Haematology-Oncology Division, Department of Paediatrics, University Hospital of Padova, Italy.
Psychooncology. 2013 Jun;22(6):1266-72. doi: 10.1002/pon.3132. Epub 2012 Jul 9.
To assess post-traumatic stress symptoms (PTSS) in mothers of children over 2 years of leukemia treatment, to identify possible early family and child predictors of this symptomatology and to indicate the temporal trajectory of PTSS.
Participants were 76 Italian mothers (mean age = 37.30 years; SD = 6.07) of children receiving treatment for acute lymphoblastic (n = 69) or myeloid (n = 7) leukemia. Mothers had 12.05 years of education (SD = 3.87), and their incomes were average (52.1%), high (26%) and low (21.9%) for Italian norms, never in poverty. The pediatric patients with leukemia were equally distributed by gender with their mean age of 7.10 years (SD = 4.18). Post-traumatic stress symptoms were measured by a 17-item checklist. Scales assessing anxiety, depression, physical (Brief Symptom Inventory 18) and cognitive functioning (Problem Scale), and life evaluation were also used. There were five assessment points: 1 week (T1), 1 month (T2), 6 months (T3), 12 months (T4) and 24 months post-diagnosis (T5).
The main results indicated moderate presence of clinical PTSS (≥9 symptoms: 24% at T2, 18% at T3, 16% at T4 and 19% at T5) that remained stable across time points, whereas Brief Symptom Inventory 18 Global score decreased and life evaluation improved. A series of hierarchical regression models identified cognitive functioning early after the diagnosis as the best predictive factor of PTSS across time points.
Specific psychological interventions could be devised for mothers at risk for short and long-term PTSS just after the diagnosis.
评估白血病治疗 2 年以上儿童母亲的创伤后应激症状(PTSS),确定该症状学的可能早期家庭和儿童预测因素,并指出 PTSS 的时间轨迹。
参与者为 76 名意大利母亲(平均年龄=37.30 岁;SD=6.07),其子女正在接受急性淋巴细胞性(n=69)或髓性(n=7)白血病治疗。母亲的受教育年限为 12.05 年(SD=3.87),其收入水平平均(52.1%)、较高(26%)和较低(21.9%),符合意大利标准,从未处于贫困状态。白血病儿科患者按性别平均分布,平均年龄为 7.10 岁(SD=4.18)。创伤后应激症状通过 17 项清单进行测量。还使用了焦虑、抑郁、身体(Brief Symptom Inventory 18)和认知功能(Problem Scale)评估量表以及生活评估量表。有五个评估点:诊断后 1 周(T1)、1 个月(T2)、6 个月(T3)、12 个月(T4)和 24 个月(T5)。
主要结果表明存在中度临床 PTSS(≥9 项症状:T2 时为 24%,T3 时为 18%,T4 时为 16%,T5 时为 19%),且随时间点稳定,而 Brief Symptom Inventory 18 总得分下降,生活评估改善。一系列层次回归模型确定,诊断后早期的认知功能是随时间点预测 PTSS 的最佳因素。
可针对诊断后短时间和长时间内存在 PTSS 风险的母亲制定特定的心理干预措施。