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新诊断出患癌儿童的父母所面临的急性压力。

Acute stress in parents of children newly diagnosed with cancer.

作者信息

Patiño-Fernández Anna Maria, Pai Ahna L H, Alderfer Melissa, Hwang Wei-Ting, Reilly Anne, Kazak Anne E

机构信息

Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

出版信息

Pediatr Blood Cancer. 2008 Feb;50(2):289-92. doi: 10.1002/pbc.21262.

Abstract

OBJECTIVE

Acute Stress Disorder (ASD) and subclinical symptoms of acute stress (SAS) may be a useful framework for understanding the psychological reactions of mothers and fathers of children newly diagnosed with a pediatric malignancy.

PATIENTS AND METHODS

Mothers (N = 129) and fathers (N = 72) of 138 children newly diagnosed with cancer completed questionnaires assessing acute distress, anxiety, and family functioning. Demographic data were also gathered. Inclusion criteria were: a confirmed diagnosis of a pediatric malignancy in a child under the age of 18 years without prior chronic or life threatening illness and fluency in English or Spanish.

RESULTS

Descriptive statistics and multiple linear regressions were used to examine predictors of SAS. Fifty-one percent (N = 66) of mothers and 40% (N = 29) of fathers met DSM-IV diagnostic criteria for ASD. The majority of the sample reported experiencing at least one SAS. General anxiety, but not family functioning, was a strong predictor of SAS in both mothers and fathers even after controlling for demographic characteristics.

CONCLUSIONS

Immediately following their child's diagnosis of cancer, most mothers and fathers experience SAS, with a subsample meeting criteria for ASD. More anxious parents are at heightened risk of more intense reactions. The findings support the need for evidence-based psychosocial support at diagnosis and throughout treatment for families who are at risk for acute distress reactions.

摘要

目的

急性应激障碍(ASD)和急性应激亚临床症状(SAS)可能是理解新诊断患有小儿恶性肿瘤患儿的父母心理反应的有用框架。

患者与方法

138名新诊断患有癌症患儿的母亲(N = 129)和父亲(N = 72)完成了评估急性痛苦、焦虑和家庭功能的问卷。还收集了人口统计学数据。纳入标准为:确诊一名18岁以下儿童患有小儿恶性肿瘤,且此前无慢性或危及生命的疾病,并且英语或西班牙语流利。

结果

使用描述性统计和多元线性回归来检验SAS的预测因素。51%(N = 66)的母亲和40%(N = 29)的父亲符合DSM-IV ASD诊断标准。大多数样本报告至少经历过一次SAS。即使在控制了人口统计学特征之后,一般焦虑而非家庭功能仍是母亲和父亲SAS的强预测因素。

结论

在孩子被诊断患有癌症后,大多数母亲和父亲会经历SAS,其中一小部分符合ASD标准。焦虑程度更高的父母出现更强烈反应的风险更高。这些发现支持了对于有急性痛苦反应风险的家庭,在诊断时及整个治疗过程中需要基于证据的心理社会支持。

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本文引用的文献

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Fathers and the well-child visit.父亲与健康儿童检查
Pediatrics. 2006 Apr;117(4):e637-45. doi: 10.1542/peds.2005-1612.
2
The medical traumatic stress toolkit.
CNS Spectr. 2006 Feb;11(2):137-42. doi: 10.1017/s1092852900010671.
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An integrative model of pediatric medical traumatic stress.儿童医学创伤应激的综合模型。
J Pediatr Psychol. 2006 May;31(4):343-55. doi: 10.1093/jpepsy/jsj054. Epub 2005 Aug 10.

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