Lee Ya-Ling, Santacroce Sheila Judge
School of Nursing, College of Medicine, National Taiwan University, 1, Jen-Ai Road, Section 1, Taipei 10063, Taiwan.
Int J Nurs Stud. 2007 Nov;44(8):1406-17. doi: 10.1016/j.ijnurstu.2006.07.002. Epub 2006 Sep 20.
Posttraumatic stress is one of many psychological late effects in young adult survivors of childhood cancer and needs to be explored thoroughly.
The purpose of this study was to examine the characteristics and correlates of posttraumatic stress symptoms in a sample of young adult survivors of childhood cancer.
Cross-sectional and correlational descriptive design was used. Data was collected by a mailed survey. The University of California at Los Angeles Post Traumatic Stress Disorder Index (PTSDI) was the measure selected for the evaluation of posttraumatic stress.
The study took place in a medical center in the Eastern part of the United States.
The inclusion criteria for participants were: (a) diagnosis of childhood cancer between birth and 19 years of age; (b) 3 or more years post successful completion of cancer treatment; (c) free of active cancer; (d) at least 19 years of age; and (e) able to read and write English. A total of 51.1% (N=46) of the potentially eligible survivors responded to the survey. The analysis was based on the data from 45 respondents who had a mean age of 27.4 years.
The mean PTSDI score was 15.7 (SD=11.0, range=0-43). Thirteen percent (n=6) of participants had PTSDI scores that exceeded the cutoff point of 32, which is considered indicative of clinically significant posttraumatic stress disorder (PTSD). Participants who lived alone (t=-2.17, p=.035), had no health insurance (t=2.08, p=.044) and did not have a history of bone marrow transplantation (t=4.52, p=.000) reported significantly higher scores on PTSDI than others. The clinically significant PTSD group had a significantly higher rate of living alone than the non-PTSD group (p=.038).
Cancer-related posttraumatic stress emerges in childhood cancer survivors in young adulthood. Health care providers should screen childhood cancer survivors for posttraumatic stress so that referrals can be made to provide survivors with further assistance.
创伤后应激是儿童癌症成年幸存者众多心理后期影响之一，需要深入探究。
本研究旨在调查儿童癌症成年幸存者样本中创伤后应激症状的特征及相关因素。
采用横断面和相关性描述性设计。通过邮寄调查问卷收集数据。选用加利福尼亚大学洛杉矶分校创伤后应激障碍指数（PTSDI）来评估创伤后应激。
研究在美国东部的一个医疗中心进行。
参与者的纳入标准为：（a）出生至19岁期间被诊断患有儿童癌症；（b）成功完成癌症治疗后3年或更长时间；（c）无活动性癌症；（d）至少19岁；（e）能够读写英语。共有51.1%（N = 46）的潜在合格幸存者回复了调查问卷。分析基于45名受访者的数据，他们的平均年龄为27.4岁。
PTSDI平均得分为15.7（标准差 = 11.0，范围 = 0 - 43）。13%（n = 6）的参与者PTSDI得分超过32分的临界值，这被认为表明存在具有临床意义的创伤后应激障碍（PTSD）。独居的参与者（t = -2.17，p = 0.035）、没有医疗保险的参与者（t = 2.08，p = 0.044）以及没有骨髓移植史的参与者（t = 4.52，p = 0.000）在PTSDI上的得分显著高于其他人。具有临床意义的PTSD组独居率显著高于非PTSD组（p = 0.038）。
儿童癌症幸存者在成年早期会出现与癌症相关的创伤后应激。医疗保健提供者应筛查儿童癌症幸存者是否存在创伤后应激，以便进行转诊，为幸存者提供进一步的帮助。
