Meert K L, Thurston C S, Thomas R
Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI 48201, USA.
Pediatr Crit Care Med. 2001 Oct;2(4):324-8. doi: 10.1097/00130478-200110000-00007.
Parental grief after the death of a child may be influenced by the chronicity of the child's illness, the quality of care provided, and the parents' ability to cope. Our objective is to identify aspects of pediatric intensive care and parental coping that have a favorable effect on parental bereavement outcome.
Follow-up survey.
University teaching hospital.
Fifty-seven parents who experienced the death of their child in the pediatric intensive care unit between January 1, 1995, and June 30, 1998.
Parents completed two standardized questionnaires, the Coping Resources Inventory and the Texas Revised Inventory of Grief. The Coping Resources Inventory quantifies five coping resources: cognitive, social, emotional, spiritual, and physical. The Texas Revised Inventory of Grief is a two-part questionnaire that quantifies the intensity of grief at two time points: (1) near the time of death, and (2) in the present. Parents had previously participated in an interview with the investigators that included questions regarding the emotional attitudes of the pediatric intensive care unit staff and the adequacy of information provided during their child's critical illness.
Texas Revised Inventory of Grief scores were used as measures of early and long-term grief.
Parents' whose child died acutely had greater intensity of early and long-term grief than those whose child died of chronic illness (p < 0.05, Mann-Whitney U test). Parents' physical coping resources and the emotional attitudes of pediatric intensive care unit staff predicted the intensity of early grief (R(2) =.27, multiple regression). Parents' cognitive coping resources, the emotional attitudes of staff, and the adequacy of information provided to parents predicted the intensity of long-term grief (R(2) =.42).
Parents' physical well-being enables more effective handling of early grief. Parents' understanding of their own self-worth and their child's illness determine long-term adaptation to loss. A caring emotional attitude displayed by pediatric intensive care unit staff has beneficial short-term and long-term effects on parental bereavement.
孩子死亡后父母的悲痛可能会受到孩子疾病的慢性程度、所提供护理的质量以及父母的应对能力的影响。我们的目的是确定儿科重症监护及父母应对方面对父母丧亲结局有积极影响的因素。
随访调查。
大学教学医院。
1995年1月1日至1998年6月30日期间在儿科重症监护病房经历孩子死亡的57位父母。
父母完成两份标准化问卷，即应对资源量表和德克萨斯修订哀伤量表。应对资源量表对五种应对资源进行量化：认知、社会、情感、精神和身体方面。德克萨斯修订哀伤量表是一份分为两部分的问卷，在两个时间点对哀伤强度进行量化：（1）死亡时附近，以及（2）当下。父母此前参加了与调查人员的访谈，其中包括关于儿科重症监护病房工作人员的情感态度以及孩子危重病期间所提供信息是否充足的问题。
德克萨斯修订哀伤量表得分用作早期和长期哀伤的衡量指标。
孩子急性死亡的父母早期和长期哀伤的强度高于孩子死于慢性病的父母（p<0.05，曼-惠特尼U检验）。父母的身体应对资源以及儿科重症监护病房工作人员的情感态度可预测早期哀伤的强度（R² = 0.27，多元回归）。父母的认知应对资源、工作人员的情感态度以及向父母提供信息的充足程度可预测长期哀伤的强度（R² = 0.42）。
父母的身体健康有助于更有效地应对早期哀伤。父母对自身自我价值和孩子疾病的理解决定了对丧亲之痛的长期适应情况。儿科重症监护病房工作人员表现出的关怀性情感态度对父母丧亲之痛有短期和长期的有益影响。
