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改善儿童忽视的早期诊断,以便在医疗环境中做出更好的应对。

Improving Early Diagnosis of Child Neglect for a Better Response in Healthcare Settings.

作者信息

Herrero-Roldán Silvia, León Inmaculada, Hernández-Cabrera Juan Andrés, Rodrigo María José

机构信息

Instituto Universitario de Neurociencia, Universidad de La Laguna, 38200 La Laguna, Spain.

Facultad de Psicología, Universidad de La Laguna, 38200 La Laguna, Spain.

出版信息

Children (Basel). 2021 Sep 27;8(10):859. doi: 10.3390/children8100859.

Abstract

Early diagnosis of child neglect is an ongoing challenge with consequences of the child's safety, health, and effective referral for intervention. This study aims to obtain a selected set of family, maternal, and dyadic variables of the immediate caregiving environment for diagnosis, preventive, and intervention responses in healthcare settings. Mothers and their children under five years old: 51 in the neglected group (NG) and 89 in the non-neglected control group (CG), were recruited through pediatric primary care services and social services in Spain. Family demographics, adverse events, childhood maltreatment, maternal psychopathologies, personality variables, and observed mother-child interactions were assessed. Gradient boosting analyses were applied for the contributor's relative importance (), followed by logistic regression and discriminant analyses for those with higher . Parametric analyses showed high diagnostic accuracy (80-82% of NG and 92% of CG) for risky factors of child neglect: having a physically neglected and depressed mother, living in families in need of financial assistance, and large families; and for protective factors: having an older mother and showing higher mother-child emotional availability. Identifying a select group of features makes early diagnosis and preventive intervention more effective for mitigating the impact of child neglect and building mother-child resilience.

摘要

儿童忽视的早期诊断一直是一项挑战,关乎儿童的安全、健康以及能否有效转介接受干预。本研究旨在获取一系列有关直接照料环境的家庭、母亲及二元变量,以便在医疗环境中进行诊断、预防及干预。通过西班牙的儿科初级保健服务和社会服务机构,招募了五岁以下儿童及其母亲:忽视组(NG)51对,非忽视对照组(CG)89对。评估了家庭人口统计学特征、不良事件、儿童期虐待、母亲精神病理学、人格变量以及观察到的母婴互动情况。应用梯度提升分析来确定各因素的相对重要性(),随后对重要性较高的因素进行逻辑回归和判别分析。参数分析表明,对于儿童忽视的风险因素,如母亲遭受身体忽视且抑郁、家庭需要经济援助以及家庭规模较大,以及保护因素,如母亲年龄较大且母婴情感交流较好,诊断准确率较高(忽视组为80 - 82%,对照组为92%)。确定一组特定特征能使早期诊断和预防性干预更有效地减轻儿童忽视的影响,并增强母婴的恢复力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8516/8535148/dbb14cc0ebd6/children-08-00859-g001.jpg

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