Kevin H. Huynh MS , Gina McKernan PhD , Amy Houtrow MD, PhD , Justin Yu MD, MS
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引用次数: 0
Abstract
Objective
Identify factors associated with reduced emotional well-being (EWB) among family caregivers of children with more complex special health care needs (SHCN).
Methods
We applied gradient-boosted trees (GBTs) to the 2016–21 National Survey of Children’s Health to identify factors associated with questions assessing 1) global mental health, 2) parental coping, and 3) parental aggravation among family caregivers of children with more complex SHCN. We then conducted adjusted logistic regression and post-hoc margins analyses to describe the relationships between GBT-identified factors and caregiver EWB outcomes.
Results
Our GBT models’ area under the curve scores ranged from 0.69 to 0.77. Among our sample, 1) caregiver reported lack of emotional support, 2) increased levels of frustration and effort in getting their child needed health services, and 3) the presence of child emotional and behavioral conditions were factors associated with reduced caregiver EWB. In margins analyses of adjusted regression models, GBT-identified factors were associated with significantly higher likelihoods of adverse caregiver EWB outcomes. For example, compared to caregivers who reported a source of emotional support, the predicted probabilities of experiencing poor/fair mental health (13.7% vs 7.8%), reduced parental coping (8.0% vs 2.1%), and frequently feeling bothered by (9.9% vs 5.4%) and angry with (3.5% vs 1.5%) their child were higher among caregivers who lacked emotional support.
Conclusions
In addition to enhanced care coordination support, future efforts aiming to improve well-being among family caregivers of children with more complex SHCN could consider targeting caregiver emotional support and/or treatment of child emotional and behavioral conditions.
期刊介绍:
Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.