摘要
Background Children and adolescents with chronic physical conditions have an increased probability of mental health problems,which may be partly attributed to the variations in play behavior.This study explores the associations between having a chronic physical condition,play behavior,and having mental health problems.Methods Data from the Generation R Study were analyzed,a population-based,prospective cohort in the Netherlands.Chronic physical conditions were typically identified before six years of age.Play behavior was assessed at ages 6 and 10.Mental health problems were measured with the Child Behavior Checklist at 14 years of age.Logistic,ranked-order,and linear regression analyses were used to examine direct associations,and mediation analyses were used to investigate indirect paths.P values were false discovery rate adjusted.Results Of the 4043 included participants,691(17%)had a chronic physical condition.Having a chronic physical condition was associated with more mental health problems and limited activity at the age of six years.Playing sports and engaging in social interactions at age 10 were related to fewer mental health problems at age 14.Limited activity mediated the relationship between having a chronic physical condition and mental health problems(social:mediated_(proportion)=8.33%,95%CI=2.02%;15.7%,P_(adj)<0.001;physical:mediated_(proportion)=7.72%,95%CI=1.73%;19.1%,P_(adj)=0.040).Conclusions Health-related limitations in social and physical activities mediate the relationship between having a chronic physical condition and mental health problems in children.Participation in social and physical activities early in life may be crucial for the mental well-being of children with a chronic physical condition.
基金
supporting the well-being of chronically ill children’project of the eHealth Junior consortium[NWA.1292.19.226]of the NWA research program'Research on Routes by Consortia(ORC)'
funded by the Netherlands Organization for Scientific Research(NWO)
funded by the European Union's Horizon 2020 research and innovation programme(EUCAN-Connect grant agreement No 824989
ATHLETE,grant agreement No 874583
ENDOMIX grant agreement No 101136566).
