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父母应对儿童癌症诊断:性别影响、夫妻间的差异以及生活质量。

Parental coping with the diagnosis of childhood cancer: gender effects, dissimilarity within couples, and quality of life.

作者信息

Goldbeck L

机构信息

Department of Pediatrics, University Clinic Ulm, Germany.

出版信息

Psychooncology. 2001 Jul-Aug;10(4):325-35. doi: 10.1002/pon.530.

Abstract

OBJECTIVE

Considering coping as dynamic process within the family, effects of gender and diagnosis are investigated. Dissimilarity within couples in coping with childhood cancer is studied longitudinally in its effects on quality of life of mothers, fathers, and the sick children.

METHODS

A total of 108 parents out of 54 complete families participated in a prospective study. Twenty-five families had a child newly diagnosed with cancer, 29 families had a child newly diagnosed with juvenile diabetes or epilepsy. The Coping Health Inventory for Parents, the Trier Coping Scales, and the Ulm Quality-of-Life Inventory for Parents were employed 1-2 weeks after diagnosis and again 10-12 weeks after diagnosis.

RESULTS

In face of childhood cancer, parents develop more rumination, defense, and information seeking, and less social support seeking strategies compared to the control group. Mothers report more frequent and more effective coping compared with fathers, but mothers and fathers do not differ in their self-reported quality of life. No convergence within couples could be demonstrated in most of the corresponding coping styles. The strongest correlation between mothers and fathers appeared in the religious coping style (r=0.60, p<0.001). Coping dissimilarity within couples in social support seeking and religion is correlated with an improvement of parental quality of life. Parental dissimilarity in information seeking is correlated with a decrease in the child's quality of life.

CONCLUSION

Coping dissimilarities between fathers and mothers have differential effects on the family members. For this reason, psychosocial interventions should support dis-synchrony when it appears adaptive, and they should help parents to overcome those differences that negatively affect their child.

摘要

目的

鉴于应对是家庭内部的动态过程,本研究调查了性别和诊断的影响。纵向研究夫妻在应对儿童癌症方面的差异对母亲、父亲和患病儿童生活质量的影响。

方法

54个完整家庭中的108位家长参与了一项前瞻性研究。25个家庭的孩子新诊断出患有癌症,29个家庭的孩子新诊断出患有青少年糖尿病或癫痫。在诊断后1 - 2周以及诊断后10 - 12周,采用父母应对健康量表、特里尔应对量表和父母乌尔姆生活质量量表。

结果

与对照组相比,面对儿童癌症时,父母会产生更多的沉思、防御和信息寻求行为,而寻求社会支持的策略则较少。母亲报告的应对频率更高且更有效,相比之下父亲则不然,但母亲和父亲在自我报告的生活质量方面没有差异。在大多数相应的应对方式中,夫妻之间未能表现出趋同。父母之间最强的相关性出现在宗教应对方式上(r = 0.60,p < 0.001)。夫妻在寻求社会支持和宗教方面的应对差异与父母生活质量的改善相关。父母在信息寻求方面的差异与孩子生活质量的下降相关。

结论

父母之间的应对差异对家庭成员有不同影响。因此,心理社会干预应在适应性出现时支持不同步,并应帮助父母克服那些对孩子产生负面影响的差异。

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