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Arch Dis Child doi:10.1136/adc.2008.150789

Problem behaviours and parenting in preschool children with cystic fibrosis

  1. Christopher Ward (chris.ward{at}rch.org.au)
  1. Centre for Community Child Health, Royal Children's Hospital, Australia
    1. John Massie (john.massie{at}rch.org.au)
    1. Department of Respitory Medicine, Royal Children's Hospital, Australia
      1. Judith Glazner (judith.glazner{at}rch.org.au)
      1. Department of Respitory Medicine, Royal Children's Hospital, Australia
        1. Jane Sheehan (jane.sheehan{at}mcri.edu.au)
        1. Centre for Community Child Health, Royal Children's Hospital, Australia
          1. Louise Canterford (louise.canterford{at}mcri.edu.au)
          1. Centre for Community Child Health, Royal Children's Hospital, Australia
            1. David Armstrong (david.armstrong{at}med.monash.edu.au)
            1. Department of Respiratory Medicine, Monash University, Australia
              1. Adam Jaffe (adam.jaffe{at}unsw.edu.au)
              1. Department of Respiratory Medicine, The Sydney Children’s Hospital, Australia
                1. Harriet Hiscock (harriet.hiscock{at}rch.org.au)
                1. Centre for Community Child Health, Royal Children's Hospital, Australia
                  • Published Online First 20 January 2009

                  Abstract

                  Background: Problems with sleep, eating and adherence to therapy may adversely affect health outcomes in children with cystic fibrosis (CF). Data about prevalence of such problems, associated parenting styles and caregiver mental health are limited.

                  Aims: To determine (1) the prevalence of sleep, mealtime, therapy adherence and externalising and internalising behavioural problems in preschool children with CF, (2) the prevalence of caregiver mental health problems and poor sleep quality and (3) associations between child behaviour problems and parenting styles.

                  Methods: Design: Cross sectional survey. Setting: Royal Children’s Hospital (Melbourne), Monash Medical Centre (Melbourne) and Sydney Children’s Hospital. Participants: Caregivers of children aged 6 months to 5 years attending CF outpatient clinics. Main outcome measures: Child externalising and internalising behaviours, sleep, eating and adherence with therapy. Predictors: Parenting style (harsh, inconsistent and over-protective).

                  Results: 117 of 139 families participated. Common problems included child sleep (small problem (31.6%), moderate / large problem (21.9%)), eating (32.4%) and adherence with physiotherapy (50.4%). Compared to normative data, sleep and mealtime problems were more prevalent. Caregivers reported high rates of symptoms that indicate depression (33.3%), anxiety (16.4%) and stress (34.2%). Harsh parenting was associated with internalising behaviours (adjusted OR 3.9, 95% CI 1.16 to 13.17, p=0.03).

                  Conclusions: Problems with sleeping, eating and physiotherapy adherence were common in preschool children with CF. Caregivers reported high rates of symptoms indicative of mental health problems. Harsh parenting was associated with internalising problems. An intervention targeting child problem behaviours and parental mental health would be appropriate for CF families.

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