Resilience in low-socioeconomic-status children with asthma: adaptations to stress.
Resilience in low-socioeconomic-status children with asthma: adaptations to stress.
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DOI：
10.1016/j.jaci.2011.06.040
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发表时间：
2011-11
期刊：
影响因子：
--
通讯作者：
Miller GE
中科院分区：
文献类型：
--
作者：
Chen E;Strunk RC;Trethewey A;Schreier HM;Maharaj N;Miller GE
低社会经济地位（SES）是许多健康问题的有力预测因素，包括哮喘损害；然而，为什么有些人不顾这种趋势，尽管生活在不利的环境中，却表现出良好的哮喘控制，人们对此知之甚少。这项研究试图测试一种心理特征——“转变并坚持”（通过更积极地重新构建压力源，同时坚持对未来的乐观想法）——是否能保护低社会经济地位儿童的哮喘。从医疗实践和社区广告中招募了121名被医生诊断为哮喘的儿童，年龄9-18岁（M年龄=12.6岁，67%为男性，61%为高加索人）。在基线时评估转移和持续以及哮喘炎症（嗜酸性粒细胞计数，刺激的IL-4细胞因子产生），在基线和6个月随访时监测哮喘损害（急救吸入器使用和缺勤的每日日记测量）和每日峰值流量。在6个月的随访期间，来自低社会经济地位背景但采用“转变和坚持”策略的儿童在基线时哮喘炎症较少（β= 0.19, p< 0.05），哮喘损害较少（减少急救吸入器的使用和更少的缺勤；β= 0.32, p< 0.01）。相比之下，转变和坚持策略对高SES儿童哮喘患者没有好处。关注低社会经济地位儿童为适应压力而发展的心理素质的方法可能是减少健康差距的一个实际和有效的起点。此外，在低社会地位群体中有效的方法可能与在高社会地位群体中最优的方法不同。
Low socioeconomic status (SES) is a strong predictor of many health problems, including asthma impairment; however, little is understood about why some individuals defy this trend by exhibiting good asthma control despite living in adverse environments. This study sought to test whether a psychological characteristic – “shift-and-persist” (dealing with stressors by reframing them more positively, while at the same time, persisting in optimistic thoughts about the future) - protects low SES children with asthma. 121 children physician-diagnosed with asthma, ages 9-18, were recruited from medical practices and community advertisements (M age=12.6, 67% male, 61% Caucasian). Shift-and-persist and asthma inflammation (eosinophil counts, stimulated IL-4 cytokine production) were assessed at baseline, and asthma impairment (daily diary measures of rescue inhaler use and school absences), and daily peak flow were monitored at baseline and at a 6-month follow-up. Children who came from low SES backgrounds but who engaged in shift-and-persist strategies displayed less asthma inflammation at baseline (β=.19, p<.05), as well as less asthma impairment (reduced rescue inhaler use and fewer school absences; β=.32, p<.01) prospectively at a 6 month follow-up period. In contrast, shift-and-persist strategies were not beneficial among high SES children with asthma. An approach that focuses on the psychological qualities that low SES children develop to adapt to stressors may represent one practical and effective starting point for reducing health disparities. Moreover, the approaches that are effective in low SES communities may be different from those that are optimal in a high SES context.
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影响因子：
11
作者：
Chen, E.;Miller, G. E.;Kobor, M. S.;Cole, S. W.
通讯作者：
Cole, S. W.
影响因子：
14.2
作者：
Chen, Edith;Hanson, Margaret D.;Miller, Gregory E.
通讯作者：
Miller, Gregory E.
影响因子：
10
作者：
Dales, RE;Choi, B;Tang, M
通讯作者：
Tang, M
DOI：
10.1111/j.1749-6632.2009.05332.x
发表时间：
2010-01-01
期刊：
BIOLOGY OF DISADVANTAGE: SOCIOECONOMIC STATUS AND HEALTH
影响因子：
--
作者：
Matthews, Karen A.;Gallo, Linda C.;Taylor, Shelley E.
通讯作者：
Taylor, Shelley E.
影响因子：
5.4
作者：
Lynch, JW;Kaplan, GA;Salonen, JT
通讯作者：
Salonen, JT