Department of Psychology, Loyola University Chicago.
The Research Institute at Nationwide Children's Hospital, Center for Biobehavioral Health.
Health Psychol. 2021 Oct;40(10):692-701. doi: 10.1037/hea0001089.
For youth with spina bifida (SB) there is a growing need to understand how responsibilities for health care are transferred from family- to self-management over time. The current study examined trajectories of responsibility for medical tasks in youth with SB across adolescence, as well as executive functioning/attention and parenting behaviors as predictors of growth.
As part of a larger, longitudinal study, 140 youth with SB (ages 8-15 at time 1; Mage = 11.43) reported on their responsibility for relevant medical tasks across five time points. Attention and executive functioning were assessed via performance-based and parent/teacher-report methods. Parenting behaviors consisted of acceptance, behavioral control, and psychological control and were assessed via observational and parent-report.
Growth curve analyses revealed significant increases in youth medical responsibility across all SB tasks over time. Attention, executive functioning, maternal behavioral control, and paternal psychological control emerged as predictors of growth parameters in responsibility for communicating about SB and managing health care appointments.
Results indicated that youth with SB obtain increasing responsibility for their health care over time. The transfer of responsibility for SB management may differ based on individual (i.e., the child's neuropsychological abilities) and family level (i.e., parenting behaviors) factors. Further research is needed to understand how growth in medical responsibility relates to changes in other aspects of SB self-management across development, such as medical adherence. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
对于患有脊柱裂(SB)的年轻人来说,随着时间的推移,他们越来越需要了解如何将医疗保健责任从家庭管理过渡到自我管理。本研究考察了 SB 青少年在青春期期间对医疗任务的责任轨迹,以及执行功能/注意力和养育行为作为增长的预测因素。
作为一项更大的纵向研究的一部分,140 名患有 SB 的年轻人(在第 1 次时年龄为 8-15 岁;Mage = 11.43)在五个时间点报告了他们对相关医疗任务的责任。注意力和执行功能通过基于表现的和父母/教师报告方法进行评估。养育行为包括接受、行为控制和心理控制,并通过观察和父母报告进行评估。
增长曲线分析显示,随着时间的推移,所有 SB 任务中年轻人的医疗责任都显著增加。注意力、执行功能、母亲行为控制和父亲心理控制是沟通 SB 和管理医疗预约方面责任增长参数的预测因素。
结果表明,随着时间的推移,患有 SB 的年轻人会逐渐承担更多的医疗保健责任。SB 管理责任的转移可能因个人(即儿童的神经心理能力)和家庭层面(即养育行为)的因素而异。需要进一步研究以了解医疗责任的增长如何与 SB 自我管理的其他方面的变化相关,例如医疗依从性。