论文标题：The relationship between household chaos and child, parent, and family outcomes: a systematic scoping review

期刊：BMC Public Health

作者：Samantha Marsh, Rosie Dobson & Ralph Maddison

发表时间：2020/04/22

DOI：10.1186/s12889-020-08587-8

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家庭混乱（household chaos），表现为家庭中缺乏秩序或环境的混乱，往往与一系列儿童和家庭的负面问题有关。BMC Public Health 近期发表的一项研究强调，需要在儿童福祉研究中考虑家庭混乱的重要性。Samantha Marsh博士在这篇博客中讨论了她的范围综述文章。

自二十一世纪初以来，家庭混乱现象及其对儿童福祉和发育的影响逐渐引起人们的关注。然而尽管如此，目前尚未有综述将现有文献进行全面的整合。我们在BMC Public Health 上发表的系统性范围综述文章旨在填补这一空白。

我们的发现

儿童家中混乱程度的增加，包括高水平的背景噪音（比如电视）、持续的忙乱、环境的躁动和混乱，对几乎每个被研究儿童都产生了负面影响。从认知和学业表现，到逆境生理以及社会情感健康，这些影响都表现出显著的一致性。

混乱和育儿

那么家庭混乱为何会对儿童福祉产生如此深远的影响呢？一个重要的因素是混乱与育儿行为之间的关系。我们发现，混乱程度增加与亲子冲突加剧、亲子关系中亲密度降低以及缺乏支持和回应的育儿方式密切相关，同样也呈现显著的一致性。而且，正如研究所证实的，亲子关系的质量与儿童福祉有着错综复杂的联系。

放慢童年生活的节奏

通过放慢儿童的生活来提升儿童的幸福感并不是一个新的概念。学术界以外的许多团体和社会运动倡导根据“童年的步伐”重新协调家庭时间，让孩子以一种比忙碌的现代社会慢得多的节奏生活。这种方式鼓励简化儿童的生活，减少不必要的活动、玩具和电子设备，并保持日常生活中中有利于儿童幸福的节奏和规律。简而言之，放慢儿童生活的重点是摒弃那些扰乱家庭生活的活动，多进行促进亲子沟通和自由玩耍的活动（但不是计算机游戏！），从而帮助建立温馨的亲子关系。

本研究的不足之处

尽管学术界之外的力量倡导简化孩子们的生活，而且纵向和横断面研究证明了混乱与不良儿童问题之间的联系，但我们尚不知道减少家庭混乱是否会产生积极影响，也不知道该如何减少混乱，因为没有研究进行过相关尝试。而且重要的是，我们还需要知道这么做是否会矫枉过正，从而导致家庭环境过分严格和死板，以至于缺乏温暖，无法形成能够带来支持和关爱的亲子关系。

COVID-19疫情下的家庭混乱

在写这篇综述的时候，我们并没有预想到目前的状况。世界各地的儿童从来没有如此长时间的待在家里。虽然我们不知道低混乱程度家庭中的儿童是否过得更好，但直觉上我们是这样认为的。在较少分散注意力的环境中，这些孩子可能会有更多的机会完成居家学习任务。他们可能还会有更多时间专注于利于情感健康和发展的室外游戏，而不是屏幕上的游戏。也许最重要的是，他们可能有机会更多地处于积极且具有支持性的育儿实践中。

因此，在COVID-19疫情期间，较低的家庭混乱程度可能会提供一个更有利于增强适应力和儿童身心健康的环境。因此，疫情提供了一个独特的机会，让我们不仅可以研究低水平的混乱如何保护儿童免受不良环境的侵害，也可以研究能否通过有效降低家庭混乱程度从整体上给孩子们带来更好的生活。

摘要：

Background

Household chaos, represented by the level of disorganisation or environmental confusion in the home, has been associated with a range of adverse child and family outcomes. This review aims to (1) identify how household chaos is measured, (2) chart study details of household chaos literature, and (3) map the existing literature with respect to the relationship between household chaos and child, parent, and family outcomes. We expect that this review will highlight the need to consider the importance of household chaos in child well-being research, particularly in those families where children may be more vulnerable to the adverse effects of household chaos.

Methods

We searched five electronic databases (last updated September 1st 2018) in addition to Google Scholar, and identified publications via a 3-stage screening process, which was conducted by two researchers. Published studies were included if they investigated the association between household chaos and child, parent, or family outcomes. Research that investigated household chaos as a mediator or moderator, or that investigated how the relationship between household chaos and the outcome of interest was mediated or moderated, were also included.

Results

One hundred twelve studies in 111 publications were included. The majority were conducted in the United States (n = 71), and used either cross-sectional (n = 60) or longitudinal (n = 49) study designs. Outcomes of interest were categorised into seven categories: (1) cognitive and academic (n = 16), (2) socio-emotional and behavioural (n = 60), (3) communication (n = 6), (4) parenting, family, and household functioning (n = 21), (5) parent outcomes (n = 6), (6) hormone (n = 8), and (7) physical health and health behaviours (n = 19). There was consistent evidence for significant correlations between household chaos and adverse outcomes across all seven categories in diverse populations with respect to age, disease status, and socio-economic status (SES).

Conclusion

There is consistent evidence for associations between household chaos and a number of adverse child, parent, and family-level outcomes. Household chaos may also help describe variations in outcomes between low SES and child development.

Peer Review reports

Household chaos represents the level of disorganisation or environmental confusion in the family home, and is characterised by high levels of background stimulation, lack of family routines, absence of predictability and structure in daily activities, and an overly fast pace of family life [1, 2]. Importantly, the construct of household chaos has been associated with a diverse range of adverse childhood outcomes, including poorer social-emotional functioning, cognitive development, academic achievement, and behavioural problems [3,4,5,6,7,8,9].

Household chaos has been linked with caregiver education, family income, and, perhaps not surprisingly, the number of people living in the household, whereby a lower level of caregiver education, lower family income, and a greater number of people in the home are associated with greater levels of chaos [10]. Despite this, the construct also been demonstrated to be distributed across socioeconomic status (SES) [10], and further, associations between household chaos and adverse child outcomes remain after controlling for SES [3, 11]. For example, one study showed that household chaos was associated with reduced cognitive ability and IQ in children, even after controlling for parent education/IQ, the home literacy environment, parental negativity, parental warmth, stressful events, and housing conditions [3]. Household chaos may therefore represent a unique risk factor for various adverse childhood outcomes, rather than simply reflecting residual confounding with, for example, SES [10].

In addition to the main effects of household chaos, the construct has also been shown to both mediate and moderate relationships between known child risk factors and adverse outcomes. For example, one study documented that the relationship between household chaos and maternal executive function was moderated by SES, suggesting that the adverse effects of household chaos may be exacerbated in socioeconomically distressed contexts [12]. Other studies have also shown that household chaos may mediate relationships between child behavioural problems and bedtime resistance [13], and poverty and socioemotional adjustment [14].

Given the varied ways in which household chaos is associated with adverse child outcomes, it is not surprising that there appears to be growing interest in the construct. Yet despite this interest, and a seemingly large body of evidence demonstrating links between household chaos and a range of adverse child outcomes, no review has been conducted in this field to date. To this end, the goal of this study was to undertake a review to investigate the relationship between household chaos and child-, parent-, and family-level outcomes.

We decided that the ideal method of synthesising the knowledge base at this time, due to the disparate nature of outcomes assessed, age range and disease status of participants, frequency and duration of follow-up, and study designs used, was a systematic scoping review. The scoping review methodology allowed us to (1) investigate how household chaos is measured, (2) summarise the research on how household chaos is included as a primary risk factor of child, parent, and family outcomes, and (3) map the existing literature, with respect to relationships between household chaos and child, parent, and family outcomes. This enabled us to assess not only how household chaos is measured, which is necessary to ensure findings are generalisable across studies, but also what dimensions have been investigated. It also enabled us to summarise the extant scientific research without focussing on a specific outcome, research design, study population (e.g. disease population), or setting [15], therefore allowing us to make recommendations for future systematic reviews and meta-analysis within the field. This review seems timely given that there is also a need to better understand if effects are independent of other known risk factors, or instead reflect an important confounding factor.

（来源：科学网）