BACKGROUND Care for children and adolescents with psychosocial problems is aimed at reducing problems. There may be a relationship between the intensity and duration of care provision and improvement of these outcomes, but evidence on this issue is lacking. We therefore examined the association between care trajectories based on duration and intensity of care for children, and the reduction in psychosocial problems after 3 years. METHODS We obtained a cohort of all children entering psychosocial care in one region (n = 1,378), the TAKECARE cohort, and followed it for 3 years, with five assessment rounds. Retention in the final round was 85.8%. Psychosocial problems were measured using the parent report of the Total Difficulty Score of the Strength and Difficulties Questionnaire (SDQ-TDS). We constructed trajectories for intensity of care using growth mixture modelling and assessed the association between duration and intensity of care trajectories and SDQ-TDS after 3 years. RESULTS After 3 months 60.6% of children and adolescents were receiving care, after 1 year 38.7% were receiving care and after 3 years 26.0%. Regarding intensity of care, three trajectories were found: one with minimal intensity during all 3 years, a second with initially medium intensity and strong reduction within 1 year, and a third with high intensity and a reduction after 1 year. Although the psychosocial problems of children and adolescents were reduced during the 3-year period, the rate of decline was relatively less marked for children and adolescents with longer care trajectories. CONCLUSION Overall, children and adolescents with psychosocial problems who received care had improved outcomes at follow-up. However, increased provision of care does not automatically lead to reduction of problems, and although overall psychosocial problems are reduced, a substantial subgroup has longer lasting problems.

中文翻译：

---

有心理社会问题的儿童和青少年的护理轨迹：一项为期 3 年的前瞻性队列研究。


背景技术 对有心理社会问题的儿童和青少年的护理旨在减少问题。护理提供的强度和持续时间与这些结果的改善之间可能存在关系，但缺乏关于这个问题的证据。因此，我们研究了基于儿童护理持续时间和强度的护理轨迹与 3 年后心理社会问题减少之间的关联。方法 我们获得了一个地区所有进入心理社会护理的儿童的队列（n = 1,378），即 TAKECARE 队列，并对其进行了为期 3 年的跟踪，共进行了五轮评估。最后一轮的保留率为 85.8%。心理社会问题是使用家长报告的力量和困难问卷总难度分数（SDQ-TDS）来衡量的。我们使用生长混合模型构建了护理强度轨迹，并评估了 3 年后护理轨迹的持续时间和强度与 SDQ-TDS 之间的关联。结果 3 个月后，60.6% 的儿童和青少年正在接受护理，1 年后，38.7% 的儿童和青少年正在接受护理，3 年后，这一比例为 26.0%。关于护理强度，发现了三种轨迹：一种在所有 3 年内都是最低强度，第二种是最初中等强度并在 1 年内大幅减少，第三种是高强度并在 1 年后减少。尽管儿童和青少年的心理社会问题在三年期间有所减少，但对于护理轨迹较长的儿童和青少年来说，下降速度相对不那么明显。结论 总体而言，接受护理的患有心理社会问题的儿童和青少年在随访中的结果有所改善。 然而，增加护理服务并不会自动导致问题减少，尽管总体心理社会问题有所减少，但相当多的亚群体存在更持久的问题。