婴幼儿期创伤性脑损伤后照顾者的功能：父母的反应是否不同？
Caregiver functioning following early childhood TBI: do moms and dads respond differently?
机构信息
Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229-3039, USA.
出版信息
NeuroRehabilitation. 2010;27(1):63-72. doi: 10.3233/NRE-2010-0581.
INTRODUCTION
Research suggests that pediatric TBI results in injury-related stress and burden and psychological distress for parents. However, existing studies have focused almost exclusively on mothers, so that we know relatively little about the impact of childhood TBI on fathers.
SPECIFIC AIMS
The aims were to prospectively examine differences in maternal and paternal response to early childhood TBI over time relative to a comparison cohort of mothers and fathers of children with orthopedic injuries (OI).
METHODS
The concurrent cohort/prospective research design involved repeated assessments of children aged 3-6 years with TBI or OI requiring hospitalization and their families. Shortly after injury and at 6, 12, and 18 months post injury, parents of 48 children with TBI (11 severe and 37 moderate) and 89 with OI completed standardized assessments of injury-related stress and burden, parental distress, and coping strategies. Mixed models analyses and Generalized Estimating Equations examined differences in maternal versus paternal burden, distress, and coping over time. The analyses included interactions of parent sex with group (severe TBI, moderate TBI, OI) and time since injury, to examine the moderating effects of injury severity on parental response to injury over time.
RESULTS
Fathers were more likely than mothers to use denial to cope following moderate and severe TBI, but not OI. Conversely, mothers were more likely to prefer acceptance and emotion-focused strategies than fathers regardless of the type of injury. The use of active coping strategies varied as a function of injury type, parent sex, and time since injury. Fathers reported greater injury-related stress and distress than mothers over time, with pronounced differences in the severe TBI and OI groups.
CONCLUSIONS
Mothers and fathers appear to respond differently following TBI. The different types of responses may serve to exacerbate emerging family dysfunction.
简介
研究表明，儿科 TBI 会导致父母受伤相关的压力和负担以及心理困扰。然而，现有研究几乎仅关注母亲，因此我们对儿童 TBI 对父亲的影响知之甚少。
具体目标
本研究旨在前瞻性地考察与骨科损伤（OI）患儿的母亲和父亲的对照组相比，母亲和父亲对幼儿 TBI 的反应随时间的差异。
方法
采用同时进行的队列/前瞻性研究设计，对需要住院治疗的 3-6 岁患有 TBI 或 OI 的儿童及其家庭进行重复评估。在受伤后不久，以及受伤后 6、12 和 18 个月，48 名患有 TBI（11 名严重和 37 名中度）和 89 名患有 OI 的儿童的父母完成了标准化的伤后压力和负担、父母痛苦和应对策略评估。混合模型分析和广义估计方程考察了母亲和父亲在随时间变化的负担、痛苦和应对方面的差异。分析包括父母性别与组别（严重 TBI、中度 TBI、OI）和受伤后时间的交互作用，以检验损伤严重程度对父母随时间对伤后反应的调节作用。
结果
与母亲相比，父亲在中度和重度 TBI 后更有可能采用否认来应对，但在 OI 中并非如此。相反，无论受伤类型如何，母亲都比父亲更倾向于采用接受和情绪聚焦策略。应对策略的使用取决于受伤类型、父母性别和受伤后时间。父亲随时间报告的伤后压力和痛苦比母亲多，在严重 TBI 和 OI 组中差异更为明显。
结论
母亲和父亲在 TBI 后似乎有不同的反应。不同类型的反应可能会加剧新出现的家庭功能障碍。
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