Objective This study examined bidirectional associations between mother- and father-reported medical responsibility and medical skill mastery in youth with spina bifida (SB). Methods Participants were 140 youth with SB and their parents who participated in three waves of a longitudinal study across four years (ages 8–15 years at Time 1). Mother- and father-report of both medical responsibility and medical skill mastery were used, and age and estimated intelligence quotient were included as covariates, in cross-lagged models. Results The cross-lagged model provided evidence for significant bidirectional associations between mother-reported medical responsibility and skill mastery across time (root mean square error of approximation=0.09, comparative fix index=0.97). These paths showed that higher levels of child responsibility predicted an increase in skill mastery and that higher levels of mastery predicted an increase in child responsibility across time. Moreover, based on mother-report, sharing of responsibility had stronger effects on increases in skill mastery (Time 1 to Time 2 β=.25, Time 2 to Time 3 β=.27) than skill mastery had on increases in child responsibility (Time 1 to Time 2 β=.08, Time 2 to Time 3 β=.07). The only significant cross-lagged path for father-report was from Time 1 skill mastery to Time 2 responsibility (β=.34). Conclusions Mothers perceive a bidirectional relationship between responsibility and skill mastery across time, whereas fathers appear to mainly consider how skills might affect a subsequent increase in responsibility sharing. Thus, it is important to consider both parents’ perspectives when working to increase medical autonomy in youth with SB.

中文翻译：

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脊柱裂青少年医疗责任和技能的交叉滞后模型

目的 本研究探讨了脊柱裂 (SB) 青少年中母亲和父亲报告的医疗责任与医疗技能掌握之间的双向关联。方法 参与者是 140 名患有 SB 的青少年及其父母，他们参加了为期四年的三轮纵向研究（时间 1 时年龄为 8-15 岁）。在交叉滞后模型中，使用了医疗责任和医疗技能掌握情况的母亲和父亲报告，并将年龄和估计的智商作为协变量包括在内。结果交叉滞后模型为母亲报告的医疗责任和技能掌握之间的显着双向关联提供了证据（近似的均方根误差=0.09，比较固定指数=0.97）。这些路径表明，较高水平的儿童责任预示着技能掌握的增加，而较高的掌握水平预示着随着时间的推移儿童责任的增加。此外，根据母亲的报告，责任分担对技能掌握的增加有更大的影响（时间 1 到时间 2 β=.25，时间 2 到时间 3 β=.27）比技能掌握对孩子责任增加的影响更大（时间 1 到时间 2 β=.08，时间 2 到时间 3 β=.07)。父亲报告的唯一显着交叉滞后路径是从时间 1 技能掌握到时间 2 责任 (β=.34)。结论 母亲认为随着时间的推移责任和技能掌握之间存在双向关系，而父亲似乎主要考虑技能如何影响随后增加的责任分担。因此，