Medical College of Wisconsin, Milwaukee, WI.
UCSF Benioff Children's Hospital Oakland, Oakland.
J Pediatr Orthop. 2021 Sep 1;41(8):463-466. doi: 10.1097/BPO.0000000000001911.
Bullying is destructive and pervasive. Although the literature suggests children with chronic health conditions are at higher risk of being bullied, there is minimal research regarding the prevalence of bullying among children with orthopaedic conditions. Our study aimed to assess the prevalence of bullying among pediatric orthopaedic outpatients and evaluate the association of orthopaedic conditions and use of orthopaedic devices with perceptions of bullying.
Patients in outpatient pediatric orthopaedic clinics, ages 10 to 17 and their parents were surveyed using the Child-Adolescent Bullying Scale-9. Basic demographic, information about the child's orthopaedic condition, and parent's perception of their child being subject to bullying were also collected. Children were asked if they had used any orthopaedic devices in the last 3 months, whether they were bullied because of their device, and if bullying affected their compliance with device use. The analysis utilized a t test or analysis of variance to compare mean Child-Adolescent Bullying Scale-9 scores across different groups.
Among the 198 patients surveyed, 61% (N=121) perceived no-to-minimal exposure to bullying, 36% (N=72) moderate exposure, and 3% (N=5) severe exposure. Children ages 10 to 13 (N=100) and children ages 14 to 17 (N=98) reported similar rates of bullying (P=0.97). Higher rates of moderate to severe bullying were reported by patients with foot deformity (80%), multiple orthopaedic diagnoses (55%), chronic pain (39%), fracture/acute injury (37%), and scoliosis (33%). Moderate to severe bullying was reported by 37% of patients who wore a cast, 40% who wore a brace/orthotic, and 52% who used multiple orthopaedic devices. Parental concern that their child was being bullied was highly correlated with their child's bullying score (P=0.0002).
More than one third of our pediatric orthopaedic outpatients (39%) experience moderate to severe levels of bullying, which is higher than the general population's reported rates of 20% to 35%. Exposure to bullying may be higher in certain diagnoses or with use of certain orthopaedic devices. Further research is needed to delineate who is at highest risk.
Level IV.
欺凌具有破坏性且普遍存在。尽管文献表明患有慢性疾病的儿童更容易被欺凌，但针对患有骨科疾病的儿童被欺凌的患病率的研究甚少。本研究旨在评估儿科骨科门诊患儿中欺凌的发生率，并评估骨科疾病和使用骨科器械与欺凌感知之间的关联。
对 10 至 17 岁的儿科骨科门诊患儿及其父母使用儿童-青少年欺凌量表-9 进行了调查。还收集了患儿的基本人口统计学信息、患儿的骨科疾病信息以及父母对患儿遭受欺凌的看法。患儿被问到他们在过去 3 个月内是否使用过任何骨科器械、是否因器械而被欺凌以及欺凌是否影响了他们对器械使用的依从性。分析采用 t 检验或方差分析比较不同组之间的儿童-青少年欺凌量表-9 评分的平均值。
在接受调查的 198 名患儿中，61%（N=121）认为自己几乎没有受到欺凌，36%（N=72）认为自己受到了中度欺凌，3%（N=5）认为自己受到了严重欺凌。10 至 13 岁（N=100）和 14 至 17 岁（N=98）的患儿报告的欺凌发生率相似（P=0.97）。足部畸形（80%）、多种骨科诊断（55%）、慢性疼痛（39%）、骨折/急性损伤（37%）和脊柱侧凸（33%）的患儿报告的中重度欺凌发生率更高。使用石膏的患儿中 37%报告中重度欺凌，使用支具/矫形器的患儿中 40%报告中重度欺凌，使用多种骨科器械的患儿中 52%报告中重度欺凌。父母担心孩子被欺负与孩子的欺凌评分高度相关（P=0.0002）。
我们的儿科骨科门诊患儿中超过三分之一（39%）经历了中重度欺凌，高于一般人群报告的 20%至 35%的欺凌发生率。在某些诊断或使用某些骨科器械时，可能会有更高的欺凌暴露率。需要进一步研究以确定哪些人面临更高的风险。
IV 级。
