Follow-Up Study of Behavioral Development and Parenting Stress Profiles in Children with Congenital Hypothyroidism

追蹤研究先天性甲狀腺功能低下症孩童之行為情緒發展及主要照顧者之親職壓力

趙美琴(Mei-Chyn Chao) ； 楊品珍(Pin-Chen Yang) ； 徐秀宜(Hsiu-Yi Hsu) ； 鐘育志(Yuh-Jyh Jong)

《The Kaohsiung Journal of Medical Sciences》 25卷11期 (2009/11) Pp. 588-595

摘要

有鑒於近年來追蹤研究經驗結果顯示，對於治療甲狀腺功能低下的孩童的長期發展重點，不能只放在認知領域。故本研究旨在探討於新生兒階段即被診斷為甲狀腺功能低下(CHT)的孩童在治療後他們的行為情緒發展及主要照顧者的親職壓力特質。我們收集了47位12歲以下病童（均是在新生兒階段得到CHT診斷並開始治療）及家長資料，除智力測驗外並安排評估工具包括有：(1)SDQ問卷：評估孩子的社會人格／情緒行為特質；(2)親職壓力量表：評估主要照顧者的壓力大小及性質；(3)精神症狀量表：評估主要照顧者的心理狀況。並同時以CHT小孩的手足為對照組（共31人），進行資料收集。結果顯示CHT的小孩治療後，於追蹤時的智力在正常範圍（平均為93.6±16.2），但在行為情緒發展範疇，則相較於手足對照組則有統計上有意義的較多困難(p=0.01)，其中並有29.8%的CHT孩童的行為情緒發展分數屬異常範圍，此外，13%的CHT孩童的主要照顧者的親職壓力處於過高狀態，均達到宜轉介處理的閥值。此些發現可提供CHT孩童長期發展及療育照顧上的參考。

關鍵字

行為問題 ； 先天性甲狀腺功能低下 ； 情緒發展 ； 親職壓力

並列摘要

Recent longitudinal experiences have emphasized that the follow-up of children with treated congenital hypothyroidism (CHT) should not be limited to the cognitive domain. This study attempted to evaluate the emotional-behavioral profiles in children with CHT together with maternal parenting stress profiles. Data for child and family characteristics were collected from 47 families with a 3-12-year-old CHT child diagnosed and treated since the newborn period. Cognitive assessments were performed. The main caregiver completed the following questionnaires: (1) Strengths and Difficulties Questionnaire, which rated behavioral symptoms in children; (2) Parenting Stress Index, which determined the quality and magnitude of parenting stress experienced by the caregiver; and (3) Symptom Checklist-90-R, which evaluated the psychopathological symptoms of the caregiver. In addition, 31 unaffected siblings were recruited as a comparative control group. The results revealed that children with treated CHT had normal intelligence quotients (mean, 93.6 ± 16.2) at the time of the study. However, CHT children had more problems in emotional-behavioral domains than sibling controls (p = 0.01). Overall, 29.8% (14/47) of the CHT children had emotional-behavioral problems above the clinical cutoff. In addition, 13% of the caregivers of CHT children had parenting stress above the clinical cutoff. Therefore, professional intervention is warranted in these subgroups of CHT children and parents.

並列關鍵字

behavioral problems ； congenital hypothyroidism ； emotional development ； parenting stress