Changing contexts of child health: an assessment of unmet physical, psychological and social needs of children with common chronic childhood illness.

Autor:	Lingam R; School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia r.lingam@unsw.edu.au.; Department of Women & Children's Health, King's College London, London, UK., Hu N; School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia., Cecil E; Department of Women & Children's Health, King's College London, London, UK., Forman J; Department of Women & Children's Health, King's College London, London, UK., Newham J; Department of Psychology, Northumbria University, Newcastle upon Tyne, UK., Satherley RM; Department of Psychological Interventions, University of Surrey, Guildford, UK., Bori MS; Department of Population Health Sciences, King's College London, London, UK., Cousens S; LSHTM, London, UK., Fox-Rushby J; Department of Population Health Sciences, King's College London, London, UK., Wolfe I; Department of Women & Children's Health, Faculty of Life Sciences and Medicine, King's College London, London, UK.
Jazyk:	angličtina
Zdroj:	Archives of disease in childhood [Arch Dis Child] 2024 May 17; Vol. 109 (6), pp. 488-496. Date of Electronic Publication: 2024 May 17.
DOI:	10.1136/archdischild-2023-326766
Abstrakt:	Background: We assessed the biopsychosocial needs and key health drivers among children living with a common chronic illness, as baseline for a cluster randomised controlled trial of a child health system strengthening intervention. Methods: Cross-sectional data were analysed from a large population sample of children from South London with asthma, eczema or constipation, as exemplar tracer conditions of a new integrated care service. Descriptive and regression analyses, accounting for sociodemographic factors, investigated social needs, psychosocial outcomes and quality of life associated with poor symptom control. Results: Among 7779 children, 4371 children (56%) had at least one uncontrolled physical health condition. Across the three domains of physical health, mental health and social needs, 77.5% of children (n=4304 of 5554) aged 4-15 years had at least one unmet need, while 16.3% of children had three unmet needs. Children from the most socioeconomically disadvantaged quintile had a 20% increased risk of at least one poorly controlled physical condition (risk ratio (RR)=1.20, 95% CI: 1.11 to 1.31, p<0.001) compared with those from the least disadvantaged quintile. There was an 85% increased risk of clinically important mental health needs among children with uncontrolled asthma (RR=1.85, 95% CI: 1.65 to 2.07, p<0.001), 57% for active constipation (RR=1.57, 95% CI: 1.12 to 2.20, p<0.01) and 39% for uncontrolled eczema (RR=1.39, 95% CI: 1.24 to 1.56, p<0.001). Health-related quality of life was associated with poor symptom control. Conclusions: There is a large burden of unmet biopsychosocial needs among children with chronic illness, signalling an urgent need for prevention, early intervention and integrated biopsychosocial care. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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