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儿童和青少年癌症后创伤后成长的相关因素:系统评价和荟萃分析。

Correlates of post-traumatic growth following childhood and adolescent cancer: A systematic review and meta-analysis.

机构信息

School of Psychology, University of Adelaide, Adelaide, South Australia, Australia.

School of Psychology, Social Work & Social Policy, University of South Australia, Adelaide, South Australia, Australia.

出版信息

Psychooncology. 2018 Apr;27(4):1100-1109. doi: 10.1002/pon.4577. Epub 2017 Nov 23.

Abstract

OBJECTIVE

A growing number of children and adolescents are experiencing and surviving cancer. This review aims to identify the demographic, medical, and psychosocial correlates of perceived post-traumatic growth in individuals of any age who were affected by paediatric cancer. Findings will highlight protective factors that may facilitate post-traumatic growth, allowing for directed social support, intervention, and follow-up care.

METHODS

A systematic search based on the key concepts "post-traumatic growth," "neoplasms," and "paediatric" retrieved 905 records from online databases: Embase, Ovid MEDLINE, PILOTS: Published International Literature on Traumatic Stress, PsycINFO, and Web of Science. Eligible studies were appraised as excellent quality with a high level of interrater reliability. The results of 18 studies were synthesised.

RESULTS

After the removal of outliers, post-traumatic growth shared small, negative associations with time since diagnosis (r = -0.14) and time since treatment completion (r = -0.19), and small, positive associations with age at diagnosis (r = 0.20), age at survey (r = 0.17), post-traumatic stress symptoms (r = 0.11), and social support (r = 0.25). Post-traumatic growth was positively and moderately associated with optimism (r = 0.31).

CONCLUSIONS

Several findings were consistent with a comparable meta-analysis in adult oncology populations. Targeted social support, clinical intervention, and education may facilitate post-traumatic growth. Longitudinal research in individuals affected by childhood and adolescent cancer would allow an examination of the effects of predictive variables on post-traumatic growth over time.

摘要

目的

越来越多的儿童和青少年正在经历和战胜癌症。本综述旨在确定任何年龄段受儿童癌症影响的个体的人口统计学、医学和心理社会因素与创伤后成长的相关性。研究结果将突出保护因素,这些因素可能促进创伤后成长,从而提供有针对性的社会支持、干预和随访护理。

方法

根据“创伤后成长”、“肿瘤”和“儿科”这三个关键概念进行系统检索,从在线数据库(Embase、Ovid MEDLINE、PILOTS:创伤应激发布国际文献、PsycINFO 和 Web of Science)中检索到 905 条记录。采用优秀质量评估标准对合格研究进行评估,并具有较高的评分者间可靠性。综合了 18 项研究的结果。

结果

去除离群值后,创伤后成长与诊断后时间(r=-0.14)和治疗完成后时间(r=-0.19)呈小的负相关,与诊断时年龄(r=0.20)、调查时年龄(r=0.17)、创伤后应激症状(r=0.11)和社会支持(r=0.25)呈小的正相关。创伤后成长与乐观(r=0.31)呈正相关且中度相关。

结论

多项研究结果与成人肿瘤学人群的一项类似荟萃分析一致。有针对性的社会支持、临床干预和教育可能促进创伤后成长。对受儿童和青少年癌症影响的个体进行纵向研究,可以考察随着时间的推移,预测变量对创伤后成长的影响。

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