Parental psychosocial factors, unmet dental needs and preventive dental care in children and adolescents with special health care needs: A stress process model.
Parental psychosocial factors, unmet dental needs and preventive dental care in children and adolescents with special health care needs: A stress process model.
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DOI：
10.1186/s12903-022-02314-y
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发表时间：
2022-07-11
期刊：
影响因子：
2.9
通讯作者：
Aleksejuniene, Jolanta
中科院分区：
文献类型：
--
作者：
Gazzaz, Arwa Z.;Carpiano, Richard M.;Laronde, Denise M.;Aleksejuniene, Jolanta
关键词：
有特殊卫生保健需求的儿童和青少年（SHCN）有较高的未满足的牙科需求，但父母因素影响牙科保健使用的潜在机制尚未确定。养育一个患有SHCN的孩子可能会提出特殊的要求，影响父母的幸福感，进而影响他们的生活。因此，本研究的总体目标是应用压力过程模型来研究父母心理社会因素在儿童SHCN和牙科护理之间的关联中的作用。具体而言，该研究测试的假设（a）儿童的SHCN状态是如何与儿童牙科保健（未满足的牙科需求和缺乏预防性牙科就诊），直接和间接通过父母的心理社会因素（养育压力，工具，和情感的社会支持）和（B）父母的社会支持缓冲养育压力和儿童牙科保健之间的关联。对2011-2012年美国全国儿童健康调查的次要数据进行了分析，对象为6至11岁儿童（n = 27，874）和12至17岁青少年（n = 31，328）。我们的年龄分层模型估计儿童SHCN状态和父母的心理社会因素与两个儿童牙科保健结果之间的关联：父母报告未满足的儿童牙科需求和缺乏预防性牙科保健。儿童（与没有）SHCN的父母报告较高的未满足的儿童牙科需求，较高的养育压力，和较低的社会支持（工具和情感）。在这两个年龄组中，父母的工具性而非情感性支持与他们的孩子未满足的牙科需求的几率较低相关。父母压力和儿童牙科保健结果之间的关联被修改了父母的社会支持。根据SHCN状态，儿童未满足的牙科需求存在差异，即使在调整父母的心理社会因素后。SHCN状态与未满足的牙科需求通过青少年中的父母工具的支持间接相关，父母工具的支持缓冲养育压力和儿童牙科保健结果之间的负相关。因此，父母的社会支持是一个重要的决定因素，儿童牙科保健和部分解释了牙科保健的差异，在青少年SHCN。在线版本包含补充材料，可通过10.1186/s12903-022-02314-y获得。
Children and adolescents with special health care needs (SHCN) have higher unmet dental needs, but the potential mechanisms by which parental factors can influence dental care use have not been determined. Parenting a child with SHCN can present special demands that affect parents’ well-being and, in turn, their caregiving. Hence, the study's overall aim was to apply the stress process model to examine the role of parental psychosocial factors in the association between child SHCN and dental care. Specifically, the study tested hypotheses regarding how (a) children’s SHCN status is associated with child dental care (unmet dental needs and lack of preventive dental visits), both directly and indirectly via parental psychosocial factors (parenting stress, instrumental, and emotional social support) and (b) parental social support buffers the association between parenting stress and child dental care. A secondary data analysis of the 2011–2012 US National Survey of Children’s Health was performed for 6- to 11-year-old children (n = 27,874) and 12- to 17-year-old adolescents (n = 31,328). Our age-stratified models estimated associations between child SHCN status and parental psychosocial factors with two child dental care outcomes: parent-reported unmet child dental needs and lack of preventive dental care. Parents of children with (vs without) SHCN reported higher unmet child dental needs, higher parenting stress, and lower social support (instrumental and emotional). Instrumental, but not emotional, parental support was associated with lower odds of their child unmet dental needs in both age groups. The association between parenting stress and child dental care outcomes was modified by parental social support. Differences existed in child unmet dental needs based on SHCN status, even after adjusting for parental psychosocial factors. SHCN status was indirectly associated with unmet dental needs via parental instrumental support among adolescents, and parental instrumental support buffered the negative association between parenting stress and both child dental care outcomes. Hence, parental social support was an important determinant of child dental care and partially explained the dental care disparities in adolescents with SHCN. The online version contains supplementary material available at 10.1186/s12903-022-02314-y.
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影响因子：
12.7
作者：
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