Children's Cancer Centre, Royal Children's Hospital, Melbourne, Australia.
J Palliat Med. 2010 Nov;13(11):1321-6. doi: 10.1089/jpm.2010.0037. Epub 2010 Oct 18.
To investigate patterns of grief and depression in a sample of parents whose child had died of cancer, and to examine factors related to burden of illness and end-of-life care as potential predictors of parental grief and depression outcomes.
Fifty-eight parents completed standardized self-report questionnaires measuring prolonged grief disorder (Inventory of Complicated Grief-Revised [ICG-R]) and depression (Beck Depression Inventory-Second Edition [BDI-II]) and participated in structured interviews designed to elicit their perceptions of their child's end-of-life care and burden of illness. The majority of participants were mothers (84%) and the mean length of time since child death was 4.5 (standard deviation [SD] = 2.4) years (range, 1.0-9.8 years).
Rates of prolonged grief disorder (PGD) were similar to those reported in other bereaved populations (10.3%); however, 41% of parents met diagnostic criteria for grief-related separation distress. Twenty-two percent of parents reported clinically significant depressive symptoms. Time since death and parental perception of the oncologist's care predicted parental grief symptoms but not depressive symptoms. Perceptions of the child's quality of life during the last month, preparedness for the child's death, and economic hardship also predicted grief and depression outcomes.
A minority of parents met criteria for PGD and depression, however, almost half the sample was experiencing significant separation distress associated with persistent longing and yearning for their child. Time since death is a significant predictor of parental psychological distress. This study also highlights the importance of end-of-life factors in parents' long-term adjustment and the need for optimal palliative care to ensure the best possible outcomes for parents.
调查一组因孩子死于癌症而悲痛欲绝的父母的悲伤和抑郁模式，并探讨与疾病负担和临终关怀相关的因素，这些因素可能是父母悲伤和抑郁结局的预测因素。
58 名家长完成了衡量延长悲伤障碍（修订后的复杂悲伤清单 [ICG-R]）和抑郁（贝克抑郁量表第二版 [BDI-II]）的标准化自我报告问卷，并参与了旨在了解其对孩子临终关怀和疾病负担看法的结构化访谈。大多数参与者是母亲（84%），自孩子去世以来的平均时间为 4.5（标准差 [SD] = 2.4）年（范围，1.0-9.8 年）。
延长悲伤障碍（PGD）的发生率与其他丧亲人群报告的发生率相似（10.3%）；然而，41%的父母符合与悲伤相关的分离障碍的诊断标准。22%的父母报告有临床显著的抑郁症状。死亡时间和父母对肿瘤医生护理的看法预测了父母的悲伤症状，但不能预测抑郁症状。儿童最后一个月的生活质量、对儿童死亡的准备情况和经济困难也预测了悲伤和抑郁的结果。
少数父母符合 PGD 和抑郁的标准，但几乎一半的样本经历了与持续渴望和怀念孩子相关的显著分离痛苦。死亡时间是父母心理困扰的一个重要预测因素。这项研究还强调了临终关怀因素在父母长期调整中的重要性，以及需要提供最佳的姑息治疗，以确保父母获得最佳结果。
