Stremler Robyn, Haddad Summer, Pullenayegum Eleanor, Parshuram Christopher
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada; The Hospital for Sick Children (SickKids), Toronto, Canada.
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada; The Hospital for Sick Children (SickKids), Toronto, Canada.
J Pediatr Nurs. 2017 May-Jun;34:36-43. doi: 10.1016/j.pedn.2017.01.012. Epub 2017 Mar 6.
Parents of children in pediatric intensive care units (PICUs) are subjected to significant psychological stress. The purpose of this study was to determine the prevalence of, and factors associated with anxiety, depressive symptoms and decisional conflict in parents of children hospitalized in the PICU. The study employed a descriptive, cross-sectional design to investigate the psychological status of 118 parents of 91 children (74 mothers and 44 fathers) admitted to the PICU, using measures of anxiety (STAI), depression (CES-D), and decisional conflict (DCS). Using hospital data and self-administered questionnaires, information on child and parent characteristics and psychological outcomes were collected. Objective measures of parental sleep also were examined using actigraphy and sleep diaries. The research findings indicated that 24% of parents achieved scores characteristic of severe anxiety. Proportions of parents with symptoms indicative of major depression and significant decisional conflict were 51% and 26% respectively. For all psychological outcomes, higher levels of social support were protective. Inconsistency in sleep schedule and sleep location affected psychological outcomes and are possible targets for future interventions. Given evidence that parents of children admitted to the PICU are at risk for developing post-traumatic stress symptoms, future studies should examine the effects of hospitalization on long-term parental psychological outcomes. Screening for those at risk and implementing interventions to promote coping strategies and reduce decisional conflict may be beneficial. Pediatric nurses have a critical role in assessing parents' psychological distress and promoting family health during a child's hospitalization.
儿科重症监护病房（PICU）中患儿的父母承受着巨大的心理压力。本研究的目的是确定入住PICU的患儿父母中焦虑、抑郁症状及决策冲突的发生率及其相关因素。该研究采用描述性横断面设计，通过焦虑量表（STAI）、抑郁量表（CES-D）和决策冲突量表（DCS），对91名患儿的118名父母（74名母亲和44名父亲）的心理状况进行调查。利用医院数据和自行填写的问卷，收集了有关儿童和父母特征以及心理结果的信息。还使用活动记录仪和睡眠日记对父母的睡眠客观指标进行了检测。研究结果表明，24%的父母焦虑得分达到重度焦虑水平。有重度抑郁症状和显著决策冲突的父母比例分别为51%和26%。对于所有心理结果而言，更高水平的社会支持具有保护作用。睡眠时间表和睡眠地点的不一致会影响心理结果，可能是未来干预的目标。鉴于有证据表明入住PICU的患儿父母有患创伤后应激症状的风险，未来的研究应考察住院治疗对父母长期心理结果的影响。对有风险的人群进行筛查，并实施干预措施以促进应对策略和减少决策冲突可能会有所帮助。儿科护士在评估父母的心理困扰以及在患儿住院期间促进家庭健康方面起着关键作用。
