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在儿科糖尿病诊所扩大行为健康筛查范围,纳入 12 岁及以下青少年的焦虑和照顾者报告,具有益处。

Benefits of expanding behavioral health screening in a pediatric diabetes clinic to include anxiety and caregiver reports in youth 12 years and younger.

机构信息

Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Health Morsani College of Medicine.

Johns Hopkins All Children's Hospital Pediatric Endocrinology, Johns Hopkins School of Nursing.

出版信息

Fam Syst Health. 2024 Mar;42(1):116-121. doi: 10.1037/fsh0000840. Epub 2023 Aug 17.

Abstract

INTRODUCTION

Depression and anxiety among youth with Type 1 diabetes (T1D) are associated with poor diabetes management. Further guidance regarding psychosocial screening measures would benefit pediatric integrated care clinics. The purpose of this exploratory study was to examine whether screening for anxiety, assessing caregiver reports, and screening children 12 years old and younger could identify a larger percentage of youth who may benefit from behavioral health support compared to the standard approach of only screening youth 13 and older for depression.

METHOD

Sixty-five youth 8-17 years old with T1D ( = 65; = 13.2 years; 55.4% females) and their caregivers (75% mothers) completed validated self-report and proxy-report depression and anxiety screeners during routine clinic visits between 2019 and 2021. Twenty-seven youth aged 13-17 also completed a measure of diabetes-related distress.

RESULTS

The standard approach of screening youth aged 13-17 for depression via self-report identified 25.6% of participants, whereas screening youth ages 8-17 for depression and anxiety via self- and proxy-reports identified 47.7%. Screening for depression/anxiety identified unique portions of youth independent of diabetes distress.

DISCUSSION

Utilizing anxiety and proxy-report measures may identify youth likely to benefit from behavioral health support who are not identified when only a self-report depression measure is used in screening. Research should evaluate whether utilizing multiple measures and screening children under 13 years old improve detection and connection to care for youth experiencing difficulty managing diabetes. Early identification and intervention could subsequently mitigate the negative impacts of social-emotional difficulties on diabetes management. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

摘要

简介

青少年 1 型糖尿病(T1D)患者的抑郁和焦虑与较差的糖尿病管理有关。进一步的心理社会筛查措施指导将使儿科综合护理诊所受益。本探索性研究的目的是检验焦虑筛查、评估照顾者报告以及对 12 岁及以下儿童进行筛查,是否比仅对 13 岁及以上青少年进行抑郁筛查更能发现更多可能需要行为健康支持的青少年。

方法

2019 年至 2021 年间,在常规诊所就诊期间,65 名 8-17 岁的 T1D 青少年(=65;年龄=13.2 岁;55.4%为女性)及其照顾者(75%为母亲)完成了经过验证的自我报告和代理报告抑郁和焦虑筛查,其中 27 名 13-17 岁的青少年还完成了一项糖尿病相关困扰的测量。

结果

通过自我报告筛查 13-17 岁青少年的抑郁症的标准方法识别出 25.6%的参与者,而通过自我报告和代理报告筛查 8-17 岁青少年的抑郁和焦虑则识别出 47.7%的参与者。抑郁/焦虑筛查可以独立于糖尿病困扰来识别出青少年。

讨论

使用焦虑和代理报告措施可能会识别出那些仅使用自我报告抑郁措施进行筛查时无法识别的可能从行为健康支持中受益的青少年。研究应评估是否使用多种措施和筛查 13 岁以下儿童可以提高对患有糖尿病的青少年的发现率和对他们的护理连接。早期识别和干预可以减轻社交情感困难对糖尿病管理的负面影响。

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