Drews Carolyn, Celano Marianne, Plager David A, Lambert Scott R
Department of Epidemiology, Rollins School of Public Health, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
J AAPOS. 2003 Aug;7(4):244-50. doi: 10.1016/s1091-8531(03)00118-6.
To examine parenting stress among caregivers of young children with congenital cataracts and to assess whether diagnostic and/or treatment differences are associated with differences in perceived parenting stress.
Parents of 41 preschool-age children with congenital cataracts (13 with bilateral cataracts [BCCs] and 28 with unilateral cataracts [UCCs], of whom 14 were aphakic and 14 were pseudophakic) completed the Parenting Stress Index (PSI) and/or a disease-specific parental stress measure, ie, the Ocular Treatment Index (OTI).
The 28-item OTI had excellent internal consistency (alpha = 0.94) and supported three of four a priori validity hypotheses. Parents of children with congenital cataracts reported normal parenting stress levels on the PSI. Parents of children with UCCs tended to report higher levels of stress, but not significantly so, than did parents of children with BCCs. Among parents of children with UCCs, those whose children were aphakic reported higher levels of stress on the OTI and all of the PSI subscales than did parents of pseudophakic children. These differences were statistically significant for two subscales (Adaptability [P =.03] and Mood [P =.01]).
Although parents of children with congenital cataracts generally did not report increased parenting stress levels, clinicians should be aware that parenting stress can adversely impact patients' families. We did observe higher stress levels in parents with children who had UCCs and did not receive an intraocular lens-particularly stress related to their child's reaction to sensory stimulation and mood-compared with parents of pseudophakic children. Thus, clinicians may want to consider parenting stress levels when choosing a treatment for children with UCCs, especially because such stress has been associated with poor treatment compliance for children with other chronic conditions.
研究先天性白内障幼儿照料者的育儿压力,并评估诊断和/或治疗差异是否与感知到的育儿压力差异相关。
41名先天性白内障学龄前儿童的家长(13名双侧白内障[BCC]患儿家长和28名单侧白内障[UCC]患儿家长,其中14名无晶状体,14名人工晶状体植入)完成了育儿压力指数(PSI)和/或疾病特异性父母压力测量指标,即眼科治疗指数(OTI)。
28项的OTI具有出色的内部一致性(α = 0.94),并支持了四个先验效度假设中的三个。先天性白内障患儿的家长在PSI上报告的育儿压力水平正常。UCC患儿的家长报告的压力水平往往高于BCC患儿的家长,但差异不显著。在UCC患儿的家长中,无晶状体患儿的家长在OTI和所有PSI分量表上报告的压力水平高于人工晶状体植入患儿的家长。这些差异在两个分量表上具有统计学意义(适应性[P = 0.03]和情绪[P = 0.01])。
虽然先天性白内障患儿的家长通常没有报告育儿压力水平增加,但临床医生应意识到育儿压力会对患者家庭产生不利影响。我们确实观察到,与人工晶状体植入患儿的家长相比,UCC患儿的家长压力水平更高,尤其是与孩子对感觉刺激的反应和情绪相关的压力,特别是在孩子未植入人工晶状体的情况下。因此,临床医生在为UCC患儿选择治疗方法时可能需要考虑育儿压力水平,特别是因为这种压力与其他慢性病患儿的治疗依从性差有关。