慢性儿科皮肤疾病的耻辱化和心理健康影响
Amy S Paller1,2, Stephanie M Rangel1, Sarah L Chamlin1,2
1Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
JAMA dermatology
|April 24, 2024
概括
儿童的慢性皮肤疾病显著影响心理健康和生活质量,超过40%的儿童经历了中度的耻辱感. 欺凌是常见的,与更高的耻辱程度有关,突出了心理社会干预的需要.
科学领域:
- 儿科皮肤病学 儿科皮肤病学
- 慢性疾病对心理的影响.
- 生活质量研究 研究 生命质量研究
背景情况:
- 儿童的慢性皮肤疾病可能会导致严重的污名化,影响心理健康和生活质量.
- 这种污名化的程度及其与心理健康结果的相关性需要进一步调查.
研究的目的:
- 评估患有慢性皮肤疾病的儿童中耻辱的流行程度和严重程度.
- 检查疾病的可见性,严重程度,心理健康 (抑郁,焦虑) 和生活质量之间的关系.
- 识别与耻辱相关的因素,如欺凌和性别.
主要方法:
- 一项涉及1671名患有慢性皮肤疾病的儿童 (8-17岁) 的横截面研究,在美国和加拿大的32个中心进行.
- 使用患者报告结果测量仪器系统 (PROMIS) Stigma-Skin,Skindex-Teen和PROMIS工具来评估耻辱感,生活质量,抑郁和焦虑.
- 基于儿童,护理人员和医生评估的疾病可见性和严重性的结果进行比较.
主要成果:
- 超过43%的儿童经历了中度至严重的耻辱 (T评分≥45).
- 耻辱感与生活质量降低 (ρ=0.73),抑郁 (ρ=0.61) 和焦虑 (ρ=0.54) 有着强烈的相关性.
- 29.4%的家长报告了欺凌行为,并且与更高的耻辱程度密切相关;女孩报告的耻辱比男孩更多.
结论:
- 医生对疾病可见性和严重性的评估可能无法完全捕捉到患者或护理人员的经验.
- 通过医疗和心理社会干预来识别和解决污名化,包括欺凌,对于从业者来说至关重要.
- 慢性皮肤疾病显著影响儿科患者的心理健康和社会福祉,需要全面的护理策略.
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