Faculty of Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare -North, UiT The Arctic University of Norway, Tromsø, Norway.
Child and Adolescent Psychiatry Unit, Kanti Children's Hospital, Kathmandu, Nepal.
BMC Psychiatry. 2022 Sep 2;22(1):584. doi: 10.1186/s12888-022-04215-4.
Teacher reports of child emotional and behavioral problems (EBPs) are sparse in many low- and middle-income countries, especially when compared to reports from parents. Cross-informant information is pivotal to clinicians when dealing with mentally ill children. In this study from Nepal, we examined teacher reports of child EBPs, the agreement between teacher and parent reports, and how this agreement varied by type of EBP and child gender.
This cross-sectional, observational study included 3808 schoolchildren aged 6-18 years from 16 districts of Nepal. Teacher and parent reports of EBPs were measured by the Nepali versions of the Teacher Report Form (TRF) and the Child Behavior Checklist (CBCL), respectively. Linear mixed model analysis was used for group comparisons and intraclass correlations. Agreement between TRF and CBCL scale scores were analyzed using Pearson's correlation coefficient.
The prevalence of EBPs according to teacher reports was 15.4%, whereas the previous parent reported prevalence was 19.1%. Also, the mean TRF score was significantly lower than mean CBCL score for the 90 common items. Mean TRF scores for Total Problems, Externalizing Problems, and Internalizing Problems were 26.9 (standard deviation, SD 24.5), 6.1 (SD 7.2), and 7.9 (SD 7.3), respectively. Consistent with parent reports, mean TRF scores for Total Problems and Externalizing Problems were higher among boys than girls, whereas no significant gender differences were found for Internalizing Problems. Teacher-parent agreement was moderate (r = .38), and slightly higher for Externalizing Problems than for Internalizing Problems (r = .37 versus r = .34). Moderate to low correlations were found for all syndrome scales, with coefficients ranging from r = .26 (Social Problems) to r = .37 (Attention Problems). The effect of child gender on the teacher-parent agreement was significant for Internalizing Problems only, with a higher agreement for girls than for boys.
Nepali teachers reported fewer child EBPs than parents. Teacher-parent agreement was moderate and varied by type of EBP and child gender. Our findings underscore the importance of obtaining information on child EBPs from both parents and teachers when evaluating and treating children in low- and middle-income countries like Nepal.
在许多低收入和中等收入国家，教师报告儿童情绪和行为问题（EBP）的情况很少，尤其是与父母的报告相比。当涉及到患有精神疾病的儿童时，来自不同信息源的信息对临床医生至关重要。在这项来自尼泊尔的研究中，我们检查了教师报告的儿童 EBP、教师和家长报告之间的一致性，以及这种一致性如何因 EBP 类型和儿童性别而异。
这是一项横断面、观察性研究，包括来自尼泊尔 16 个地区的 3808 名 6-18 岁的在校儿童。教师和家长分别通过尼泊尔版的教师报告表（TRF）和儿童行为检查表（CBCL）报告 EBP。使用线性混合模型分析进行组间比较和组内相关。使用 Pearson 相关系数分析 TRF 和 CBCL 量表评分之间的一致性。
根据教师报告，EBP 的患病率为 15.4%，而之前的父母报告患病率为 19.1%。此外，90 个共同项目的 TRF 评分平均值明显低于 CBCL 评分平均值。TRF 的总分、外化问题和内化问题的平均得分为 26.9（标准差 24.5）、6.1（标准差 7.2）和 7.9（标准差 7.3）。与父母报告一致，男孩的 TRF 总分和外化问题得分均高于女孩，而内化问题得分则无显著性别差异。教师-家长的一致性中等（r=0.38），外化问题的一致性略高于内化问题（r=0.37 对 r=0.34）。对于所有综合征量表，都发现了中等至低度的相关性，系数范围从 r=0.26（社会问题）到 r=0.37（注意力问题）。儿童性别对教师-家长一致性的影响仅在内化问题方面显著，女孩的一致性高于男孩。
尼泊尔教师报告的儿童 EBP 少于父母。教师-家长的一致性中等，且因 EBP 类型和儿童性别而异。我们的研究结果强调了在评估和治疗尼泊尔等低收入和中等收入国家的儿童时，从父母和教师那里获取儿童 EBP 信息的重要性。
