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家庭压力源与资源作为照顾者和幼儿健康的社会决定因素

Family Stressors and Resources as Social Determinants of Health among Caregivers and Young Children.

作者信息

Slopen Natalie, Cook Benjamin Le, Morgan Justin Winston, Flores Michael William, Mateo Camila, Garcia Coll Cynthia, Acevedo Garcia Dolores, Priest Naomi, Wethington Elaine, Lee Esther, Moyer Margo, Tran Nathaniel M, Krumholz Sandra, Williams David R

机构信息

Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA.

Center on the Developing Child, Harvard University, Cambridge, MA 02138, USA.

出版信息

Children (Basel). 2022 Mar 23;9(4):452. doi: 10.3390/children9040452.

Abstract

Life course-informed theories of development suggest it is important to integrate information about positive and negative aspects of the social environment into studies of child and parental wellbeing, including both stressors that compromise health and resources that promote well-being. We recruited a sample of 169 pairs of caregivers and young children (birth to 5 years) from a community health clinic and administered survey questions to assess stressors and resources. We constructed inventories of stressors and resources and examined the relationships between these inventories and caregivers' depressive symptoms, anxiety symptoms, and sleep problems, and young children's medical diagnoses derived from electronic health records. Cumulative stressors and resources displayed bivariate and adjusted associations with caregivers' depressive symptoms, anxiety symptoms, and sleep problems. For depressive and anxiety symptoms, these associations were evident in models that included stressors and resources together. Caregivers with high stressors and low resources displayed the highest levels of depressive and anxiety symptoms and sleep problems. In terms of children's health outcomes, only modest trends were evident for developmental/mental health outcomes, but not other diagnostic categories. Future studies are needed to examine stressors and resources together in larger samples and in relation to prospectively assessed measures of child well-being.

摘要

基于生命历程的发展理论表明,将社会环境的积极和消极方面的信息纳入儿童和父母幸福感的研究非常重要,这包括损害健康的压力源和促进幸福的资源。我们从一家社区健康诊所招募了169对照顾者和幼儿(出生至5岁)的样本,并通过问卷调查来评估压力源和资源。我们构建了压力源和资源清单,并研究了这些清单与照顾者的抑郁症状、焦虑症状和睡眠问题,以及从电子健康记录中得出的幼儿医学诊断之间的关系。累积压力源和资源与照顾者的抑郁症状、焦虑症状和睡眠问题呈现出双变量和调整后的关联。对于抑郁和焦虑症状,这些关联在同时纳入压力源和资源的模型中很明显。压力源高且资源少的照顾者表现出最高水平的抑郁和焦虑症状以及睡眠问题。就儿童的健康结果而言,在发育/心理健康结果方面仅出现了适度的趋势,但在其他诊断类别中则不明显。未来的研究需要在更大的样本中同时考察压力源和资源,并与前瞻性评估的儿童幸福感指标相关联。

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