能不知道在哪里可以找到社区援助。然而，CMC 儿童的父母最有可能从医疗保健提供者和倡导团体获得情绪支持（<0.001）。
在所有父母中，CMC 父母的心理健康状况处于最差的风险水平。他们更常报告说他们不知道在哪里可以获得社区帮助，但他们确实表示他们从医疗保健提供者和倡导团体那里获得了情绪支持。未来的研究人员应找到直接支持 CMC 父母情绪健康的方法。
