Condition severity and psychosocial functioning in pre-adolescents with spina bifida: Disentangling proximal functional status and distal adjustment outcomes
Condition severity and psychosocial functioning in pre-adolescents with spina bifida: Disentangling proximal functional status and distal adjustment outcomes
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DOI：
10.1093/jpepsy/24.6.499
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发表时间：
1999-12-01
影响因子：
3.6
通讯作者：
Coers, S
中科院分区：
文献类型：
--
作者：
Hommeyer, JS;Holmbeck, GN;Coers, S
目的：通过测试近端功能状态和远端调节结果的几种直接、间接和介导效应模型，研究70例8岁和9岁的脊柱裂前青少年的病情严重程度和心理社会功能之间的关系。参与活动的程度、学习能力、运动能力、注意力问题）和远端调节结果（例如，行为问题、社会能力）与母亲、父亲和教师的报告进行评估。严重程度变量包括脊柱病变水平，脊柱裂分类，分流状态，amphibia状态，分流手术的数量，和两个严重composite.Results：条件的严重程度与近端功能状态的结果在父母和教师的报告。相比之下，未发现严重度参数与远端调节结局之间存在显著关系。研究结果支持疾病严重程度的近端效应模型以及间接效应模型（例如，分流的存在-->较少的学术能力-->较少的社会能力）并且与最近的理论公式（例如，结论：解开近端功能状态结果和远端调整结果在病情严重程度和心理社会功能研究中至关重要。我们讨论了临床意义。
Objective: To examine relations between condition severity and psychosocial functioning in 70 8- and 9-year-old pre-adolescents with spina bifida by testing several direct, indirect, and mediated effects models for proximal functional status and distal adjustment outcomes.Methods: Proximal functional status outcomes (e.g., degree of involvement in activities, scholastic competence, athletic competence, attentional problems) and distal adjustment outcomes (e.g., behavior problems, social competence) were assessed with mother, father, and teacher report. Severity variables included spinal lesion level, spina bifida classification, shunt status, ambulation status, number of shunt surgeries, and two severity composites.Results: Condition severity was associated with the proximal functional status outcomes across parent and teacher report. In contrast, no significant relationships were found between the severity parameters and distal adjustment outcomes. Findings supported a proximal effects model of condition severity as well as an indirect effects model (e.g., presence of a shunt --> less scholastic competence --> less social competence) and were consistent with recent theoretical formulations (e.g., Wallander Sr Varni, 1995).Conclusions: Disentangling proximal functional status outcomes and distal adjustment outcomes is critical in studies of condition severity and psychosocial functioning. We discuss clinical implications.