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预测儿童重症住院后父母的创伤后应激、焦虑和抑郁。

Prediction of parental posttraumatic stress, anxiety and depression after a child's critical hospitalization.

机构信息

European University of Madrid, School of Biomedical Sciences, Department of Psychology, Spain.

Universidad Autónoma de Madrid, School of Psychology, Department of Biological and Health Psychology, Spain.

出版信息

J Crit Care. 2018 Jun;45:149-155. doi: 10.1016/j.jcrc.2018.02.006. Epub 2018 Feb 16.

Abstract

OBJECTIVE

To study the role of parental resilience, emotions accessed during admission and perceived stress in predicting the degree of parental posttraumatic stress disorder (PTSD), anxiety and depression symptoms after a child's treatment in intensive care.

METHODS

This was prospective longitudinal cohort study. A total of 196 parents of pediatric intensive care survivors completed questionnaires assessing resilience, perceived stress, emotions experienced during admission, 48h post-discharge (T0). Sociodemographic and medical data were also collected. Main outcomes were anxiety, depression and PTSD, three (T1) and six (T2) months later.

RESULTS

At T2, 23% of parents reported clinically significant levels of symptoms of PTSD, 21% reported moderate-severe anxiety, and 9% reported moderate-severe depression. These rates were not statistically different to rates at T1. Path analyses indicated that 47% of the variance in psychopathology symptoms at T2 could be predicted from the variables assessed at T0. Resilience was a strong negative predictor of psychopathology symptoms, but this effect was mostly indirect, mediated by the stress that parents perceive during their child's critical hospitalization.

CONCLUSIONS

Mobilizing coping in order to maintain resilience and to decrease their perceived stress levels could improve parents' mental health outcomes following their child's intensive care treatment.

摘要

目的

研究父母韧性、入院期间的情绪体验和感知压力在预测儿童重症监护治疗后父母创伤后应激障碍(PTSD)、焦虑和抑郁症状严重程度中的作用。

方法

这是一项前瞻性纵向队列研究。共有 196 名儿科重症监护幸存者的父母完成了评估韧性、感知压力、入院期间情绪体验的问卷,在出院后 48 小时(T0)进行评估。还收集了社会人口学和医疗数据。主要结局是焦虑、抑郁和 PTSD,分别在 3 个月(T1)和 6 个月(T2)后进行评估。

结果

在 T2,23%的父母报告 PTSD 症状达到临床显著水平,21%报告中度至重度焦虑,9%报告中度至重度抑郁。这些比率与 T1 的比率没有统计学差异。路径分析表明,T2 时心理病理学症状的 47%可以从 T0 评估的变量中预测出来。韧性是心理病理学症状的一个强有力的负向预测因素,但这种影响主要是间接的,是由父母在孩子重症住院期间感知到的压力介导的。

结论

为了维持韧性和降低感知压力水平,调动应对能力可以改善父母在孩子重症监护治疗后的心理健康结局。

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