Rabineau Kristen M, Mabe P Alex, Vega Roger A
Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta, GA 30912, USA.
J Pediatr Hematol Oncol. 2008 May;30(5):358-65. doi: 10.1097/MPH.0b013e318168e76b.
The experience of childhood cancer can be one of the most severe stressors that parents endure. Studies using illness-specific measures of parental stress indicate that moderate-to-severe parenting stress is quite common in the first year of childhood cancer treatment, and as many as 5% to 10% of these parents go on to develop posttraumatic stress disorder. This review of the literature suggested that although parenting stress symptoms may be relatively transitory for most parents dealing with childhood cancer, the impact of these stress symptoms on parent and child functioning is substantive and worthy of therapeutic attention. The stresses entailed in childhood cancer should be viewed as complex and varied across stages of diagnosis and treatment. Factors associated with increased risk of parental posttraumatic stress symptoms include poor social support, adverse experience with invasive procedures, negative parental beliefs about the child's illness and/or associated treatment, and trait anxiety. For those parents with risk factors that might forebode more severe and enduring stress reactions to their children's cancer, therapeutic strategies are proposed to ameliorate their stress and reduce the development and/or maintenance of posttraumatic stress symptoms.
儿童癌症经历可能是父母所承受的最严重压力源之一。使用针对疾病的父母压力测量方法的研究表明,在儿童癌症治疗的第一年,中度至重度的育儿压力相当普遍,多达5%至10%的此类父母会继而患上创伤后应激障碍。对文献的这项综述表明,尽管对于大多数应对儿童癌症的父母来说,育儿压力症状可能相对短暂,但这些压力症状对父母和孩子功能的影响是实质性的,值得治疗关注。儿童癌症所带来的压力应被视为在诊断和治疗阶段复杂且多样。与父母创伤后应激症状风险增加相关的因素包括社会支持不足、侵入性程序带来的不良体验、父母对孩子疾病和/或相关治疗的负面信念以及特质焦虑。对于那些具有可能预示对孩子癌症产生更严重且持久压力反应的风险因素的父母,提出了治疗策略以减轻他们的压力,并减少创伤后应激症状的发展和/或持续存在。