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韧性而非医疗因素:父母如何预测患病新生儿的生活质量。

Resilience Rather than Medical Factors: How Parents Predict Quality of Life of Their Sick Newborn.

机构信息

Division of Neonatology, Department of Pediatrics, CHU Sainte-Justine, University of Montreal, Montreal, Québec, Canada.

Division of Neonatology, Department of Pediatrics, McGill University Health Center, McGill University, Montreal, Québec, Canada.

出版信息

J Pediatr. 2018 Sep;200:64-70.e5. doi: 10.1016/j.jpeds.2018.05.025. Epub 2018 Jun 27.

Abstract

OBJECTIVE

To assess the influence of resiliency and stress on parental perspectives of the future quality of life (QOL) of neonatal intensive care unit (NICU) newborns at high risk of neurodevelopmental disability.

STUDY DESIGN

We conducted a prospective multicenter questionnaire study. Perspectives from parents of newborns at high risk of disability as per neonatal follow-up criteria were compared with a low-risk group consisting of parents of all other NICU newborns. Parental anxiety and resiliency, measured using Brief Symptom Inventory and Sense of Coherence scales, respectively, were associated with QOL projections.

RESULTS

Parents returned 129 (81%) questionnaires. Parents considering their newborn as currently sicker were more stressed (P = .011) and worried about future physical (P < .001) and mental (P < .001) health, QOL (P < .001), coping (P = .019), and financial (P < .001) and emotional (P = .002) impact on the family. Ooverall, there was no difference between parents of high-risk and low-risk newborns on QOL projections. Almost all parents projected a good future QOL. Less resilient parents projected more pain (P = .04), more financial (P = .019), and emotional (P = .031) impact on their family, and were 10 times more likely to predict that their newborn would remain chronically ill.

CONCLUSIONS

Parental projection of future QOL of NICU newborns is not associated with risk of disability. Most parents predict overall a good future QOL and focus more on familial impact. The Sense of Coherence scale may be used in clinical settings to identify less resilient parents.

摘要

目的

评估弹性和压力对有神经发育障碍高风险的新生儿重症监护病房(NICU)新生儿未来生活质量(QOL)的父母观点的影响。

研究设计

我们进行了一项前瞻性多中心问卷调查研究。根据新生儿随访标准,将高危残疾新生儿父母的观点与由所有其他 NICU 新生儿父母组成的低危组进行比较。分别使用简明症状量表和心理韧性量表测量父母的焦虑和韧性,与 QOL 预测值相关。

结果

父母共返回 129 份(81%)问卷。认为新生儿目前病情较重的父母压力更大(P=0.011),对未来身体(P<0.001)和精神健康(P<0.001)、QOL(P<0.001)、应对(P=0.019)、财务(P<0.001)和情绪(P=0.002)的影响更为担忧。整体而言,高危和低危新生儿父母在 QOL 预测值上没有差异。几乎所有的父母都对未来的 QOL 做出了良好的预测。弹性较低的父母更可能预测到他们的孩子会遭受更多的痛苦(P=0.04)、更多的财务(P=0.019)和情绪(P=0.031)影响,并更有可能预测他们的新生儿将长期患病。

结论

父母对 NICU 新生儿未来 QOL 的预测与残疾风险无关。大多数父母预测整体上有一个良好的未来 QOL,并更关注家庭的影响。心理韧性量表可在临床环境中用于识别弹性较低的父母。

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