Wijnberg-Williams Barbara J, Kamps Willem A, Klip Ed C, Hoekstra-Weebers Josette E H M
Psychosocial Services, University Medical Center Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
Psychooncology. 2006 Jan;15(1):1-8. doi: 10.1002/pon.927.
We investigated the psychological functioning of parents of children suffering from pediatric cancer using a prospective design over a five-year time period. Parents of children diagnosed with cancer participated at diagnosis (T1), six months (T2), twelve months (T3), and five years later (T4, n = 115). Repeated measures ANOVAs were calculated for the three measures of psychological distress (GHQ, SCL-90 and STAI-S) to examine changes over time and gender differences. Independent T-tests were computed to examine differences between the mean scores of the parents at T4 and the norm groups. The effects of health status and earlier levels of distress on T4 functioning were examined using ANOVA and partial correlational analysis. Results showed that levels of reported distress, psychoneurotic symptoms and state anxiety significantly decreased across time to normal levels at T4 except on the GHQ. A significantly higher percentage of parents (27%) than in the norm group (15%) showed clinically elevated scores on the GHQ. Mothers had higher scores than fathers only on state anxiety. Parents of relapsed children reported higher anxiety levels than parents of surviving and deceased children. Psychological functioning at T1 was significantly related to functioning at T4. These results support the conclusion that although parental distress decreases with time, a significant number of parents still suffer from clinical distress after five years. Parents of relapsed children are at risk for long-term psychological problems as are those with higher levels of psychosomatic complaints at diagnosis.
我们采用前瞻性设计，对患小儿癌症儿童的父母在五年期间的心理功能进行了调查。被诊断患有癌症儿童的父母在诊断时（T1）、六个月后（T2）、十二个月后（T3）以及五年后（T4，n = 115）参与调查。针对心理困扰的三项测量指标（一般健康问卷、症状自评量表90和状态焦虑量表）进行重复测量方差分析，以检验随时间的变化以及性别差异。进行独立样本t检验，以检验T4时父母的平均得分与常模组之间的差异。使用方差分析和偏相关分析，检验健康状况和早期困扰水平对T4功能的影响。结果显示，除一般健康问卷外，报告的困扰、精神神经症状和状态焦虑水平随时间显著下降，在T4时降至正常水平。与常模组（15%）相比，有显著更高比例的父母（27%）在一般健康问卷上的得分临床升高。仅在状态焦虑方面，母亲的得分高于父亲。复发儿童的父母报告的焦虑水平高于存活和死亡儿童的父母。T1时的心理功能与T4时的功能显著相关。这些结果支持以下结论：尽管父母的困扰随时间减少，但仍有相当数量的父母在五年后仍遭受临床困扰。复发儿童的父母以及诊断时身心症状水平较高的父母有长期心理问题的风险。
