Ozono Shuichi, Saeki Toshinari, Mantani Tomoyuki, Ogata Akiko, Okamura Hitoshi, Yamawaki Shigeto
Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan.
Support Care Cancer. 2007 Mar;15(3):309-17. doi: 10.1007/s00520-006-0139-1. Epub 2006 Oct 5.
The purpose of this study was to investigate factors related to severe posttraumatic stress symptoms (PTSS) in adolescent survivors of childhood cancer and their parents.
Eighty-nine families (88 adolescent survivors of childhood cancer, 87 mothers, 72 fathers) completed a self-report questionnaire. Multivariate logistic regression analyses were performed using the following risk factors for severe PTSS: trait anxiety, family functioning, demographic and medical variables.
Severe PTSS were reported by 10.9% (n=9) of the survivors, 20.7% (n=18) of the mothers, and 22.2% (n=16) of the fathers. Preliminary analyses found significant correlations of PTSS between mother-survivor (Spearman's gamma=0.377, p<0.01) and mother-father (Spearman's gamma=0.483, p<0.01). The results of multivariate analyses indicated that higher trait anxiety [odds ratio (OR):1.16; 95% confidence interval (CI): 1.03-1.31; p<0.05] and having medical sequelae (OR: 5.85; 95% CI:1.02-33.72; p<0.05) were significant factors related to PTSS for survivors. For mothers, the significant PTSS-related factors were: higher trait anxiety (OR:1.13; 95% CI:1.04-1.23; p<0.01); 5- to 9-year interval from the first diagnosis to the present investigation, compared to more than a 10-year interval (OR: 6.45; 95% CI:1.67-24.89; p<0.01); and a relatively lower rating on "roles" of family functioning (OR: 12.34; 95% CI:1.11-136.97; p<0.05). For fathers, trait anxiety was a significant related factor (OR: 1.07; 95% CI:1.01-1.14; p<0.05).
Survivors and their parents suffered from PTSS after long interval from completion of treatment, and PTSS-related factors varied for each family member. Appropriate allocation of responsibility for family functioning may promote the ability to decrease PTSS, especially for mothers.
本研究的目的是调查儿童癌症青少年幸存者及其父母中与严重创伤后应激症状（PTSS）相关的因素。
八十九个家庭（88名儿童癌症青少年幸存者、87名母亲、72名父亲）完成了一份自我报告问卷。使用以下严重PTSS的风险因素进行多变量逻辑回归分析：特质焦虑、家庭功能、人口统计学和医学变量。
10.9%（n=9）的幸存者、20.7%（n=18）的母亲和22.2%（n=16）的父亲报告有严重PTSS。初步分析发现，母亲与幸存者之间（斯皮尔曼γ系数=0.377，p<0.01）以及母亲与父亲之间（斯皮尔曼γ系数=0.483，p<0.01）的PTSS存在显著相关性。多变量分析结果表明，较高的特质焦虑[比值比（OR）：1.16；95%置信区间（CI）：1.03 - 1.31；p<0.05]和有医学后遗症（OR：5.85；95%CI：1.02 - 33.72；p<0.05）是幸存者PTSS的重要相关因素。对于母亲来说，与PTSS相关的重要因素有：较高的特质焦虑（OR：1.13；95%CI：1.04 - 1.23；p<0.01）；从首次诊断到本次调查间隔5至9年，相比间隔超过10年（OR：6.45；95%CI：1.67 - 24.89；p<0.01）；以及在家庭功能的“角色”方面评分相对较低（OR：12.34；95%CI：1.11 - 136.97；p<0.05）。对于父亲来说，特质焦虑是一个重要相关因素（OR：1.07；95%CI：1.01 - 1.14；p<0.05）。
幸存者及其父母在治疗结束很长一段时间后患有PTSS，且与PTSS相关的因素因家庭成员而异。合理分配家庭功能责任可能会提高降低PTSS的能力，尤其是对母亲而言。
