Billings A G, Moos R H, Miller J J, Gottlieb J E
Health Psychol. 1987;6(4):343-59. doi: 10.1037//0278-6133.6.4.343.
Juvenile rheumatic diseases are serious chronic illnesses potentially capable of disrupting a child's development and functioning. This study examined the psychosocial functioning of 43 children with severe rheumatic disease as compared to that of 52 children with a milder or inactive form of rheumatic disease. Both patient groups also were compared to 93 healthy children from demographically matched families. Data were obtained from parent reports, from physician evaluation, and, for children who were old enough, from self-reports. The severe patient group showed more parent-reported psychological and physical problems than both the mild patient group and the healthy controls. Compared to the mild group, the severe group also missed more days of school due to illness. Older children in the severe group were more likely to miss school due to illness and to participate in fewer social activities with their families and friends than the controls; however, the older children reported comparable mood and functioning in other areas. An expanded model is proposed to examine risk and resistance factors predictive of psychological and social dysfunction among children with severe chronic disease.
青少年风湿性疾病是严重的慢性疾病，有可能干扰儿童的发育和功能。本研究调查了43名患有严重风湿性疾病的儿童的心理社会功能，并与52名患有较轻或非活动性风湿性疾病的儿童进行了比较。这两组患者还与来自人口统计学匹配家庭的93名健康儿童进行了比较。数据来自家长报告、医生评估，对于年龄足够大的儿童，还来自自我报告。严重患者组在家长报告的心理和身体问题方面比轻度患者组和健康对照组都更多。与轻度组相比，严重组因疾病缺课的天数也更多。严重组中年龄较大的儿童比对照组更有可能因病缺课，与家人和朋友参加的社交活动也更少；然而，年龄较大的儿童在其他方面报告的情绪和功能相当。本文提出了一个扩展模型，以研究预测严重慢性病儿童心理和社会功能障碍的风险和抵抗因素。
