Family Navigation Project, Sunnybrook Research Institute, Toronto, Ontario, Canada.
MD Program, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Health Soc Care Community. 2022 Nov;30(6):e5125-e5134. doi: 10.1111/hsc.13927. Epub 2022 Jul 23.
This study investigated the factors associated with clinical symptoms and level of functioning at baseline and after 4 months of navigation, in youth with mental health and/or addiction concerns involved with a family navigation service. Participants in this pre-post study were caregivers who accessed a mental health and addictions navigation service between March 2018 and July 2019 on behalf of their youth aged 13-26 who had mental health and/or addiction concerns. Evaluations were conducted at baseline and at 4 months after entering navigation. The dependent variable, youth mental health symptoms and functioning, was assessed by caregivers using the Symptoms and Functioning Severity Scale. The sample included 345 caregivers of youth (youth: mean age 18 years, 57% male). At intake, using multiple linear regression, caregiver strain (β = 0.481, p < 0.001), youth completion of ADLs (β = -0.156, p = 0.002) and youth motivation (β = -0.110, p = 0.021) contributed significantly to variance in symptoms and functioning (R = 0.373, p < 0.001). Using ANOVA to compare complete pre/post data (n = 115), there was a significant main effect of time on the youth symptoms and functioning score (F[1, 107] = 9.278, p = 0.003). Furthermore, the interaction of time, youth completion of ADLs (low vs. high at baseline) and youth motivation (low vs. high at baseline) was significant (F[1, 107] = 4.699, p = 0.032). Youth with low motivation and low completion of ADLs at baseline experienced the largest improvements in symptoms and functioning after 4 months of navigation. These findings suggest that this group of youth should be a primary target in mental health and addiction navigation.
本研究调查了与心理健康和/或成瘾问题青少年及其照顾者在接受家庭导航服务后 4 个月的临床症状和功能水平相关的因素。该研究采用了前后测设计，参与者为在 2018 年 3 月至 2019 年 7 月期间使用心理健康和成瘾导航服务的照顾者，其子女年龄在 13-26 岁之间，有心理健康和/或成瘾问题。评估在基线和进入导航后的 4 个月进行。照顾者使用症状和功能严重程度量表评估青少年心理健康症状和功能的因变量。样本包括 345 名青少年（青少年：平均年龄 18 岁，57%为男性）的照顾者。在进入服务时，使用多元线性回归分析，照顾者压力（β=0.481，p<0.001）、青少年完成日常生活活动的能力（β=-0.156，p=0.002）和青少年动机（β=-0.110，p=0.021）显著预测了症状和功能的变化（R2=0.373，p<0.001）。采用方差分析比较完整的前后测数据（n=115），发现时间对青少年症状和功能评分有显著的主效应（F[1, 107]=9.278，p=0.003）。此外，时间、青少年完成日常生活活动的能力（低与高）和青少年动机（低与高）的交互作用具有统计学意义（F[1, 107]=4.699，p=0.032）。在基线时动机和日常生活活动能力较低的青少年在接受 4 个月导航服务后症状和功能的改善最大。这些发现表明，这组青少年应该是心理健康和成瘾导航的主要目标人群。
