小儿癌症患者父母的创伤后应激症状：一项中介分析
Posttraumatic Stress Symptoms in Parents of Pediatric Cancer Patients: A Mediational Analysis.
作者信息
Harper Felicity W K, Peterson Amy M, Albrecht Terrance L, Taub Jeffrey W, Phipps Sean, Penner Louis A
机构信息
Karmanos Cancer Institute, Population Studies and Disparities Research Program, Detroit, MI, USA ; Wayne State University School of Medicine, Department of Oncology, Detroit, MI, USA.
Karmanos Cancer Institute, Population Studies and Disparities Research Program, Detroit, MI, USA.
出版信息
J Trauma Stress Disord Treat. 2014;3(4). doi: 10.4172/2324-8947.1000133.
OBJECTIVE
Prior research finds that anxiety and depression among parents of pediatric cancer patients are associated with posttraumatic stress symptoms in response to children's cancer. This study examined whether this relationship is mediated by parents' negative affective reactions in response to their children's cancer-related treatment procedures.
METHODS
Participants were parents of 101 patients within six months of diagnosis who had completed at least two treatment-related procedures. Parents completed measures of trait anxiety and depression at baseline and posttraumatic stress symptoms at 3-month follow-up assessment. On the day of each treatment procedure, parents completed measures of state anxiety immediately before and negative mood and distress immediately after the procedure.
RESULTS
Trait anxiety was positively associated with state anxiety immediately before procedures and negative mood after procedures. Depression was positively associated with state anxiety immediately before procedures and negative mood and distress after procedures. Both trait anxiety and depression were positively associated with posttraumatic stress symptoms at 3-months follow-up. Parent state anxiety, negative mood, and distress partially mediated the effects of trait anxiety and/or depression on posttraumatic stress symptoms. Controlling for child age and social desirability did not affect these relationships.
CONCLUSIONS
Parents' trait anxiety and depression may influence cancer-related posttraumatic stress partially through their effect on parents' negative affective reactions at the time of their child's treatment procedures. These findings provide a more nuanced understanding of how parents' affect in response to procedures contributes to parent posttraumatic stress and suggest that interventions targeting treatment-related affective reactions of parents with high trait anxiety and/or depression may reduce the risk for longer-term distress and posttraumatic stress symptoms.
目的
先前的研究发现，儿科癌症患者父母的焦虑和抑郁与因孩子患癌而产生的创伤后应激症状有关。本研究考察了这种关系是否由父母对孩子癌症相关治疗程序的负面情绪反应所介导。
方法
参与者为101名患者的父母，这些患者在诊断后六个月内，且已完成至少两次与治疗相关的程序。父母在基线时完成特质焦虑和抑郁量表的测量，并在3个月的随访评估时完成创伤后应激症状量表的测量。在每次治疗程序当天，父母在程序开始前立即完成状态焦虑量表的测量，并在程序结束后立即完成负面情绪和痛苦量表的测量。
结果
特质焦虑与程序开始前的状态焦虑以及程序后的负面情绪呈正相关。抑郁与程序开始前的状态焦虑以及程序后的负面情绪和痛苦呈正相关。特质焦虑和抑郁在3个月随访时均与创伤后应激症状呈正相关。父母的状态焦虑、负面情绪和痛苦部分介导了特质焦虑和/或抑郁对创伤后应激症状的影响。控制孩子年龄和社会期望性并不影响这些关系。
结论
父母的特质焦虑和抑郁可能部分通过对孩子治疗程序时父母负面情绪反应的影响，进而影响与癌症相关的创伤后应激症状。这些发现为父母对治疗程序的情绪反应如何导致父母创伤后应激症状提供了更细致入微的理解，并表明针对特质焦虑和/或抑郁程度高的父母的治疗相关情绪反应的干预措施，可能会降低长期痛苦和创伤后应激症状的风险。
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