Unit of Survivorship and
Unit of Survivorship and.
Pediatrics. 2019 May;143(5). doi: 10.1542/peds.2018-2605. Epub 2019 Apr 3.
Objective measures on parental distress after a child's cancer diagnosis are sparse. We examined the risk for first prescription of psychotropic medicine among parents of children with cancer compared with parents of children who were cancer free. In addition, we examined if sociodemographic and clinical characteristics are associated with risk of first prescription of psychotropic medication in parents of children with cancer.
We followed all parents of children with cancer ( = 6744) from the Danish Cancer Registry (1998-2014) using parents of matched children who were cancer free ( = 65 747) as a comparison. To identify vulnerable subgroups among parents of children with cancer, we followed all parents of children with cancer from the Childhood Cancer Registry (2003-2015; = 3290 parents). In Cox proportional hazard models, we estimated hazard ratios (HRs) for a first prescription of psychotropic medication according to cancer status of the child and sociodemographic and clinical risk factors.
Parents of children with cancer were at increased risk for a first prescription of psychotropic medication compared with parents of children who were cancer free up to 2 years after the diagnosis, the risk being highest in the first year (HR, 1.83 [95% confidence interval (CI), 1.66-2.01]). Parents of children with cancer, especially parents who lost their child, had an increased risk for a first prescription of hypnotics (HR, 6.91; 95% CI, 3.50-13.66) and anxiolytics (HR, 4.55, 95% CI, 1.57-13.17) in the first year after diagnosis.
Efforts should be made to ensure that medical teams are adequately educated to address stress responses in the parents.
儿童癌症诊断后父母的痛苦的客观衡量指标很少。我们研究了与无癌症儿童的父母相比,癌症儿童的父母首次开精神药物处方的风险。此外,我们还研究了社会人口统计学和临床特征是否与癌症儿童父母首次开精神药物处方的风险相关。
我们通过丹麦癌症登记处(1998-2014 年)对所有癌症儿童的父母(n=6744)进行了随访,并将无癌症儿童的父母(n=65747)作为对照组进行了比较。为了确定癌症儿童父母中的脆弱亚组,我们通过儿童癌症登记处(2003-2015 年;n=3290 名父母)对所有癌症儿童的父母进行了随访。在 Cox 比例风险模型中,我们根据儿童的癌症状况和社会人口统计学及临床危险因素,估计了首次开精神药物处方的风险比(HR)。
与无癌症儿童的父母相比,癌症儿童的父母在诊断后 2 年内首次开精神药物处方的风险增加,第一年的风险最高(HR,1.83 [95%置信区间(CI),1.66-2.01])。癌症儿童的父母,尤其是失去孩子的父母,在诊断后第一年首次开催眠药(HR,6.91;95%CI,3.50-13.66)和抗焦虑药(HR,4.55,95%CI,1.57-13.17)的风险增加。
应努力确保医疗团队得到充分教育,以解决父母的应激反应。