Ireys H T, Silver E J
Department of Maternal and Child Health, School of Hygiene and Public Health, Johns Hopkins School of Public Health, Baltimore, MD 21205, USA.
J Dev Behav Pediatr. 1996 Apr;17(2):77-83.
Longitudinal data were used to investigate direct and indirect effects of demographic factors, parameters of chronic health conditions, service use variables, and perception of family impact of illness on mental health of 169 mothers of children with diverse chronic health conditions. Bivariate analyses indicated that baseline assessments of demographic factors, condition parameters, and service use were: (1) generally unrelated to maternal mental health at 1 year and (2) modestly related to maternal perception of the condition's impact on the family 1 year later. Perceived impact and maternal mental health themselves were moderately related. Multivariate analyses indicated that the need to watch for changes in the child's condition, the presence of communication or speech problems, and the number of hospitalizations in the previous year predicted maternal perceptions of the impact of the condition 1 year later. Mothers perception of impact had a direct effect on mothers' mental health after accounting for condition parameters. Results suggest that condition parameters and service use can affect maternal mental health through mothers' perceptions of the impact of the condition on family life. Implications for interventions to prevent maternal health problems are discussed.
纵向数据用于调查人口统计学因素、慢性健康状况参数、服务使用变量以及疾病对家庭影响的认知等因素对169名患有不同慢性健康状况儿童的母亲心理健康的直接和间接影响。双变量分析表明,人口统计学因素、状况参数和服务使用的基线评估结果为:(1)一般与1年后的母亲心理健康无关;(2)与1年后母亲对疾病对家庭影响的认知有适度关联。感知到的影响与母亲心理健康本身呈中度相关。多变量分析表明,留意孩子状况变化的必要性、沟通或言语问题的存在以及前一年的住院次数可预测1年后母亲对疾病影响的认知。在考虑了状况参数后,母亲对影响的认知对母亲的心理健康有直接影响。结果表明,状况参数和服务使用可通过母亲对疾病对家庭生活影响的认知来影响母亲的心理健康。文中还讨论了预防母亲健康问题干预措施的意义。