Nonoyama Tomo
Nursing Science, Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya 461-8673, Aichi, Japan.
Pediatr Rep. 2025 Jun 18;17(3):68. doi: 10.3390/pediatric17030068.
BACKGROUND/OBJECTIVES: Increased burdens on caregivers of infants and toddlers significantly affect caregivers' quality of life and health. Although adequate care during infancy contributes to child development and special health care needs affect caregiver burden, the risk factors for and protective factors against increased caregiver burden remain unclear. We aimed to evaluate children's health care needs and required caregiving time and identify factors associated with increased caregiver burden.
We conducted an online survey of 287 Japanese caregivers who were randomly selected from a web panel and were raising children aged <4 years. The survey comprised a sociodemographic data form, Children with Special Health Care Needs (CSHCN) Screener, caregiving time survey form, and questions on increased burden. Needs and caregiving time were evaluated by dividing the participants into CSHCN and non-CSHCN groups. Related factors were analyzed using increased burden as the dependent variable. The chi-square test, Mann-Whitney U test, and modified Poisson regression were used for data analysis.
Among the children of the 287 participating caregivers, 16.4% were identified as CSHCN, while 96.9% had no specific diagnosis. Overall, 38.3% of the CSHCN group met only one of the five CSHCN Screener items. The CSHCN group spent significantly more time providing and arranging/coordinating health care. The non-CSHCN group spent significantly more time providing daily care. After adjusting for covariates, increased caregiver burden was significantly associated with a younger age of the child, more caregiving time required 6 months prior to the survey, and providing care for CSHCN.
To help reduce the burden of childcare on caregivers of infants and young children, children's needs should be identified and generous childcare provided from an early age. Early identification of CSHCN and appropriate support for families may help reduce caregiver burden during early childhood.
背景/目的：婴幼儿照料者负担的增加会显著影响其生活质量和健康状况。尽管婴儿期得到充分照料有助于儿童发育，且特殊医疗保健需求会影响照料者负担，但照料者负担增加的风险因素和保护因素仍不明确。我们旨在评估儿童的医疗保健需求和所需照料时间，并确定与照料者负担增加相关的因素。
我们对287名日本照料者进行了在线调查，这些照料者是从一个网络小组中随机选取的，他们抚养的孩子年龄小于4岁。调查包括一份社会人口统计学数据表、特殊医疗保健需求儿童（CSHCN）筛查表、照料时间调查表以及关于负担增加的问题。通过将参与者分为CSHCN组和非CSHCN组来评估需求和照料时间。以负担增加作为因变量分析相关因素。采用卡方检验、曼-惠特尼U检验和修正泊松回归进行数据分析。
在287名参与调查的照料者的孩子中，16.4%被确定为CSHCN，而96.9%没有具体诊断。总体而言，CSHCN组中38.3%仅符合五项CSHCN筛查项目中的一项。CSHCN组在提供和安排/协调医疗保健方面花费的时间明显更多。非CSHCN组在提供日常照料方面花费的时间明显更多。在对协变量进行调整后，照料者负担增加与孩子年龄较小、调查前6个月所需照料时间较多以及照料CSHCN显著相关。
为帮助减轻婴幼儿照料者的育儿负担，应识别儿童的需求并从早期提供充足的育儿支持。早期识别CSHCN并为家庭提供适当支持可能有助于减轻幼儿期照料者的负担。
