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患有慢性病儿童的兄弟姐妹的临床健康结局:系统评价和荟萃分析。

Clinical Health Outcomes of Siblings of Children with Chronic Conditions: A Systematic Review and Meta-Analysis.

机构信息

Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.

Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.

出版信息

J Pediatr. 2022 Nov;250:83-92.e8. doi: 10.1016/j.jpeds.2022.07.002. Epub 2022 Jul 8.

Abstract

OBJECTIVE

The objective of the study was to assess clinical mental and physical health outcomes of siblings of children with chronic health condition(s) compared with siblings of healthy children or normative data.

STUDY DESIGN

We searched Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, and CINAHL through August 9, 2021. We included English-language studies that reported clinically diagnosable mental or physical health outcomes among siblings of children (<18 years old) with a chronic health condition, included a comparison group, and used an experimental or observational study design. Two reviewers extracted data and independently assessed risk of bias using the Newcastle Ottawa Scale.

RESULTS

Of 9899 screened studies, 34 were included; 28 studies reported on mental health, 3 reported on physical health, and 3 reported on mortality. Siblings of children with chronic conditions had greater depression rating scale scores than their comparison groups (standardized mean difference = 0.53; 95% CI = 0.38-0.68; P < .001 [6 studies]), whereas anxiety scores were not substantially increased (standardized mean difference = 0.21; 95% CI = -0.02 to 0.43; P = .07 [7 studies]). The effects for confirmed psychiatric diagnoses (7 studies), mortality (3 studies), or physical health outcomes (3 studies) could not be meta-analyzed given the limited number of studies and between-study heterogeneity.

CONCLUSION

Siblings of children with chronic health conditions may be at an increased risk of depression. Our findings suggest the need for targeted interventions to support the psychological well-being of siblings of children with chronic health conditions.

摘要

目的

本研究旨在评估与健康儿童或正常数据相比,患有慢性疾病儿童的兄弟姐妹的临床心理和身体健康结果。

研究设计

我们检索了 Ovid MEDLINE、Embase、Cochrane 对照试验中心注册库、PsycINFO 和 CINAHL,检索时间截至 2021 年 8 月 9 日。我们纳入了报告患有慢性疾病(<18 岁)儿童的兄弟姐妹中存在临床诊断的心理健康或身体健康结果的英语研究,包括对照组成员,并采用了实验或观察性研究设计。两位评审员提取数据,并使用 Newcastle-Ottawa 量表独立评估偏倚风险。

结果

在筛选出的 9899 项研究中,有 34 项研究符合纳入标准;其中 28 项研究报告了心理健康结果,3 项研究报告了身体健康结果,3 项研究报告了死亡率。患有慢性疾病儿童的兄弟姐妹的抑郁评定量表评分高于其对照组成员(标准化均数差=0.53;95%置信区间=0.38-0.68;P<0.001[6 项研究]),而焦虑评分并未显著升高(标准化均数差=0.21;95%置信区间=-0.02 至 0.43;P=0.07[7 项研究])。由于研究数量有限且存在研究间异质性,无法对确诊精神科诊断(7 项研究)、死亡率(3 项研究)或身体健康结果(3 项研究)进行荟萃分析。

结论

患有慢性健康状况儿童的兄弟姐妹可能面临更高的抑郁风险。我们的研究结果表明,需要有针对性的干预措施来支持患有慢性健康状况儿童的兄弟姐妹的心理健康。

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