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Body image and psychosocial outcomes in youth and young adults with differences of sex development: a multi-method study. 有性别发展差异的青年和青少年的身体形象和心理社会结果:一项多方法研究。
IF 2.7 3区 心理学 Q2 PSYCHOLOGY, DEVELOPMENTAL Pub Date : 2024-07-01 DOI: 10.1093/jpepsy/jsae041
Canice E Crerand, Ayah Shehata, Hailey Umbaugh, Hillary M Kapa, Jennifer Hansen-Moore, Leena Nahata, Cindy Buchanan, Diane Chen, Joseph Rausch, Shivika Udaipuria, Venkata R Jayanthi, Yee-Ming Chan, Keeley J Pratt, Elizabeth Buschur, Justin Indyk, Amy C Tishelman

Objective: Differences of sex development (DSD) can affect the physical health, appearance, and psychosocial functioning of affected individuals, but little is known about how subjective appearance perceptions (body image) impact psychosocial outcomes. This study evaluated body image and its associations with psychosocial outcomes including quality of life, resilience, and psychosocial adjustment.

Methods: This cross-sectional, multi-method study assessed body image and psychosocial outcomes including quality of life, adjustment, and resilience in 97 youth and young adults with DSD (mean age = 17 ± 3.7 years; 56% assigned female in infancy) using psychometrically sound instruments. A subsample (n = 40) completed qualitative interviews.

Results: Quantitative results indicated that overall, participants were satisfied with their physical appearance, although less so with their primary sex characteristics. Body image dissatisfaction was associated with poorer psychosocial adjustment, quality of life, and resilience. Qualitatively, youth and young adults reported a variety of perceptions, both positive and negative, related to their body image and the impact of living with a DSD condition. Themes identified included appearance management; effects of DSD on body image; diagnostic factors and features; attitudes about diagnosis; and treatment.

Conclusions: Body image is significantly associated with psychosocial outcomes in youth and young adults with DSD, with qualitative findings highlighting both positive and negative body image experiences. Results have implications for clinical care including screening for appearance concerns, normalization of appearance variations, and intervention development to better support healthy body image and psychosocial functioning in youth and young adults with DSD.

目的:性别发育差异(DSD)会影响受影响个体的身体健康、外观和社会心理功能,但人们对主观外观认知(身体形象)如何影响社会心理结果知之甚少。本研究评估了身体形象及其与生活质量、复原力和社会心理适应等社会心理结果之间的关系:这项横断面、多方法研究使用心理测量工具评估了 97 名患有 DSD 的青少年和年轻成人(平均年龄 = 17 ± 3.7 岁;56% 在婴儿期被分配为女性)的身体形象和心理社会结果,包括生活质量、适应能力和复原力。一个子样本(n = 40)完成了定性访谈:定量结果显示,总体而言,参与者对自己的外貌感到满意,但对自己的主要性别特征不太满意。身体形象不满意与较差的社会心理适应能力、生活质量和复原力有关。从定性角度来看,青年和青少年报告了与他们的身体形象和生活在 DSD 条件下的影响有关的各种看法,既有积极的,也有消极的。确定的主题包括外貌管理、DSD 对身体形象的影响、诊断因素和特征、对诊断的态度以及治疗:身体形象与患有 DSD 的青年和年轻成年人的心理社会结果密切相关,定性研究结果突出了积极和消极的身体形象体验。研究结果对临床治疗具有重要意义,包括筛查外貌问题、使外貌变化正常化以及制定干预措施,以更好地支持患有 DSD 的青少年健康的身体形象和社会心理功能。
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引用次数: 0
Growth of condition-related knowledge among youth with spina bifida: associations with neurocognitive functioning and self-management skills. 脊柱裂青少年病情相关知识的增长:与神经认知功能和自我管理技能的关联。
IF 2.7 3区 心理学 Q2 PSYCHOLOGY, DEVELOPMENTAL Pub Date : 2024-07-01 DOI: 10.1093/jpepsy/jsad097
Olivia E Clark, Zoe R Smith, Taylor Hilderbrand, Grayson N Holmbeck

Objective: This study aims to characterize the growth in condition-related knowledge in youth with spina bifida (SB), identify neurocognitive predictors of growth, and examine associations between growth in knowledge and subsequent levels of medical self-management skills.

Methods: Participants were recruited from a larger longitudinal study involving 140 youth with SB and caregivers, who completed questionnaires and interviews every 2 years over 8 years. The current study included the youth report of condition-related knowledge and medical self-management skills. Youth attention and executive functioning were assessed via parent and teacher reports and performance-based assessment. Latent growth curves were conducted in Mplus Version 8 (Múthen, L. K., & Múthen, B. O. [1998]. Mplus User's Guide. [Eighth]. Muthén & Muthén) to examine change over time in youth-reported condition-related knowledge. Neurocognitive variables were included as predictors of growth in knowledge and regression analyses were used to predict medical self-management skills from growth in condition-related knowledge.

Results: Youth condition-related knowledge increased linearly. Better youth performance on working memory and attention performance-based tasks predicted a higher intercept for condition-related knowledge at T1, but not slope. Teacher and parent reports of inattention and executive dysfunction were not consistent predictors of intercept and growth. Slope of condition-related knowledge was not predictive of subsequent youth self-management skills.

Conclusions: Youth with SB gain condition-related knowledge over time. However, executive dysfunction and inattention may impede gains in condition-related knowledge. Thus, executive functioning supports, attention-related interventions, and psychoeducation may support condition-related knowledge gains and later medical self-management skills, but further research assessing family and cultural factors is needed.

研究目的本研究旨在描述脊柱裂(SB)青少年病情相关知识增长的特点,确定增长的神经认知预测因素,并研究知识增长与后续医疗自我管理技能水平之间的关联:参与者是从一项大型纵向研究中招募的,该研究涉及 140 名患有脊柱裂的青少年和照顾者,他们在 8 年中每两年填写一次问卷并接受一次访谈。目前的研究包括青少年对病情相关知识和医疗自我管理技能的报告。青少年的注意力和执行功能通过家长和教师的报告以及基于表现的评估进行评估。潜增长曲线在 Mplus Version 8(Múthen, L. K., & Múthen, B. O. [1998].Mplus User's Guide.[第八版]。Muthén & Muthén)来研究青少年报告的病情相关知识随时间的变化。将神经认知变量作为知识增长的预测因素,并使用回归分析从病情相关知识的增长中预测医疗自我管理技能:结果:青少年与病情相关的知识呈线性增长。青少年在基于工作记忆和注意力表现的任务中表现较好,这预示着在 T1 阶段病情相关知识的截距较高,但斜率却不高。教师和家长关于注意力不集中和执行功能障碍的报告对截距和增长的预测不一致。病情相关知识的斜率不能预测青少年随后的自我管理技能:结论:随着时间的推移,患有 SB 的青少年会获得与病情相关的知识。然而,执行功能障碍和注意力不集中可能会阻碍病情相关知识的增长。因此,执行功能支持、注意力相关干预和心理教育可能有助于病情相关知识的增长和日后医疗自我管理技能的提高,但还需要进一步研究评估家庭和文化因素。
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引用次数: 0
Systematic review and meta-analysis of interventions to promote medication adherence among children, adolescents, and young adults with medical conditions. 对促进患有疾病的儿童、青少年和年轻成人坚持服药的干预措施进行系统回顾和荟萃分析。
IF 2.7 3区 心理学 Q2 PSYCHOLOGY, DEVELOPMENTAL Pub Date : 2024-06-21 DOI: 10.1093/jpepsy/jsae036
Meghan E McGrady, Mary E Keenan-Pfeiffer, Amy C Lang, Amy E Noser, Anshul P Tyagi, Julia K Herriott, Rachelle R Ramsey

Objective: This meta-analysis examined the efficacy of adherence-promotion interventions for children, adolescents, and young adults prescribed a medication for > 90 days as part of a treatment regimen for a medical condition.

Methods: A systematic literature review was conducted to identify randomized controlled trials of adherence-promotion interventions published between 2013 and 2023 and including children, adolescents, and/or young adults with a medical condition. A total of 38 articles representing 39 trials met inclusion criteria. A narrative synthesis was conducted to summarize included trials and a random-effects model was used to compute an overall intervention effect. Effect sizes by adherence outcome assessment methodology, participant age, and technology use were also computed.

Results: Pediatric adherence-promotion interventions demonstrate a medium effect with those randomized to an intervention displaying greater improvements in medication adherence than those randomized to a comparator condition (SMD = 0.46, 95% CI: 0.31, 0.60, n = 37; 95% Prediction Interval: -0.32, 1.23).

Conclusions: Adherence interventions for children, adolescents, and young adults with medical conditions increase adherence.

研究目的这项荟萃分析研究了针对儿童、青少年和年轻成人的依从性促进干预措施的疗效,这些干预措施作为治疗方案的一部分,在儿童、青少年和年轻成人中的用药时间超过90天:我们进行了一项系统性文献综述,以确定2013年至2023年期间发表的关于促进依从性干预措施的随机对照试验,其中包括患有某种疾病的儿童、青少年和/或年轻成人。共有代表 39 项试验的 38 篇文章符合纳入标准。我们对纳入的试验进行了叙述性综合总结,并使用随机效应模型计算了总体干预效果。此外,还按依从性结果评估方法、参与者年龄和技术使用情况计算了效果大小:结果:儿科依从性促进干预显示出中等效果,随机接受干预的患者比随机接受对比条件的患者在用药依从性方面有更大改善(SMD = 0.46,95% CI:0.31,0.60,n = 37;95% 预测区间:-0.32,1.23):结论:对患有疾病的儿童、青少年和年轻成人进行坚持治疗干预可提高坚持治疗率。
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引用次数: 0
Proof of concept of the Universal Baby video innovation for early child development in Lima, Peru. 在秘鲁利马验证 "环球宝贝 "视频创新促进儿童早期发展的概念。
IF 3.6 3区 心理学 Q2 PSYCHOLOGY, DEVELOPMENTAL Pub Date : 2024-06-14 DOI: 10.1093/jpepsy/jsae035
Adrianne K Nelson, Christa J Griest, Llubitza M Munoz, Nancy Rumaldo, Ann C Miller, Guadalupe M Soplapuco, Leonid Lecca, Sonya S Shin, Llalu R Acuña, Yesica V Valdivia, Alicia R Ramos, Diego G Ahumada, Blanca R H Ramos, Sarah A Mejia, Esther O Serrano, William H Castro, Victoria E Oliva, Annie S Heyman, Lauren P Hartwell, Ronnie L Blackwell, Diego F Diaz, Martha M Vibbert

Objective: Community-based video interventions offer an effective and potentially scalable early interaction coaching tool for caregivers living in low resource settings. We tested the Universal Baby (UB) video innovation; an early interaction coaching tool using video sourced and produced locally with early child development (ECD) expert supervision.

Methods: This proof-of-concept study enrolled 40 caregivers of children ages 10-18 months assigned to intervention and control groups by health establishments in Carabayllo, Lima, Peru. Mother/child dyads received 12 weekly group health education sessions with social support. Of those, 16 caregivers also received 6 UB videos featuring brain science education and local clips of responsive, reciprocal interaction, also known as "serve and return" interaction. Survey data assessed feasibility and acceptability of the intervention. We assessed improved quality of mother/child interaction using the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO).

Results: We found the program feasible. We successfully trained the local team to produce UB videos using locally-sourced footage and delivered the videos as part of a community-based intervention. We also found it to be acceptable in that participants enthusiastically received the UB videos, reporting they enjoyed being videotaped, and learned how to recognize and appropriately respond to their child's nuanced sounds and gestures. The median change in total PICCOLO scores favored the intervention group compared to the control group.

Conclusions: UB offers great potential as a sustainable, potentially scalable, and culturally appropriate tool to promote equity for child development among young children living in low resource homes globally.

目的:基于社区的视频干预为生活在资源匮乏环境中的看护者提供了一种有效且可推广的早期互动指导工具。我们测试了 "通用婴儿"(UB)视频创新;这是一种早期互动指导工具,使用的视频来源于当地,并在儿童早期发展(ECD)专家的监督下制作完成:这项概念验证研究招募了 40 名 10-18 个月大儿童的照顾者,他们被秘鲁利马卡拉贝洛的卫生机构分配到干预组和对照组。母婴二人组每周接受 12 次有社会支持的集体健康教育课程。其中,16 名照顾者还接受了 6 个 UB 视频,内容包括脑科学教育和当地的反应性、互惠互动(也称为 "服务与回报 "互动)剪辑。调查数据评估了干预措施的可行性和可接受性。我们使用 "父母与子女互动 "来评估母子互动质量的改善情况:结果:结果:我们发现该计划是可行的。我们成功地对当地团队进行了培训,使其能够使用本地素材制作 UB 视频,并将视频作为社区干预措施的一部分进行分发。我们还发现该计划是可以接受的,因为参与者热情地接受了 UB 视频,表示他们喜欢被录像,并学会了如何识别和适当回应孩子细微的声音和手势。与对照组相比,PICCOLO 总分变化的中位数更有利于干预组:作为一种可持续、可扩展、文化适宜的工具,UB 在促进全球低资源家庭幼儿的公平儿童发展方面具有巨大潜力。
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引用次数: 0
Perceived transition readiness among adolescents and young adults with neurofibromatosis type 1 and plexiform neurofibromas: a cross-sectional descriptive study. 患有 1 型神经纤维瘤病和丛状神经纤维瘤的青少年和年轻人的过渡准备意识:一项横断面描述性研究。
IF 2.7 3区 心理学 Q2 PSYCHOLOGY, DEVELOPMENTAL Pub Date : 2024-06-13 DOI: 10.1093/jpepsy/jsae006
Atara Siegel, Robin Lockridge, Kari L Struemph, Mary Anne Toledo-Tamula, Paige Little, Pamela L Wolters, Anne Dufek, Cecilia Tibery, Melissa Baker, Brigitte C Wideman, Staci Martin

Objectives: Neurofibromatosis type 1 (NF1) is a genetic cancer predisposition syndrome that can impact multiple organ systems and is associated with plexiform neurofibroma tumors, requiring care from birth through adulthood. Adolescents and young adults (AYAs) with NF1 face several barriers to transition from pediatric to adult care. This cross-sectional study aimed to assess transition readiness in this population and to evaluate relationships between specific NF1 symptoms and transition readiness.

Methods: AYAs (aged 16-24) enrolled in existing studies related to NF1 were eligible. AYAs and their parents completed measures of transition readiness (Transition Readiness Assessment Questionnaire version 4 [TRAQ-4]), and AYAs also completed a transition readiness interview (UNC TRxANSITION).

Results: Thirty-eight AYAs (mean age = 19.95 ± 2.68 years) participated in the study. Average TRAQ scores indicated that AYAs were still learning Self-Management skills (M = 3.37, SD = 1.08) and Self-Advocacy skills (M = 3.98, SD = 0.67). Older AYAs had higher TRAQ scores for Self-Management (r = 0.70, p < .001) and Self-Advocacy (r = 0.41, p = .011) than younger AYAs. Parents and AYAs had similar TRAQ scores. About one third of AYAs (37.8%, n = 14) expressed uncertainty about how NF1 might affect them in the future. The remaining AYAs mostly expressed concerns regarding tumor growth, pain, or cancer.

Conclusions: In this small study, preliminary findings suggest that AYAs with NF1 express confidence in many areas of transition readiness but continue to require support, particularly with Self-Management skills. Given the gaps in understanding of future health risks, AYAs with NF1 would benefit from early assessment, psychoeducation, and support for transition readiness to adult care.

目的:神经纤维瘤病 1 型(NF1)是一种遗传性癌症易感综合征,可影响多个器官系统,并与丛状神经纤维瘤肿瘤有关,从出生到成年都需要护理。患有 NF1 的青少年和年轻人(AYAs)在从儿科护理过渡到成人护理的过程中面临着一些障碍。这项横断面研究旨在评估这一人群的过渡准备情况,并评估特定 NF1 症状与过渡准备情况之间的关系:参加现有 NF1 相关研究的青少年(16-24 岁)均符合条件。青少年及其父母完成了过渡准备度量(过渡准备评估问卷第 4 版 [TRAQ-4]),青少年还完成了过渡准备度量访谈(UNC TRxANSITION):38 名青少年(平均年龄为 19.95±2.68 岁)参加了研究。TRAQ 平均得分表明,青少年仍在学习自我管理技能(M = 3.37,SD = 1.08)和自我辩护技能(M = 3.98,SD = 0.67)。老年亚健康者在自我管理(r = 0.70,p < .001)和自我倡导(r = 0.41,p = .011)方面的 TRAQ 分数高于年轻亚健康者。父母和亚裔青少年的 TRAQ 分数相似。约三分之一的青少年(37.8%,n = 14)对 NF1 在未来可能对他们产生的影响表示不确定。其余的青少年大多对肿瘤生长、疼痛或癌症表示担忧:在这项小型研究中,初步结果表明,NF1 青少年患者对过渡准备的许多方面表示有信心,但仍然需要支持,特别是自我管理技能方面的支持。鉴于对未来健康风险的认识存在差距,患有 NF1 的青少年将受益于早期评估、心理教育和支持,以做好向成人护理过渡的准备。
{"title":"Perceived transition readiness among adolescents and young adults with neurofibromatosis type 1 and plexiform neurofibromas: a cross-sectional descriptive study.","authors":"Atara Siegel, Robin Lockridge, Kari L Struemph, Mary Anne Toledo-Tamula, Paige Little, Pamela L Wolters, Anne Dufek, Cecilia Tibery, Melissa Baker, Brigitte C Wideman, Staci Martin","doi":"10.1093/jpepsy/jsae006","DOIUrl":"10.1093/jpepsy/jsae006","url":null,"abstract":"<p><strong>Objectives: </strong>Neurofibromatosis type 1 (NF1) is a genetic cancer predisposition syndrome that can impact multiple organ systems and is associated with plexiform neurofibroma tumors, requiring care from birth through adulthood. Adolescents and young adults (AYAs) with NF1 face several barriers to transition from pediatric to adult care. This cross-sectional study aimed to assess transition readiness in this population and to evaluate relationships between specific NF1 symptoms and transition readiness.</p><p><strong>Methods: </strong>AYAs (aged 16-24) enrolled in existing studies related to NF1 were eligible. AYAs and their parents completed measures of transition readiness (Transition Readiness Assessment Questionnaire version 4 [TRAQ-4]), and AYAs also completed a transition readiness interview (UNC TRxANSITION).</p><p><strong>Results: </strong>Thirty-eight AYAs (mean age = 19.95 ± 2.68 years) participated in the study. Average TRAQ scores indicated that AYAs were still learning Self-Management skills (M = 3.37, SD = 1.08) and Self-Advocacy skills (M = 3.98, SD = 0.67). Older AYAs had higher TRAQ scores for Self-Management (r = 0.70, p < .001) and Self-Advocacy (r = 0.41, p = .011) than younger AYAs. Parents and AYAs had similar TRAQ scores. About one third of AYAs (37.8%, n = 14) expressed uncertainty about how NF1 might affect them in the future. The remaining AYAs mostly expressed concerns regarding tumor growth, pain, or cancer.</p><p><strong>Conclusions: </strong>In this small study, preliminary findings suggest that AYAs with NF1 express confidence in many areas of transition readiness but continue to require support, particularly with Self-Management skills. Given the gaps in understanding of future health risks, AYAs with NF1 would benefit from early assessment, psychoeducation, and support for transition readiness to adult care.</p>","PeriodicalId":48372,"journal":{"name":"Journal of Pediatric Psychology","volume":" ","pages":"383-391"},"PeriodicalIF":2.7,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11175589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139747562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diabetes distress in urban Black youth with type 1 diabetes and their caregivers: associations with glycemic control, depression, and health behaviors. 患有 1 型糖尿病的城市黑人青少年及其照顾者的糖尿病困扰:与血糖控制、抑郁和健康行为的关系。
IF 2.7 3区 心理学 Q2 PSYCHOLOGY, DEVELOPMENTAL Pub Date : 2024-06-13 DOI: 10.1093/jpepsy/jsad096
Meredyth Evans, Deborah A Ellis, Anthony T Vesco, Marissa A Feldman, Jill Weissberg-Benchell, April Idalski Carcone, Jennifer Miller, Claudia Boucher-Berry, Colleen Buggs-Saxton, Bernard Degnan, Bassem Dekelbab, Tina Drossos

Objectives: Adolescents with type 1 diabetes (T1D) and their caregivers endorse high diabetes distress (DD). Limited studies have documented the impact of DD on Black youth. The aims of the present study were to (1) describe DD among a sample of Black adolescents with T1D and their caregivers, (2) compare their DD levels with published normative samples, and (3) determine how DD relates to glycemic outcomes, diabetes self-management, parental monitoring of diabetes, and youth depressive symptoms.

Methods: Baseline data from a multicenter clinical trial were used. Participants (N = 155) were recruited from 7 Midwestern pediatric diabetes clinics. Hemoglobin A1c (HbA1c) and measures of DD, parental monitoring of diabetes care, youth depression and diabetes management behaviors were obtained. The sample was split into (1) adolescents (ages 13-14; N = 95) and (2) preadolescents (ages 10-12; N = 60). Analyses utilized Cohen's d effect sizes, Pearson correlations, t-tests, and multiple regression.

Results: DD levels in youth and caregivers were high, with 45%-58% exceeding either clinical cutoff scores or validation study sample means. Higher DD in youth and caregivers was associated with higher HbA1c, lower diabetes self-management, and elevated depressive symptoms, but not with parental monitoring of diabetes management.

Conclusions: Screening for DD in Black youth with T1D and caregivers is recommended, as are culturally informed interventions that can reduce distress levels and lead to improved health outcomes. More research is needed on how systemic inequities contribute to higher DD in Black youth and the strategies/policy changes needed to reduce these inequities.

目的:患有 1 型糖尿病 (T1D) 的青少年及其照顾者对糖尿病困扰 (DD) 的认可度很高。有关 DD 对黑人青少年影响的研究记录有限。本研究的目的是:(1) 描述 T1D 黑人青少年及其照顾者的糖尿病困扰;(2) 将他们的糖尿病困扰水平与已发表的标准样本进行比较;(3) 确定糖尿病困扰与血糖结果、糖尿病自我管理、父母对糖尿病的监控以及青少年抑郁症状之间的关系:方法:采用一项多中心临床试验的基线数据。参与者(N = 155)是从美国中西部 7 家儿科糖尿病诊所招募的。研究人员采集了血红蛋白 A1c (HbA1c)、DD 测量值、父母对糖尿病护理的监控、青少年抑郁症和糖尿病管理行为。样本分为(1)青少年(13-14 岁;95 人)和(2)学龄前儿童(10-12 岁;60 人)。分析采用了 Cohen's d 效果大小、皮尔逊相关性、t 检验和多元回归等方法:结果:青少年和照护者的DD水平很高,45%-58%的人超过了临床临界值或验证研究样本平均值。青少年和护理人员的DD水平较高与HbA1c升高、糖尿病自我管理能力降低和抑郁症状升高有关,但与父母对糖尿病管理的监督无关:结论:建议对患有 T1D 的黑人青少年和照顾者进行 DD 筛查,并采取有文化背景的干预措施,这些措施可降低困扰程度并改善健康状况。还需要开展更多的研究,以了解系统性不平等是如何导致黑人青少年糖尿病发病率升高的,以及减少这些不平等所需的策略/政策变化。
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引用次数: 0
A systematic review and meta-analysis of pediatric integrated primary care for the prevention and treatment of physical and behavioral health conditions. 儿科综合初级保健对预防和治疗身体和行为健康状况的系统回顾和荟萃分析。
IF 3.6 3区 心理学 Q2 PSYCHOLOGY, DEVELOPMENTAL Pub Date : 2024-06-12 DOI: 10.1093/jpepsy/jsae038
Cody A Hostutler, Jeffrey D Shahidullah, Jennifer A Mautone, Tiffany M Rybak, Chimereodo Okoroji, Teryn Bruni, Kevin G Stephenson, Leah Vance Utset, Kurt A Freeman, Leah LaLonde, Andrew R Riley

Objective: To evaluate the effects of behavioral health interventions delivered within pediatric integrated primary care models on clinical outcomes.

Methods: We searched Medline, EMBASE, CENTRAL, PsycINFO, and SCOPUS for studies published from January 1, 1998, to September 20, 2023. We included studies that evaluated onsite behavioral health integration in pediatric primary care using a comparator condition (usual, enhanced usual care, or waitlist). Outcome data on symptom change, impairment/quality of life, health indicator, and behavior change were extracted using Covidence software. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed Risk of bias analysis was conducted using the Cochrane Risk of Bias tool. We used multilevel meta-analysis to synthesize multiple outcomes nested within studies. Open Science Foundation pre-registration: #10.17605/OSF.IO/WV7XP.

Results: In total, 33 papers representing 27 studies involving 6,879 children and caregivers were included. Twenty-four studies were randomized controlled trials and three were quasi-experimental designs. Seventeen papers reported on treatment trials and 16 reported on prevention trials. We found a small overall effect size (SMD = 0.19, 95% confidence interval [0.11, 0.27]) supporting the superiority of integrated primary care to usual or enhanced usual care. Moderator analyses suggested similar effectiveness between co-located and integrated models and no statistically significant differences were found between treatment and prevention trials.

Conclusions: Results suggest that integrated primary care is superior to usual and enhanced usual care at improving behavior, quality of life, and symptoms. Integrated primary care research needs improved standards for reporting to promote better synthesis and understanding of the literature.

目的评估儿科综合初级保健模式中提供的行为健康干预对临床结果的影响:我们检索了 Medline、EMBASE、CENTRAL、PsycINFO 和 SCOPUS 中从 1998 年 1 月 1 日至 2023 年 9 月 20 日发表的研究。我们纳入了使用比较条件(常规护理、增强型常规护理或候补名单)对儿科初级护理中的现场行为健康整合进行评估的研究。我们使用 Covidence 软件提取了有关症状变化、功能障碍/生活质量、健康指标和行为变化的结果数据。偏倚风险分析使用 Cochrane 偏倚风险工具进行。我们使用多层次荟萃分析法对研究中嵌套的多个结果进行综合分析。开放科学基金会预注册:#10.17605/OSF.IO/WV7XP.结果:共纳入 33 篇论文,代表 27 项研究,涉及 6879 名儿童和护理人员。其中 24 项研究为随机对照试验,3 项为准实验设计。17篇论文报告了治疗试验,16篇报告了预防试验。我们发现,综合初级护理优于常规护理或增强型常规护理的总体效应较小(SMD = 0.19,95% 置信区间 [0.11, 0.27])。主持人分析表明,同地模式和综合模式之间的效果相似,治疗和预防试验之间没有统计学意义上的显著差异:结论:研究结果表明,在改善行为、生活质量和症状方面,综合初级护理优于常规护理和强化常规护理。综合初级保健研究需要改进报告标准,以促进更好地综合和理解文献。
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引用次数: 0
Perceived acceptability and appropriateness of a web-based program targeting risk for anxiety in young children and their parents. 针对幼儿及其父母焦虑风险的网络程序的可接受性和适宜性。
IF 3.6 3区 心理学 Q2 PSYCHOLOGY, DEVELOPMENTAL Pub Date : 2024-06-10 DOI: 10.1093/jpepsy/jsae040
Isaac A Mirzadegan, Ericka M Lewis, Sally L Cole, Alexandria Meyer

Objective: This mixed-methods study examined perceived acceptability and appropriateness of a novel digital mental health program targeting anxiety risk (i.e., perfectionism or error sensitivity) in 5-to-7-year-old children and their parents.

Methods: Parent-child dyads participated in a modular, web-based cognitive-behavioral program targeting negative overreactions to making mistakes. The program, "Making Mistakes", consisted of a 6-month series of short video clips, journaling activities, and weekly reminders, and modules were delivered to caregivers and children separately. 86 dyads completed self-report measures, 18 of whom participated in semi-structured interviews, following completion of the primary program module. A standard thematic analysis was used to elucidate themes from the parent and child interview content.

Results: Our quantitative and qualitative results were generally aligned. Children and parents viewed the novel digital mental health program as acceptable and appropriate, favoring the cognitive behavioral strategies such as modeling positive reactions to mistakes, responding positively to child mistakes, and emphasizing effort over outcome. Participants also provided helpful feedback related to program content, delivery, and engagement, as well as suggestions to enhance the program.

Conclusions: Findings have implications for design and content features of parent-based and dyad-based programs, as well as digital mental health programs focused on reducing anxiety risk.

研究目的这项混合方法研究考察了5至7岁儿童及其父母对针对焦虑风险(即完美主义或错误敏感性)的新型数字心理健康项目的可接受性和适当性:亲子二人组参加了一个模块化、基于网络的认知行为项目,该项目针对的是犯错后的消极过度反应。该项目名为 "犯错",包括一系列为期 6 个月的视频短片、日记活动和每周提醒,模块分别提供给照顾者和儿童。在完成主要项目模块后,有 86 个家庭完成了自我报告测量,其中 18 个家庭参加了半结构化访谈。我们采用了标准的主题分析法来阐明父母和儿童访谈内容的主题:我们的定量和定性结果基本一致。儿童和家长都认为这个新颖的数字心理健康项目是可以接受的,也是合适的,他们更倾向于认知行为策略,如示范对错误的积极反应、对儿童的错误做出积极回应,以及强调努力而非结果。参与者还提供了与程序内容、交付和参与度相关的有益反馈,以及改进程序的建议:研究结果对以家长为基础、以双亲为基础的项目以及以降低焦虑风险为重点的数字心理健康项目的设计和内容特点具有借鉴意义。
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引用次数: 0
Commentary: Increasing generalizability of parent psychosocial functioning within the context of pediatric chronic pain. 评论:在儿科慢性疼痛的背景下提高家长社会心理功能的通用性。
IF 3.6 3区 心理学 Q2 PSYCHOLOGY, DEVELOPMENTAL Pub Date : 2024-05-16 DOI: 10.1093/jpepsy/jsae019
Brittany Ricart, Jocelyn Smith Carter
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引用次数: 0
Quality of life of caregivers at the end of their child's pediatric cancer treatment: cancer-specific worry and material hardship. 儿童癌症治疗结束后照顾者的生活质量:癌症特有的担忧和物质困难。
IF 3.6 3区 心理学 Q2 PSYCHOLOGY, DEVELOPMENTAL Pub Date : 2024-05-16 DOI: 10.1093/jpepsy/jsae014
Liana R Galtieri, Megan N Perez, Lamia P Barakat

Objective: Emerging research suggests that completion of pediatric cancer treatment can be challenging for caregivers given shifting roles and responsibilities. Lower caregiver quality of life (QOL) has been associated with cancer-related variables, higher cancer caregiving strain, and more household material hardship during pediatric cancer treatment. Caregiver QOL at the end of treatment has not been fully investigated but has implications for child and family well-being. Using a psycho-oncology framework, this study aimed to understand the cumulative burden of household material hardship and cancer-related factors on caregiver QOL at the end of treatment.

Methods: Caregivers (N = 143) of children (Mage=10.51 years) within 1 year of ending active cancer treatment completed self-report questionnaires assessing their QOL, cancer-specific worry, and material hardship (e.g., housing, insurance). Total months of active cancer treatment were extracted from the medical record. Hierarchical linear regression was used to test the relative effects of length of treatment, material hardship, and cancer-specific worry on caregiver QOL.

Results: Cancer-specific worry was significantly associated with and accounted for significant variance in caregiver QOL, above and beyond the length of treatment and material hardship. Caregivers who endorsed more cancer-specific worry had poorer QOL. Material hardship was also significantly associated with caregivers' QOL, but length of treatment was not.

Conclusions: Caregivers with sufficient resources and less worry about cancer have higher QOL. Findings highlight the importance of end-of-treatment screening of caregivers' subjective cancer-specific worry in addition to material hardship, irrespective of their cancer-related stressors, for ongoing psychosocial support.

目的:新近的研究表明,由于角色和责任的转变,完成小儿癌症治疗对护理者来说是一项挑战。在儿科癌症治疗期间,护理者较低的生活质量(QOL)与癌症相关变量、较高的癌症护理压力和较多的家庭物质困难有关。护理人员在治疗结束后的生活质量尚未得到充分研究,但这对儿童和家庭的福祉具有重要影响。本研究采用肿瘤心理学框架,旨在了解治疗结束时家庭物质困难和癌症相关因素对照顾者QOL造成的累积负担:儿童(年龄=10.51岁)的照顾者(N = 143)在结束积极癌症治疗后的一年内填写了自我报告问卷,评估他们的QOL、癌症特异性担忧和物质困难(如住房、保险)。从医疗记录中提取了癌症治疗的总月数。采用层次线性回归法检验治疗时间、物质困难和癌症特异性担忧对照顾者QOL的相对影响:结果:癌症特异性担忧与照顾者的 QOL 有显著相关性,并且在照顾者的 QOL 中占显著差异,超过了治疗时间和物质困难的影响。对癌症特异性担忧较多的护理者的 QOL 较差。物质困难也与照顾者的 QOL 有很大关系,但治疗时间的长短与照顾者的 QOL 无关:结论:资源充足、对癌症担忧较少的护理者的 QOL 较高。研究结果凸显了在治疗末期筛查护理人员的主观癌症特异性担忧以及物质困难的重要性,无论他们是否面临与癌症相关的压力,这对持续的心理支持都非常重要。
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期刊
Journal of Pediatric Psychology
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