Thompson Emma J, Anderson Vicki A, Hearps Stephen J C, McCarthy Maria C, Mihalopoulos Cathrine, Nicholson Jan M, Rayner Meredith, Muscara Frank
Melbourne School of Psychological Sciences, University of Melbourne.
Clinical Sciences, Murdoch Childrens Research Institute.
Health Psychol. 2017 Aug;36(8):779-786. doi: 10.1037/hea0000476. Epub 2017 May 22.
Posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms (PTSSs) are common for parents of children with life-threatening illnesses or injuries. The impact of these psychological sequelae on parents' personal use of health services is unknown. The present study aimed to investigate whether PTSS severity prospectively predicts increased health service utilization (HSU), and to examine the relative importance of other predisposing and enabling factors in predicting HSU.
The sample comprised 106 parents of children with various life threatening illnesses, who completed a resource use questionnaire at 19 months following their child's diagnosis or admission. HSU was assessed as reported general practitioner and psychologist visits.
Parent PTSS severity at 7 months following their child's diagnosis or hospital admission predicted being in higher service utilization categories in the following 12 months; as PTSS score increased, the odds of being in higher categories increased. Hierarchical ordinal logistic regression procedures indicated predisposing and enabling factors failed to further explain HSU.
These findings highlight the importance of PTSSs to HSU and are consistent with studies of samples experiencing other forms of trauma, such as war or natural disaster. Our results also suggest that an individuals' need, in terms of the severity of their PTSSs, appears most important in predicting their health service engagement. Although this is positive, the effectiveness of this service use, in terms of cost and outcomes, remains unclear. Further, despite the levels of PTSSs observed in the present sample, a minority of individuals sought psychosocial care. (PsycINFO Database Record
创伤后应激障碍(PTSD)和创伤后应激症状(PTSSs)在患有危及生命疾病或受伤儿童的父母中很常见。这些心理后遗症对父母个人使用医疗服务的影响尚不清楚。本研究旨在调查PTSS严重程度是否能前瞻性地预测医疗服务利用率(HSU)的增加,并检验其他易感因素和促成因素在预测HSU方面的相对重要性。
样本包括106名患有各种危及生命疾病儿童的父母,他们在孩子确诊或入院19个月后完成了一份资源使用问卷。HSU通过报告的全科医生和心理医生就诊次数进行评估。
孩子确诊或入院7个月时父母的PTSS严重程度预测了在接下来12个月中处于更高服务利用类别的可能性;随着PTSS分数的增加,处于更高类别的几率也增加。分层有序逻辑回归程序表明,易感因素和促成因素未能进一步解释HSU。
这些发现突出了PTSSs对HSU的重要性,并且与对经历其他形式创伤(如战争或自然灾害)样本的研究一致。我们的结果还表明,就PTSSs的严重程度而言,个体的需求在预测其医疗服务参与方面似乎最为重要。尽管这是积极的,但就成本和结果而言,这种服务使用的有效性仍不清楚。此外,尽管在本样本中观察到了PTSSs的水平,但少数个体寻求了心理社会护理。(PsycINFO数据库记录)