Zahner G E, Daskalakis C
Department of Epidemiology, Harvard School of Public Health, Boston, Mass 02115, USA.
Am J Public Health. 1997 Sep;87(9):1440-8. doi: 10.2105/ajph.87.9.1440.
This study was designed to identify factors associated with service use for child psychopathology in three settings: mental health, general health, and school.
Subjects were 2519 children, 6 to 11 years of age, assessed in two cross-sectional Connecticut surveys in the late 1980s. Three groups of variables (sociodemographics, child's illness profile, and parental attitudes) were examined through multivariate logistic regression.
Most sociodemographics showed moderate associations with all settings, although some previously reported effects (e.g. birth order, sibship size) were not observed. Of the illness profile measures, only Child Behavior Checklist total scores predicted use in the final model (odds ratio [OR] = 1.6, 95% confidence interval [CI] = 1.1, 2.3). Health problems were associated with increased use in all settings (OR = 1.5, 95% CI = 1.3, 1.9), while academic problems were associated only with increased school service use (OR = 5.2, 95% CI = 3.9, 7.0). Parental belief that the child needed help was most strongly associated with service use (common OR for all settings = 5.3, 95% CI = 4.1, 6.8).
Sociodemographics, parental attitudes, and children's illness profiles independently influence service use for psychopathology in school-aged children.
本研究旨在确定在心理健康、普通健康和学校这三种环境中与儿童精神病理学服务利用相关的因素。
研究对象为2519名6至11岁的儿童,他们在20世纪80年代后期康涅狄格州的两项横断面调查中接受了评估。通过多变量逻辑回归分析了三组变量(社会人口统计学、儿童疾病概况和父母态度)。
大多数社会人口统计学因素与所有环境都呈现出中等程度的关联,尽管未观察到一些先前报道的影响(如出生顺序、同胞数量)。在疾病概况测量指标中,只有儿童行为检查表总分在最终模型中预测了服务利用情况(优势比[OR]=1.6, 95%置信区间[CI]=1.1, 2.3)。健康问题与所有环境中服务利用的增加相关(OR = 1.5, 95% CI = 1.3, 1.9),而学业问题仅与学校服务利用的增加相关(OR = 5.2, 95% CI = 3.9, 7.0)。父母认为孩子需要帮助与服务利用的关联最为强烈(所有环境的共同OR = 5.3, 95% CI = 4.1, 6.8)。
社会人口统计学、父母态度和儿童疾病概况独立影响学龄儿童精神病理学服务的利用。