Department of Pediatrics, Harvard Medical School and Massachusetts General Hospital (KA Kuhlthau), Boston, Mass.
Critical Care Medicine, Department of Pediatrics, University of Utah School of Medicine (SG Ames), Salt Lake City, Utah.
Acad Pediatr. 2022 Mar;22(2S):S22-S27. doi: 10.1016/j.acap.2021.07.019.
Families of children and youth with special health care needs (CYSHCN) can face challenges with regard to health and well-being. Health systems are designed to support CYSHCN but do not often consider the health and well-being of their family. Despite a growing body of literature, substantial gaps remain in our understanding of the impact of caregiving on family health and well-being and mechanisms of supporting families. In order to better understand and address these gaps, a national CYSHCN network developed a national research agenda to prioritize key areas of insufficient understanding of health and well-being for families of CYSHCN. Questions identified by the research agenda include: 1) How can family resiliency and adaptability be measured and improved? 2) How can we better assess family mental health needs and implement appropriate interventions? 3) What is the impact of family health on CYSHCN health outcomes? This paper describes a review of what is currently known regarding health for families of CYSHCN, gaps in the literature focused on the research agenda questions, and recommendations for future research. Based on the research agenda and current state of research for family health of CYSHCN, the authors recommend focusing on resiliency and adaptability as outcomes, using implementation science to address mental health concerns of family members and to further assess the impact of family health on health outcomes of CYSHCN. In addition, research should have a special focus on diverse populations of families and consider these questions in the context of different family structures.
有特殊医疗需求的儿童和青少年(CYSHCN)的家庭在健康和福祉方面可能会面临挑战。卫生系统旨在支持 CYSHCN,但通常不考虑其家庭的健康和福祉。尽管文献越来越多,但我们对护理对家庭健康和福祉的影响以及支持家庭的机制的理解仍存在很大差距。为了更好地理解和解决这些差距,一个全国性的 CYSHCN 网络制定了一项国家研究议程,优先考虑对 CYSHCN 家庭健康和福祉了解不足的关键领域。研究议程确定的问题包括:1)如何衡量和提高家庭的适应力和弹性?2)我们如何更好地评估家庭的心理健康需求并实施适当的干预措施?3)家庭健康对 CYSHCN 健康结果的影响是什么?本文描述了对目前已知的 CYSHCN 家庭健康状况的审查,重点介绍了针对研究议程问题的文献差距,并为未来的研究提出了建议。基于研究议程和目前关于 CYSHCN 家庭健康的研究状况,作者建议将重点放在适应性和弹性作为结果上,利用实施科学来解决家庭成员的心理健康问题,并进一步评估家庭健康对 CYSHCN 健康结果的影响。此外,研究应特别关注不同家庭群体,并在不同家庭结构的背景下考虑这些问题。