title: Psychosocial characteristics and predictors of health-care use in families of young children with cystic fibrosis in Western Australia.
abstract: OBJECTIVE
  Early childhood psychosocial experiences determine future health and health-care use. Identifying psychosocial predictors in cystic fibrosis may inform intervention strategies that can reduce health-care utilization.
  
  
  METHODS
  The study was designed as a prospective cohort study.
  
  
  METHODS
  The study was set in the only cystic fibrosis clinic in Western Australia.
  
  
  METHODS
  The patients were children up to 6 years diagnosed with cystic fibrosis in Western Australia between 2005 and 2011.
  
  
  METHODS
  Psychosocial data collected for each year of life were compared with Australian population data and analysed as predictors of annual hospital, emergency and outpatient visits.
  
  
  RESULTS
  Compared with the Australian population, cystic fibrosis families demonstrated lower socio-economic status and labour supply (P < 0.001), increased residential mobility (P < 0.001) and trends towards increased rates of parental separation (P = 0.066). Marital discord and maternal and child psychological stress significantly predicted increased hospital admissions, emergency and outpatient visits.
  
  
  CONCLUSIONS
  Social gradients may exist for families of young children with cystic fibrosis in Western Australia with potential implications for child health. Family psychological and relationship stress predicted increased child cystic fibrosis-related health-care use.
authors.affiliation: Respiratory Department, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia.|Schools of Psychology and Medical Education, Curtin University, Perth, Western Australia, Australia.
authors.forename: Tonia
authors.initials: T
authors.lastname: Douglas
authors.affiliation: Department of Paediatrics, Fiona Stanley Hospital, Joondalup Child Development Centre, Perth, Western Australia, Australia.
authors.forename: Jennifer
authors.identifier: http://orcid.org/0000-0002-6732-6473
authors.initials: J
authors.lastname: Green
authors.affiliation: Respiratory Department, Telethon Kids Institute, Perth, Western Australia, Australia.
authors.forename: Judy
authors.initials: J
authors.lastname: Park
authors.affiliation: Respiratory Department, Telethon Kids Institute, Perth, Western Australia, Australia.
authors.forename: Lidija
authors.initials: L
authors.lastname: Turkovic
authors.affiliation: Department of Respiratory Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.|Department of Paediatrics, University of Melbourne, Infection, Immunity and Environment, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Massie
authors.affiliation: Medical School, The University of Queensland, Brisbane, Queensland, Australia.|College of Healthcare Sciences, Tropical Health, Tropical Health Research Unit, Townsville Health District, James Cook University, Townsville, Queensland, Australia.
authors.forename: Linda
authors.identifier: http://orcid.org/0000-0003-4911-0107
authors.initials: L
authors.lastname: Shields
mesh_terms: D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000523:psychology*; D005260:Female; D005544:Forecasting; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008603:Mental Health; D010290:Parents; D011446:Prospective Studies; D012923:Social Class; D014904:Western Australia
keywords: child; cystic fibrosis; mental health; parent; psychosocial determinant; social gradient