Long-term mental health effects of a pediatric home care program.
The increased survival of youngsters with chronic physical disorders has led to concern about their long-term psychological adjustment. Few data are available on how to reduce the psychological morbidity that occurs in the presence of chronic childhood illness. An earlier report of a randomized controlled trial of a pediatric home care program demonstrated that this program, combining comprehensive biomedical and psychosocial care, reduced the short-term psychological morbidity of those receiving home care. However, data have not previously been available on whether the short-term improvement in adjustment is associated with any long-term benefits. This report presents long-term follow-up data collected 4 1/2 to 5 years after enrollment on 68% of the original sample. After this interval there were even larger differences between the experimental and control groups than those previously observed at 6 months and 1 year. This finding provides strong evidence that a comprehensive family-oriented outreach program for youngsters with chronic physical disorders can have long-term mental health benefits. It should encourage clinicians to develop similar programs and investigators to look for long-term effects of other interventions.
Stein
R E
RE
Department of Pediatrics, Albert Einstein College of Medicine, Bronx Municipal Hospital Center, New York 10461.
Jessop
D J
DJ
D000223:Adaptation, Psychological; D000553:Ambulatory Care; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease / Q000523:psychology*; D005190:Family; D005500:Follow-Up Studies; D006699:Home Care Services; D006801:Humans; D008603:Mental Health; D011897:Random Allocation