Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53726, USA.
Acad Pediatr. 2013 Mar-Apr;13(2):105-12. doi: 10.1016/j.acap.2012.11.005. Epub 2013 Feb 4.
First, we sought to determine if parents of children with cancer or a brain tumor had greater stress compared to parents of healthy children and to evaluate the correlates of stress among parents of children with cancer or brain tumors. Second, we sought to examine the relationship between perceived stress and symptoms of stress and how that relationship may differ for parents of children with cancer.
In-person, interviewer-assisted surveys were administered to 73 case dyads (children with cancer or a brain tumor and their parents) and 133 comparison dyads (children without health problems and their parents from a community sample). Descriptive analyses and multivariable logistic regressions were performed for case-comparison and case-only analyses to distinguish correlates of parental stress.
Parents of children with cancer exhibited higher levels of physiological symptoms of stress than parents of healthy children. Poor sleep quality and greater social stress (negative social interactions) were significant correlates of increased levels of stress in parents of children with cancer (odds ratio 4.23, 95% confidence interval 1.15-15.60; and odds ratio 1.07, 95% confidence interval 1.00-1.14, respectively). A subset of parents reported symptoms of stress but not perceived stress, and this discordance was more pronounced among cancer caregivers.
Implementation of screening tools that include symptoms of stress may help clinicians to comprehensively identify parents of children with cancer who are in need of additional services. Targeted stress-reduction interventions that address sleep quality and negative social interactions may mitigate the deleterious effects of caregiving, improving the psychosocial well-being of both parents and children with cancer.
首先，我们试图确定癌症或脑肿瘤患儿的父母是否比健康儿童的父母承受更大的压力，并评估癌症或脑肿瘤患儿父母压力的相关因素。其次，我们试图研究感知压力与压力症状之间的关系，以及这种关系如何因癌症患儿的父母而异。
对 73 例病例对照（患有癌症或脑肿瘤的儿童及其父母）和 133 例对照对照（来自社区样本的无健康问题的儿童及其父母）进行了面对面、访谈者协助的调查。对病例对照和病例仅分析进行描述性分析和多变量逻辑回归，以区分父母压力的相关因素。
癌症患儿的父母表现出比健康儿童的父母更高水平的生理压力症状。睡眠质量差和更大的社会压力（负面社会互动）是癌症患儿父母压力水平升高的显著相关因素（比值比 4.23，95%置信区间 1.15-15.60；比值比 1.07，95%置信区间 1.00-1.14）。一部分父母报告了压力症状，但没有感知到压力，而癌症护理人员的这种不和谐更为明显。
实施包括压力症状在内的筛查工具可能有助于临床医生全面识别需要额外服务的癌症患儿的父母。针对睡眠质量和负面社会互动的有针对性的减压干预措施可能会减轻照顾的负面影响，提高癌症患儿及其父母的心理健康。
