Changing contexts of child health: an assessment of unmet physical, psychological and social needs of children with common chronic childhood illness.
Arch Dis Child
; 109(6): 488-496, 2024 May 17.
Article
em En
| MEDLINE
| ID: mdl-38383134
ABSTRACT
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.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Qualidade de Vida
/
Asma
/
Constipação Intestinal
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article