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Physical Health of Maltreated Children Shortly After Entry Into Foster Care

其他書名	Assessment and Prediction of Documented Medical Problems and Caregiver Reported Health Status
出版	University of California, San Diego and San Diego State University, 2002
URL	http://books.google.com.hk/books?id=BIra7qdeVrsC&hl=&source=gbs_api

註釋Studies of children in foster care have reported higher rates of medical problems and chronic conditions than reported for children in the general population. Although parent reports have been used to assess health in epidemiological studies, substitute caregiver reports have not been examined in foster care studies of physical health. Studies in this area have primarily conducted record reviews, reporting widely varying estimates; few studies have examined the impact of potentially related demographic and foster care specific factors. The present study assessed physical health through record review of medical problems and substitute caregiver reports of children's general health status (excellent, good, fair/poor). These two indicators were compared with health indices derived from epidemiological studies and from other foster care studies. Logistic and multinomial regression analyses were conducted to examine potentially predictive factors of the health indicators, including sociodemographic factors (i.e., age, ethnicity) and aspects specific to foster care (i.e., maltreatment exposure, placement type). Results revealed 25% of this foster care cohort had a serious medical problem; a prevalence lower than the rate of chronic conditions for children in the general population, and lower than rates of medical problems and chronic conditions reported for children in other foster care samples. However, a smaller proportion of children in the foster care cohort (44.1%) were reported by their substitute caregivers to be in excellent health relative to children in the general population (52.5%), and a larger proportion was reported to be in fair/poor health (11.6% and 1.9%, respectively). Substitute caregiver reports of health status were related to medical problems, providing limited evidence of their validity. Both predictive regression analysis models were statistically significant. Results indicated that younger children and those living in non-relative foster care were more likely to have medical problems and lower reported health status. Medical problems were also more likely among those identified as drug exposed at birth; and reported health status was lower for African American children than for Caucasian children. The limitations of the present study, as well as the implications for future research, are discussed.