title: Protocol for a study of the psychosocial determinants of health in early childhood among children with cystic fibrosis.
abstract: OBJECTIVE
  To investigate the causal associations between family relationships, family functioning, social circumstances and health outcomes in young children with cystic fibrosis.
  
  
  BACKGROUND
  The anticipated health gains for patients with cystic fibrosis, promised by early diagnosis through newborn screening, have yet to be fully realized, despite advances in cystic fibrosis health care with aggressive management in multidisciplinary clinics and the development of specific medications. Adverse psychosocial functioning may underpin the current lack of progress as it is well recognized that compromised early parent-child attachment relationship experiences and adverse social circumstances have negative impacts on lifelong health status and health resource use, even in healthy children.
  
  
  METHODS
  A cross-sectional (initial) and longitudinal (progressive), multicentre study of children aged 3 months-6 years with cystic fibrosis, who have been diagnosed by newborn screening.
  
  
  METHODS
  Questionnaire and observational measures of parent psychosocial functioning, parenting and parent-child attachment and social markers; and including clinical outcomes of regular health surveillance with clinical, lung imaging (computerized tomography) and bronchoalveolar lavage for airway microbiology and inflammation.
  
  
  CONCLUSIONS
  This will be the first study to investigate the causal effect of psychosocial functioning, parenting and attachment on physical health outcome measures in children with cystic fibrosis.
authors: Lady Cilento Children's Hospital, Brisbane, Queensland, Australia.|Curtin University, Perth, Western Australia, Australia.
authors: Tonia
authors: T
authors: Douglas
authors: Royal Children's Hospital Melbourne, Victoria, Australia.|Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.|Department of Paediatrics, University of Melbourne, Victoria, Australia.
authors: Brigid
authors: B
authors: Jordan
authors: School of Psychology and Social Science, Edith Cowan University, Perth, Western Australia, Australia.
authors: Lynn
authors: L
authors: Priddis
authors: Royal Children's Hospital Mental Health, Melbourne, Victoria, Australia.|Psychological Sciences & Paediatrics, University of Melbourne, Victoria, Australia.
authors: Vicki
authors: V
authors: Anderson
authors: Department of Respiratory Medicine, Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia.
authors: Jane
authors: J
authors: Sheehan
authors: School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia.
authors: Robert T
authors: RT
authors: Kane
authors: Department of Paediatrics, University of Melbourne, Victoria, Australia.|Department of Respiratory Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.|Infection, Immunity and Environment, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
authors: John
authors: J
authors: Massie
authors: Edith Cowan University, Perth, Western Australia, Australia.|Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.
authors: Cindy
authors: C
authors: Branch-Smith
authors: Tropical Health Research Unit and College of Healthcare Sciences, Townsville Hospital and Health Service/James Cook University, Queensland, Australia.|Medical School, The University of Queensland, Townsville, Queensland, Australia.
authors: Linda
authors: L
authors: Shields
mesh_terms: D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000503:physiopathology*; D006304:Health Status; D006801:Humans; D007223:Infant
keywords: cohort study; cystic fibrosis; longitudinal study; new born screening; nursing; protocol