School of Psychology, University of Liverpool, Brownlow Hill, Liverpool, L69 3GB.
Psychological Services, Alder Hey Children's NHS Foundation Trust, Eaton Road, Liverpool, L12 2AP.
J Pediatr Psychol. 2019 Mar 1;44(2):229-237. doi: 10.1093/jpepsy/jsy079.
The purpose of this study was to examine the association between factors: guilt, shame, self-compassion, and parents' psychological adjustment to their child's burn injury.
Participants were 91 parents and primary caregivers (63 mothers, 25 fathers, 3 other) of 71 children recruited on the ward or at outpatient clinics during the first 8 weeks following their child's burn injury. In 20 cases, both parents participated, while for 51 children only one parent participated. Participants completed questionnaires which assessed adjustment (symptoms of depression, anxiety, and posttraumatic stress syndrome [PTSS]) as well as guilt, shame, and self-compassion.
Multilevel analysis indicated that feelings of guilt and shame were associated with poorer adjustment in parents, while parents who rated high in self-compassion reported fewer symptoms of depression and PTSS. Guilt and shame showed a differing pattern of effects with shame explaining more variance for anxiety and depression. Length of hospitalization predicted PTSS; however, the remaining injury factors (size of burn, requiring a skin graft) were unrelated to parental adjustment.
Health-care professionals should pay close attention to families' subjective injury experiences. Screening for psychological distress should be offered to all families regardless of the size and severity of the burn injury.
本研究旨在探讨以下因素之间的关联:内疚、羞耻、自我同情和父母对孩子烧伤的心理适应。
参与者为 91 名父母和主要照顾者(63 名母亲,25 名父亲,3 名其他),他们的孩子在烧伤后第 1 周到第 8 周期间在病房或门诊接受了招募。在 20 例中,父母双方都参与了,而在 51 例中只有一位父母参与了。参与者完成了评估父母调整(抑郁、焦虑和创伤后应激综合征[PTSS]症状)以及内疚、羞耻和自我同情的问卷。
多层次分析表明,内疚和羞耻感与父母的不良调整有关,而自我同情程度较高的父母报告抑郁和 PTSS 症状较少。羞耻感对焦虑和抑郁的解释方差更大,而羞耻感和内疚感的影响模式不同。住院时间预测了 PTSS;然而,其余的损伤因素(烧伤面积、需要植皮)与父母的调整无关。
医疗保健专业人员应密切关注家庭的主观损伤体验。无论烧伤的大小和严重程度如何,都应向所有家庭提供心理健康筛查。