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父母对多国调查中青少年心理健康筛查的偏好。

Parental Preferences for Mental Health Screening of Youths From a Multinational Survey.

机构信息

Center for the Developing Brain, Child Mind Institute, New York, New York.

Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.

出版信息

JAMA Netw Open. 2023 Jun 1;6(6):e2318892. doi: 10.1001/jamanetworkopen.2023.18892.

Abstract

IMPORTANCE

Screening youths for mental disorders may assist in prevention, promote early identification, and be associated with reduced related lifetime impairment and distress.

OBJECTIVE

To assess parents' and caregivers' comfort with and preferences for pediatric mental health screening and factors associated with these preferences.

DESIGN, SETTING, AND PARTICIPANTS: This survey study used an online survey available from July 11 to 14, 2021, through Prolific Academic. Analyses were conducted from November 2021 to November 2022. The survey was administered to English-speaking parents and caregivers in the US, UK, Canada, and 16 other countries who were aged 21 years or older and had at least 1 child aged 5 to 21 years living at home.

MAIN OUTCOMES AND MEASURES

The main outcomes were parental preferences regarding content, implementation, and review of the findings of pediatric mental health screening. Parental comfort with screening topics was reported on a 6-point Likert scale with 6 indicating highest comfort. Mixed-effects logistic regression models were used to evaluate factors associated with parental comfort levels.

RESULTS

Of 1200 survey responses requested, data were collected from 1136 participants (94.7%). The final sample meeting the inclusion criteria comprised 972 parents and caregivers aged 21 to 65 years (mean [SD] age, 39.4 [6.9] years; 606 [62.3%] female). A total of 631 participants (64.9%) supported annual mental health screening for their child, and 872 (89.7%) preferred reviewing the screening results with professional staff (eg, physicians). Participants reported significantly decreased comfort with child self-report compared with parent-report screening assessments (b = -0.278; SE = 0.009; P < .001), although they were generally comfortable with both options. Despite slight variations based on country of residence, screening topic, and child's age, participants were generally comfortable discussing all 21 screening topics on the survey. The greatest comfort was with sleep problems (mean [SE] score, 5.30 [0.03]); the least comfort was with firearms (mean [SE] score, 4.71 [0.05]), gender identity (mean [SE] score, 4.68 [0.05]), suicidality (mean [SE] score, 4.62 [0.05]), and substance use or abuse (mean [SE] score, 4.78 [0.05]).

CONCLUSIONS AND RELEVANCE

In this survey study of parents and caregivers, parent-reported and child self-reported mental health screening in primary care settings was supported by the majority of the sample, although comfort levels differed according to various factors (eg, screening topic). Participants preferred to discuss screening results with professional health care staff. In addition to parental need for expert guidance, the study findings highlight the growing awareness of child mental health needs and the importance of addressing mental health concerns early via regular mental health screenings.

摘要

重要性

对青少年进行精神障碍筛查可能有助于预防、促进早期识别,并减少与之相关的终身损害和痛苦。

目的

评估父母对儿童心理健康筛查的舒适度和偏好,以及与这些偏好相关的因素。

设计、地点和参与者:这项调查研究使用了 2021 年 7 月 11 日至 14 日通过 Prolific Academic 提供的在线调查。分析于 2021 年 11 月至 2022 年 11 月进行。该调查针对的是居住在美国、英国、加拿大和其他 16 个国家的 21 岁或以上、家中至少有 1 名 5 至 21 岁子女的英语使用者父母和照顾者。

主要结果和措施

主要结果是父母对儿童心理健康筛查内容、实施和结果审查的偏好。父母对筛查主题的舒适度通过 6 点李克特量表进行报告,6 表示最高舒适度。采用混合效应逻辑回归模型评估与父母舒适度水平相关的因素。

结果

在要求的 1200 份调查回复中,共收集了 1136 名参与者(94.7%)的数据。符合纳入标准的最终样本包括 972 名年龄在 21 至 65 岁的父母和照顾者(平均[标准差]年龄 39.4[6.9]岁;606[62.3%]为女性)。共有 631 名参与者(64.9%)支持对其子女进行年度心理健康筛查,872 名(89.7%)更喜欢与专业人员(如医生)一起审查筛查结果。与父母报告的筛查评估相比,参与者报告的儿童自我报告筛查的舒适度明显降低(b=-0.278;SE=0.009;P<0.001),尽管他们通常对这两种选择都感到舒适。尽管基于居住国、筛查主题和儿童年龄存在细微差异,但参与者通常对调查中的所有 21 个筛查主题都感到舒适。最舒适的是睡眠问题(平均[SE]评分 5.30[0.03]);最不舒适的是枪支(平均[SE]评分 4.71[0.05])、性别认同(平均[SE]评分 4.68[0.05])、自杀意念(平均[SE]评分 4.62[0.05])和药物使用或滥用(平均[SE]评分 4.78[0.05])。

结论和相关性

在这项针对父母和照顾者的调查研究中,大多数样本支持在初级保健环境中进行父母报告和儿童自我报告的心理健康筛查,尽管舒适度水平因各种因素而异(例如,筛查主题)。参与者更喜欢与专业医疗保健人员讨论筛查结果。除了父母对专家指导的需求外,研究结果还强调了人们对儿童心理健康需求的认识不断提高,以及通过定期心理健康筛查尽早解决心理健康问题的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d354/10282888/38d037b7997d/jamanetwopen-e2318892-g001.jpg

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