A National Mental Health Profile of Parents of Children With Medical Complexity
A National Mental Health Profile of Parents of Children With Medical Complexity
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DOI：
10.1542/peds.2020-023358
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发表时间：
2021-08-01
期刊：
影响因子：
8
通讯作者：
Li, Yue
中科院分区：
文献类型：
--
作者：
Bayer, Nathaniel D.;Wang, Hongyue;Li, Yue
目的医疗复杂性（CMC）患儿父母的心理健康状况尚不清楚，但它却推动着儿童和家庭的健康结果。与有特殊卫生保健需要的非复杂儿童（CSHCN）和无特殊卫生保健需要儿童（非CSHCN）的父母相比，我们检查了CMC父母自我报告的心理健康状况、对社区帮助来源的了解和情感支持。方法利用2016-2017年全国儿童健康综合调查中家长报告的数据，将人群分为3组：有CMC的家庭、非复杂CSHCN的家庭和非CSHCN的家庭。我们在以下方面比较了这些组：(1)父母的心理健康状况差或一般的风险以及去哪里寻求社区帮助的知识；(2)父母报告的情感支持来源。结果：63 955 588对亲子对（从65 204对样本中加权）中，与非复杂CSHCN父母相比，CMC父母报告心理健康状况不佳或一般的调整比值（调整比值比[aOR] 2.0； 95%置信区间[CI] 1.1-3.8）和非CSHCN父母（调整比值比[aOR] 4.6； 95%置信区间[CI] 2.5-8.6）。与非复杂CSHCN （aOR为2.1,95% CI为1.4-3.1）和非CSHCN （aOR为2.9,95% CI为2.0-4.3）的父母相比，CMC的父母不知道去哪里寻求社区帮助的几率更大。然而，CMC的父母最有可能报告从卫生保健提供者和倡导团体获得情感支持（P < 0.001）。结论：在所有家长中，患有CMC的家长报告心理健康状况不佳的风险最高。他们更多地报告说，他们不知道在哪里找到社区帮助，但他们确实说，他们从卫生保健提供者和倡导团体那里得到了情感支持。未来的研究者应该寻找直接支持CMC家长情绪健康的方法。
OBJECTIVES The mental health of parents of children with medical complexity (CMC) is poorly understood, yet it drives child and family health outcomes. For parents of CMC, compared with parents of noncomplex children with special health care needs (CSHCN) and children without special health care needs (non-CSHCN), we examined self-reported mental health, knowledge of community sources for help, and emotional support. METHODS Using parent-reported data from the combined 2016-2017 National Survey of Children's Health, we divided the population into 3 groups: households with CMC, noncomplex CSHCN, and non-CSHCN. We compared these groups regarding the following: (1) parents' risks for poor or fair mental health and knowledge of where to go for community help and (2) parent-reported sources of emotional support. RESULTS Of 63 955 588 parent-child dyads (weighted from a sample of 65 204), parents of CMC had greater adjusted odds of reporting poor or fair mental health compared with parents of noncomplex CSHCN (adjusted odds ratio [aOR] 2.0; 95% confidence interval [CI] 1.1-3.8) and non-CSHCN (aOR 4.6; 95% CI 2.5-8.6). Parents of CMC had greater odds of not knowing where to find community help compared with parents of noncomplex CSHCN (aOR 2.1; 95% CI 1.4-3.1) and non-CSHCN (aOR 2.9; 95% CI 2.0-4.3). However, parents of CMC were most likely to report receiving emotional support from health care providers and advocacy groups (P < .001). CONCLUSIONS Among all parents, those with CMC were at the highest risk to report suboptimal mental health. They more often reported that they do not know where to find community help, but they did say that they receive emotional support from health care providers and advocacy groups. Future researchers should identify ways to directly support the emotional wellness of parents of CMC.