Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee.
Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.
Pediatr Blood Cancer. 2017 Apr;64(4). doi: 10.1002/pbc.26279. Epub 2016 Nov 3.
Retinoblastoma is typically diagnosed in young children and may present unique parenting challenges. Qualitative research suggests that parents experience distress related to the initial diagnosis and treatment that subsequently resolves. The objectives were to systematically assess parenting stress over time in parents of young children with retinoblastoma and to examine associations between parenting stress and child outcomes.
Parents of children with retinoblastoma completed the Parenting Stress Index (PSI) during serial psychological assessments scheduled based on the child's age (6 months to 5 years). Caregivers of 92 patients (85.9% mothers) completed the assessments. Child outcomes included developmental functioning and parent-reported adaptive functioning.
At baseline and age 5, all subscales on the PSI were within normal limits, and most were significantly below normative means (i.e., demonstrating low levels of stress). All domains remained relatively stable over time. Associations between parenting stress and child outcomes were much stronger at age 5 than at baseline. Child-directed parenting stress was a small but significant contributor to declines in child functioning over time.
Parents of children with retinoblastoma report normal levels of parenting stress while their children are young. However, baseline parenting stress appears to contribute to changes in child functioning over time. Future studies should assess illness-related aspects of adjustment to further understand the parenting experience of young children with cancer and/or having a visually impaired child.
视网膜母细胞瘤通常在幼儿中诊断,可能会带来独特的育儿挑战。定性研究表明,父母在经历初始诊断和治疗时会感到痛苦,而这种痛苦随后会缓解。本研究的目的是系统评估患有视网膜母细胞瘤的幼儿父母的育儿压力随时间的变化,并探讨育儿压力与儿童结局之间的关系。
根据儿童年龄(6 个月至 5 岁),对患有视网膜母细胞瘤的儿童的父母进行了多次心理评估,在此期间,父母完成了父母压力指数(PSI)评估。92 名患者的照顾者(85.9%为母亲)完成了评估。儿童结局包括发育功能和父母报告的适应功能。
在基线和 5 岁时,PSI 的所有分量表均在正常范围内,且大多数明显低于正常值(即,表现出低水平的压力)。所有领域在整个研究期间都相对稳定。与基线相比,育儿压力与儿童结局之间的关联在 5 岁时更强。针对儿童的育儿压力是导致儿童功能随时间下降的一个小但显著的因素。
患有视网膜母细胞瘤的儿童的父母在孩子年幼时报告的育儿压力处于正常水平。然而,基线育儿压力似乎会随着时间的推移而导致儿童功能的变化。未来的研究应评估与疾病相关的适应方面,以进一步了解患有癌症的幼儿和/或视力受损儿童的育儿体验。