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患有身体疾病或身心共病儿童的兄弟姐妹的心理健康。

Mental health of siblings of children with physical illness or physical-mental comorbidity.

作者信息

Qureshi Saad A, Reaume Shannon V, Bedard Chloe, Ferro Mark A

机构信息

School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.

出版信息

Child Care Health Dev. 2023 May;49(3):456-463. doi: 10.1111/cch.13061. Epub 2022 Sep 19.

Abstract

OBJECTIVES

This study examined the mental health of siblings of children with physical illness (PI), with or without co-occurring mental illness.

METHODS

The sample included children aged 2 to 16 years with a chronic PI and their aged-matched healthy siblings (n = 169 dyads). Physical-mental comorbidity (PM) was present if children screened positive for ≥1 mental illness on the Mini International Neuropsychiatric Interview for Children and Adolescents. Parents completed the Strengths and Difficulties Questionnaire (SDQ) to measure child and sibling mental health.

RESULTS

Within child-sibling dyads, siblings of children with PI had significantly worse mental health related to conduct problems (d = 0.31), peer problems (d = 0.18) and total difficulties (d = 0.20). Siblings of children with PM had significantly better mental health related to emotional problems (d = 0.42), hyperactivity/inattention (d = 0.23) and total difficulties (d = 0.32). Siblings of children with PI had similar mental health compared with child population norms used in the development of the SDQ. In contrast, siblings of children with PM had significantly worse mental health across all SDQ domains, with the exception of prosocial behaviour. After adjusting for parent psychopathology and family functioning, no statistically significant differences between siblings of children with PM versus siblings of children with PI were found.

CONCLUSIONS

Differences in mental health exist between children with PI or PM versus their healthy siblings. However, differences between siblings of children with PI versus siblings of children with PM can be explained by parental and family factors (e.g. marital status, education and income). Findings reinforce family-centred care approaches to address the needs of children with PI or PM and their families.

摘要

目的

本研究调查了患有躯体疾病(PI)的儿童的兄弟姐妹的心理健康状况,这些儿童伴有或不伴有共病精神疾病。

方法

样本包括年龄在2至16岁之间患有慢性PI的儿童及其年龄匹配的健康兄弟姐妹(n = 169对)。如果儿童在《儿童及青少年版迷你国际神经精神访谈》中筛查出≥1种精神疾病呈阳性,则存在身心共病(PM)。父母完成了优势与困难问卷(SDQ)以评估儿童及其兄弟姐妹的心理健康。

结果

在儿童-兄弟姐妹对中,患有PI的儿童的兄弟姐妹在品行问题(d = 0.31)、同伴问题(d = 0.18)和总困难(d = 0.20)方面的心理健康状况明显更差。患有PM的儿童的兄弟姐妹在情绪问题(d = 0.42)、多动/注意力不集中(d = 0.23)和总困难(d = 0.32)方面的心理健康状况明显更好。患有PI的儿童的兄弟姐妹的心理健康状况与SDQ编制过程中使用的儿童总体规范相似。相比之下,患有PM的儿童的兄弟姐妹在SDQ的所有领域(亲社会行为除外)的心理健康状况明显更差。在调整了父母的精神病理学和家庭功能后,未发现患有PM的儿童的兄弟姐妹与患有PI的儿童的兄弟姐妹之间存在统计学上的显著差异。

结论

患有PI或PM的儿童与其健康兄弟姐妹之间存在心理健康差异。然而,患有PI的儿童的兄弟姐妹与患有PM的儿童的兄弟姐妹之间的差异可以由父母和家庭因素(如婚姻状况、教育程度和收入)来解释。研究结果强化了以家庭为中心的护理方法,以满足患有PI或PM的儿童及其家庭的需求。

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