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Journal of the Korean Academy of Family Medicine 2001;22(10):1467-1475.
Published online October 1, 2001.
The influence of family functioning on psychosocial dysfunction in children.
Churl Min Kim, Jae Ho Lee, Joo Ha Lee, Eun Sook Park
Department of Family Medicine, Medical College, the Catholic University of Korea.
가족지지의 결여가 어린이의 정신사회적 기능에 미치는 영향
김철민, 이재호, 이주하, 박은숙
가톨릭대학교 의과대학 가정의학과
Abstract
Background
: A large number of children with psychosocial dysfunction are not recognized within schools or primary care settings. In several research, an incresaing amount of attention has been paid to the importance of low family support as apredictor of psychosocial dysfunction in children. Our study examined the agreement and relationship between the lack of family support as measured by the Family APGAR and child psychosocial dysfunction as screened by the Pediatric Symptom Checklist(PSC). Therefore, We studied the usefulness of Family APGAR as a screening tool of child psychosocial Dysfunction.

Methods : We set 643 children that are engaged in elementary school. We gave a questionnaire to their parents and made them record the questionnaire which contained the sociodemographic date, past history of child and parents, the Family APGAR and the translated Pediatric Symptom Checklist(PSC). Finally, we analysed only 506 complete data. We use the SAS/PC 6.12 that is a statistical analysis program.

Results : Children with a lack of family support (APGAR+) were 5.1 times as likely to receive scores indicating dysfunction on the PSC(PSC+). Families with a lack of support were significantly more likely to report low parental educational achievement and low income. Sixty percent of children from families with a lack of support were identified as having a psychosocial dysfunction by the PSC rating; however, only 24% percent of the children identified with psychosocial dysfunction by the PSC had scores indicating poor family functioning on the Family APGAR. Families with a lack of support had significantly higher total scores on PSC(mean=20.2) than families with adequate support(mean=11.9) the strength of the agreement between the Family APGAR and the PSC was k=.29.

Conclusion : A lack of family support is associated with child psychosocial dysfunction as assessed by the PSC. However, the Family APGAR was not a sensitive measure of child psychosocial dysfunction, and thus it supplements, but does not replace the PSC.
초록
연구배경 : 어린이 정신사회적 기능이상의 예측인자로서 가족지지 결여의 중요성이 대두되어왔으나, 정신사회적 기능이상을 가진 많은 수의 어린이들이 거의 선별되지 못하고 있다. 본 연구는 가족지지의 결여에 대한 검사인 Family APGAR의 어린이 정신사회적 기능이상에서의 효용성을 알아보는 데에 있다.

방법 : 본 연구는 1998년 7월부터 9월까지 수도권 소재 2개 초등학교 어린이 643명의 가정을 대상으로 하였다. 배포한 설문지는 학부형이 직접 작성하여 적절히 기입된 506개의 설문을 분석하였다. 설문내용은 사회인구학적 변수, Family APGAR Pediatric Symptom Checklist(35문항) 등 총 51문항으로 구성되었다. 통계분석은 SAS/PC 6.12를 이용하였다.

결과 : 낮은 가족지지(APGAR+)를 보이면서 Pediatric Symptom Checklist상 기능이상 (PSC+)으로 나타나는 경우가, 보통 이상의 가족지지(ARGAR-)를 보이면서 PSC+인 경우보다 비교위험도가 8.8배였다. PSC+인 어린이가 APGAR+일 가능성은 PSC-인 어린이의 가정이 APGAR+일 가능성에 비해 5.1배였다. PSC와 Family APGAR의 일치강도는 k=.29였다.

결론 : 가족지지의 결여는 어린이의 정신사회적 기능이상과 연관성이 있다. 그러나 Family APGAR는 아동의 정신사회적 기능이상을 측정하는 민감도 높은 검사는 아니어서, 어린이의 정신사회적 기능이상을 파악하는데 보조적으로 사용할 수는 있어도 전적으로 대치할 수는 없는 것으로 나타났다.


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