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时间能治愈所有创伤吗?一项关于儿童癌症幸存者父母及丧亲父母创伤后应激症状发展的纵向研究。

Does time heal all wounds? A longitudinal study of the development of posttraumatic stress symptoms in parents of survivors of childhood cancer and bereaved parents.

作者信息

Ljungman Lisa, Hovén Emma, Ljungman Gustaf, Cernvall Martin, von Essen Louise

机构信息

Clinical Psychology in Healthcare, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.

Pediatric Oncology, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

出版信息

Psychooncology. 2015 Dec;24(12):1792-8. doi: 10.1002/pon.3856. Epub 2015 Jun 4.

Abstract

BACKGROUND

A lack of longitudinal studies has hampered the understanding of the development of posttraumatic stress symptoms (PTSS) in parents of children diagnosed with cancer. This study examines level of PTSS and prevalence of posttraumatic stress disorder (PTSD) from shortly after diagnosis up to 5 years after end of treatment or child's death, in mothers and fathers.

METHODS

A design with seven assessments (T1-T7) was used. T1-T3 were administered during treatment and T4-T7 after end of treatment or child's death. Parents (N = 259 at T1; n = 169 at T7) completed the PTSD Checklist Civilian Version. Latent growth curve modeling was used to analyze the development of PTSS.

RESULTS

A consistent decline in PTSS occurred during the first months after diagnosis; thereafter the decline abated, and from 3 months after end of treatment only minimal decline occurred. Five years after end of treatment, 19% of mothers and 8% of fathers of survivors reported partial PTSD. Among bereaved parents, corresponding figures were 20% for mothers and 35% for fathers, 5 years after the child's death.

CONCLUSIONS

From 3 months after end of treatment the level of PTSS is stable. Mothers and bereaved parents are at particular risk for PTSD. The results are the first to describe the development of PTSS in parents of children diagnosed with cancer, illustrate that end of treatment is a period of vulnerability, and that a subgroup reports PTSD 5 years after end of treatment or child's death.

摘要

背景

缺乏纵向研究阻碍了我们对被诊断患有癌症儿童的父母创伤后应激症状(PTSS)发展情况的理解。本研究考察了从诊断后不久直至治疗结束后5年或孩子死亡后,父母中PTSS的水平以及创伤后应激障碍(PTSD)的患病率,涉及母亲和父亲。

方法

采用了包含七次评估(T1 - T7)的设计。T1 - T3在治疗期间进行,T4 - T7在治疗结束或孩子死亡后进行。父母(T1时N = 259;T7时n = 169)完成了平民版创伤后应激障碍检查表。使用潜在增长曲线模型分析PTSS的发展情况。

结果

诊断后的头几个月,PTSS持续下降;此后下降趋势减弱,从治疗结束3个月后仅出现极小幅度的下降。治疗结束5年后,存活儿童的母亲中有19%、父亲中有8%报告有部分创伤后应激障碍。在丧亲父母中,孩子死亡5年后,母亲和父亲的相应比例分别为20%和35%。

结论

从治疗结束3个月后,PTSS水平稳定。母亲和丧亲父母患创伤后应激障碍的风险尤其高。这些结果首次描述了被诊断患有癌症儿童的父母中PTSS的发展情况,表明治疗结束是一个易受伤害的时期,并且有一个亚组在治疗结束或孩子死亡5年后报告患有创伤后应激障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30f9/5033007/4d9a702848f6/PON-24-1792-g001.jpg

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