Kountz-Edwards Samantha, Aoki Christa, Gannon Caitlin, Gomez Rowena, Cordova Matthew, Packman Wendy
Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, CA, USA.
Chronic Illn. 2017 Dec;13(4):262-274. doi: 10.1177/1742395317690034. Epub 2017 Jan 30.
Background Juvenile dermatomyositis (JDM), a rare autoimmune disease, accounts for more than 80% of idiopathic inflammatory myopathy childhood cases, making it the most common idiopathic inflammatory myopathy among children. The average age of onset is approximately 7 years and commonly leads a chronic course. Symptoms of JDM include cutaneous features (Gottron's rash, heliotrope rash, or nail fold capillary changes), musculoskeletal features, calcinosis and lipodystrophy (a symmetrical deficit of subcutaneous fatty tissue), and acanthosis (thickening of the skin). Despite improvement in treatment regimens and the lowering of mortality rates, some children still lose their lives to JDM. This study assessed the effects of caring for a child diagnosed with JDM on the family system. Methods Participants included 36 mothers and 3 fathers of a child diagnosed with JDM. Parents were administered self-report measures, which assessed the overall family functioning (PedsQL-Family Impact Module), and the parents' mood and level of distress (profile of mood states). Additionally, parents were administered a semi-structured interview that included background information, psychosocial information, and sources of support. Results and conclusion Families of children with JDM reported difficulties in family functioning, communication problems, and an increased number of conflicts. Parents appeared to be experiencing higher than average levels of worry, worse physical functioning, and family relationships when compared to normative populations. Parents would benefit from psychosocial support due to the many challenges associated with caring for a child with JDM.
背景 幼年皮肌炎(JDM)是一种罕见的自身免疫性疾病,在儿童特发性炎性肌病病例中占比超过80%,使其成为儿童中最常见的特发性炎性肌病。平均发病年龄约为7岁,通常病程呈慢性。JDM的症状包括皮肤表现(Gottron疹、向阳疹或甲襞毛细血管改变)、肌肉骨骼表现、钙质沉着和脂肪营养不良(皮下脂肪组织的对称性缺失)以及棘皮症(皮肤增厚)。尽管治疗方案有所改进且死亡率有所降低,但仍有一些儿童死于JDM。本研究评估了照顾一名被诊断为JDM的儿童对家庭系统的影响。方法 参与者包括36名被诊断为JDM儿童的母亲和3名父亲。对父母进行了自我报告测量,评估整体家庭功能(儿童生活质量量表-家庭影响模块)以及父母的情绪和痛苦程度(情绪状态剖面图)。此外,对父母进行了半结构化访谈,内容包括背景信息、心理社会信息和支持来源。结果与结论 JDM患儿的家庭报告了家庭功能方面的困难、沟通问题以及冲突数量增加。与正常人群相比,父母似乎经历着高于平均水平的担忧、更差的身体功能和家庭关系。由于照顾患有JDM的儿童存在诸多挑战,父母将受益于心理社会支持。