Publication: Aile apartmanında yaşamanın çocuk ruh sağlığı üzerine etkilerinin değerlendirilmesi
Abstract
Aile apartmanlarında, akrabalar ile aynı apartmanda yaĢama, ülkemize has olan; ve özellikle göç alan bölgelerde oldukça sık rastlanılan bir olgudur. Bu çalıĢmada, bugüne kadar yeterince araĢtırılmamıĢ bir toplumsal yapı olan aile apartmanlarının, aileler ve çocukları üzerindeki etkilerini ve psikopatoloji ile olan iliĢkisini; ana-baba tutumları, çocuk yetiĢtirme uygulamaları ve aile iĢlevselliği kapsamında değerlendirmek hedeflenmiĢtir. Kliniğimize ilk kez baĢvuran veya takipte olan, 0-18 yaĢ arası çocuk ve ergenler ile aileleri arasından araĢtırmaya katılmaya gönüllü olanlar, çalıĢmaya alınmıĢtır. Aile apartmanında oturmakta olanlar (n=101) çalıĢma grubuna, aile apartmanında oturmayanlar (n=36) ise kontrol grubuna dahil edilmiĢtir. Katılımcıların sosyodemografik bilgileri, oluĢturduğumuz sosyodemografik bilgi formu ile elde edilmiĢtir. Psikopatoloji ve iĢlevsellik değerlendirmeleri klinik görüĢme sırasında Çoçuklar Ġçin Duygulanım Bozuklukları Ve ġizofreni GörüĢme Çizelgesi–ġimdi Ve YaĢam Boyu ġekli–Türkçe Uyarlaması (ÇGDġ-ġY-T) ile yapılmıĢtır. Çocuklardan yaĢ gruplarına ve becerilerine göre “Çocuklar Ġçin Depresyon Ölçeği”, “Güvenli Bağlanma Ölçeği”, “Ebeveyn ve Akranlara Bağlanma Envanteri–kısa formu”, “Çocuklar Ġçin YaĢam Kalitesi Ölçeği–Çocuk formu”, “Ailede Özerk-ĠliĢkisel Benlik Ölçeği”, “Çocukluk Çağı Anksiyete Tarama Ölçeği–Çocuk formu”; ebeveynlerden “Aile Değerlendirme Ölçeği”, “Beck Depresyon Envanteri”, “Aile Hayatı ve Çocuk YetiĢtirme Tutumu Ölçeği”, “ĠliĢki Ölçekleri Anketi”, “Anne-Baba Tutum Ölçeği”, “Çocuk YetiĢtirme Stilleri Ölçeği”, “Çocuklar Ġçin YaĢam Kalitesi Ölçeği–Anne-Baba Formu”, “Çocukluk Çağı Anksiyete Tarama Ölçeği–Anne-Baba Formu” ve “Güçler–Güçlükler Anketi” formlarını doldurmaları istenmiĢtir. 101 kiĢilik çalıĢma grubunu 35 kız (%34,6) ve 66 erkek (%65,3) çocuk oluĢturmaktaydı. Çocukların yaĢı 1,4 – 17,6 yıl arasında değiĢiyordu; grubun yaĢ ortalaması ise 107,95±37,44 aydı ÇalıĢma grubundaki çocukların %64,3 (n=63)‟ünün, ve kontrol grubundaki çocukların %52,8 (n=19)‟ inin ailesinde psikiyatrik hastalık/ tedavi öyküsü olduğu öğrenilmiĢtir. ÇalıĢma grubundaki çocukların 75 (%74,3)‟inde; kontrol grubundaki çocukların 31 (%86,1) „inde görülmesi sebebiyle örneklemdeki en sık tanı Dikkat Eksikliği Hiperaktivite Bozukluğu (DEHB)‟ dur. ÇalıĢma ve kontrol grubu karĢılaĢtırıldığında klinik özelliklerin benzer olduğu bulundu. ÇalıĢma grubunda; çocukların geliĢimsel basamakları, anksiyete ve depresyon puanları, annelerin postpartum depresyon öyküleri ve aile apartmanında oturmaktan duydukları memnuniyet puanları ile pek çok parametre arasında anlamlı bağıntı saptanmıĢtır. Annelerin % 41‟i aile apartmanında bulunmaktan %50 üzerinde memnuniyetsizlik bildirmektedir. Çocukların davranıĢsal ve duygusal belirtilerinde aile apartmanında yaĢamanın etken olduğu annelerin % 58‟i tarafından düĢünülmektedir. Yüksek memnuniyet gösteren grup, düĢük memnuniyet gösteren grup ve kontrol grubu arasında yapılan analizler sonucunda; çocukların babaya güvenli bağlanması (p=0,009), annenin güvenli bağlanma özellikleri göstermesi (p=0,039), anne ve babanın depresyon Ģiddeti (sırasıyla p=0,008 ve p=0,019), ailenin genel iĢlevselliği (p=0,024), ailelerin çocuk yetiĢtirmede benimsediği tutum (p=0,001), çocukların yaĢadığı davranıĢ sorunları (p=0,046), arkadaĢ problemleri (p=0,000) ve toplam zorlanmaları (p=0,002) ile ailelerin çocuklarının psikososyal (p=0,004) ve genel (p=0,002) yaşam kalitesini değerlendirmeleri açısından gruplar arasında anlamlı fark olduğu saptanmıĢtır. Bu çalıĢma sosyolojik bir olgu olan aile apartmanında yaĢamanın çocuk ve ebeveynlerin duygu ve davranıĢlarına çeşitli etkilerini ortaya koymaktadır. Ülkemizdeki çocuk psikiyatrisi uygulamalarında aile apartmanı öyküsü varsa üzerinde özellikle durulmalıdır. apartmanı, anne-baba tutumu, işlevsellik, benlik, bağlanma, yaşam kalitesi.
Living with relatives in “family buildings” is a feature unique to Turkey, more common in rural-urban immigration areas. Life in family buildings is an issue that needs to be investigated deeply. In this study; we aim to research into the effects of family buildings on children and their families, in terms of psychopathology, parental attitudes, parenting practices and family functioning. Children between the ages of 0 – 18, referred to our outpatient clinic either for the first time or regularly, were informed about the research. Volunteers living in family buildings (n=101) were included in the study group; and volunteers not living in family buildings (n=36) were included in the control group. Participants‟ sociodemographic characteristics were obtained by means of a sociodemographic information questionnaire, assembled by the researchers. Psychopathology and functionality were assessed during the clinical interview by means of the K-SADS-PL, Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version –Turkish Version. Children were asked to fill “The Children‟s Depression Inventory”, “Secure Attachment Scale”, “Inventory of Parent and Peer Attachment-Short form”, “The Pediatric Quality of Life Inventory-Child form”, “Autonomous-Related Self in Family Scale”, “The Screen for Child Anxiety Related Emotional Disorders-Child form”; and parents were asked to fill “Family Assessment Device”, “Beck Depression Inventory”, “Parental Attitude Research Instrument”, “The Relationship Scales Questionnaire”, “Parental Attitudes Instrument”, “Parenting Styles Scale”, “The Pediatric Quality of Life Inventory-Parent form”, “The Screen for Child Anxiety Related Emotional Disorders-Parent form” and “Strengths and Difficulties Questionnaire”. The sample of 101 participants in the study group consisted of 35 girls (34,6%) and 66 boys (65,3%). Age of the sample group differed from 1,4 to 17,6 years; and the mean age was 107,95±37,44 months. v 64,3% of the study group (n=63) and 52,8% of the control group have psychiatric disturbances in their family history. Having been seen in 75 children (74,3%) in study group and in 31children (86,1%) in control group; ADHD has been the most common diagnose in the sample. Clinical features of the study and the control group were found to be similar. In study group, there is significant relationship between a number of parameters and children‟s developmental milestones, and anxiety -depression levels; and mothers‟ postpartum depression history and satisfaction scores about living in family buildings. 41% of mothers reported ≥50% dissatisfaction about living in family buildings. And 58% of mothers believe their children‟s behavioral and emotional symptoms are affected by living in the family buildings. The analyses between “highly satisfied” group, “not-at-all satisfied” group and control group showed that in terms of children‟s secure attachment to fathers (p=,009), mothers‟ secure attachment characteristics (p=,039), both parents‟ depression severity (for mothers p=,008; for fathers p=,019), general family functioning (p=,024), parental attitudes (p=,001), children‟s behavioral difficulties, peer problems and overall stress (p=,046; p=,000; p=,002 respectively) and parents‟ ratings on the children‟s psychosocial and total quality of life (p=,004 and p=,002 respectively); the three groups significantly differed from each other. This study reveals that ,being a sociological issue, living in family buildings has many emotional and behavioral effects on parents and children. We should elaborate on the history of living in family buildings in our child psychiatry practice. Family building, parental attitude, functionality, self, attachment, quality of life.
Living with relatives in “family buildings” is a feature unique to Turkey, more common in rural-urban immigration areas. Life in family buildings is an issue that needs to be investigated deeply. In this study; we aim to research into the effects of family buildings on children and their families, in terms of psychopathology, parental attitudes, parenting practices and family functioning. Children between the ages of 0 – 18, referred to our outpatient clinic either for the first time or regularly, were informed about the research. Volunteers living in family buildings (n=101) were included in the study group; and volunteers not living in family buildings (n=36) were included in the control group. Participants‟ sociodemographic characteristics were obtained by means of a sociodemographic information questionnaire, assembled by the researchers. Psychopathology and functionality were assessed during the clinical interview by means of the K-SADS-PL, Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version –Turkish Version. Children were asked to fill “The Children‟s Depression Inventory”, “Secure Attachment Scale”, “Inventory of Parent and Peer Attachment-Short form”, “The Pediatric Quality of Life Inventory-Child form”, “Autonomous-Related Self in Family Scale”, “The Screen for Child Anxiety Related Emotional Disorders-Child form”; and parents were asked to fill “Family Assessment Device”, “Beck Depression Inventory”, “Parental Attitude Research Instrument”, “The Relationship Scales Questionnaire”, “Parental Attitudes Instrument”, “Parenting Styles Scale”, “The Pediatric Quality of Life Inventory-Parent form”, “The Screen for Child Anxiety Related Emotional Disorders-Parent form” and “Strengths and Difficulties Questionnaire”. The sample of 101 participants in the study group consisted of 35 girls (34,6%) and 66 boys (65,3%). Age of the sample group differed from 1,4 to 17,6 years; and the mean age was 107,95±37,44 months. v 64,3% of the study group (n=63) and 52,8% of the control group have psychiatric disturbances in their family history. Having been seen in 75 children (74,3%) in study group and in 31children (86,1%) in control group; ADHD has been the most common diagnose in the sample. Clinical features of the study and the control group were found to be similar. In study group, there is significant relationship between a number of parameters and children‟s developmental milestones, and anxiety -depression levels; and mothers‟ postpartum depression history and satisfaction scores about living in family buildings. 41% of mothers reported ≥50% dissatisfaction about living in family buildings. And 58% of mothers believe their children‟s behavioral and emotional symptoms are affected by living in the family buildings. The analyses between “highly satisfied” group, “not-at-all satisfied” group and control group showed that in terms of children‟s secure attachment to fathers (p=,009), mothers‟ secure attachment characteristics (p=,039), both parents‟ depression severity (for mothers p=,008; for fathers p=,019), general family functioning (p=,024), parental attitudes (p=,001), children‟s behavioral difficulties, peer problems and overall stress (p=,046; p=,000; p=,002 respectively) and parents‟ ratings on the children‟s psychosocial and total quality of life (p=,004 and p=,002 respectively); the three groups significantly differed from each other. This study reveals that ,being a sociological issue, living in family buildings has many emotional and behavioral effects on parents and children. We should elaborate on the history of living in family buildings in our child psychiatry practice. Family building, parental attitude, functionality, self, attachment, quality of life.