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婴儿或儿童死亡后父母的急性病、卫生服务利用和用药变化。

Acute Illnesses, Use of Health Services, and Changes in Medication Among Parents After Infant or Child Death.

机构信息

Dorothy Brooten is a professor, JoAnne M. Youngblut is Dr Herbert and Nicole Wertheim Professor, Rosa M. Roche is a clinical assistant professor, and Carmen Caicedo is an assistant professor, Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami, Florida. Teresa Del-Moral is an associate professor, Department of Neonatology, and G. Patricia Cantwell is the division chief of pediatric critical care medicine and medical director, pediatric palliative medicine, Holtz Children's Hospital, Miller School of Medicine, University of Miami, Miami, Florida. Balagangadhar R. Totapally is a clinical professor, Florida International University and chief, Division of Critical Care Medicine, Nicklaus Children's Hospital, Miami, Florida.

出版信息

Am J Crit Care. 2019 May;28(3):193-201. doi: 10.4037/ajcc2019572.

Abstract

BACKGROUND

The death of an infant or child has been described as the most stressful life event, but few reports exist on the effects on parents' physical health in the year after the death.

OBJECTIVE

To examine acute illnesses, use of health services, and medication changes among parents from 3 racial/ethnic groups 1 to 13 months after the death of an infant or child in the neonatal intensive care unit or pediatric intensive care unit.

METHODS

In a longitudinal study, 96 parents (41% black, 32% Hispanic, 27% white) of deceased infants or children were recruited from 4 children's hospitals and death records. Parents reported demographic information, acute illnesses, health services used, and medication changes 1 to 13 months after the death. Descriptive statistics and 1-way analysis of variance were used to analyze the data.

RESULTS

Seventy mothers (age, mean [SD], 35.9 [7.13] years) and 26 fathers (age, 39.0 [7.37] years) participated; 56% of mothers and 42% of fathers had preexisting health problems before the death. Morbidity was greatest in the first 6 months, was relatively quiescent in months 7 through 10, and increased in months 11 through 13. Mothers reported 363 acute illnesses, 16 hospitalizations, and 124 medication changes. Morbidity rates and medication changes for fathers followed similar patterns but with lower frequency.

CONCLUSION

After the death of an infant or child, interventions for parents, especially parents with chronic health problems, are best targeted on illness prevention and mental health in months 1 to 6 and 11 to 13 following the death.

摘要

背景

婴儿或儿童的死亡被描述为最具压力的生活事件,但很少有报告描述死亡后一年内父母身体健康的影响。

目的

检查 3 个种族/族裔群体的父母在新生儿重症监护病房或儿科重症监护病房中婴儿或儿童死亡后 1 至 13 个月内的急性疾病、使用卫生服务和药物变化。

方法

在一项纵向研究中,从 4 家儿童医院和死亡记录中招募了 96 名死亡婴儿或儿童的父母(41%为黑人,32%为西班牙裔,27%为白人)。父母报告了人口统计学信息、急性疾病、使用的卫生服务以及死亡后 1 至 13 个月的药物变化。使用描述性统计和单向方差分析来分析数据。

结果

有 70 名母亲(年龄,平均值[标准差],35.9[7.13]岁)和 26 名父亲(年龄,39.0[7.37]岁)参加了研究;56%的母亲和 42%的父亲在死亡前存在健康问题。发病在头 6 个月最高,在第 7 至 10 个月相对静止,在第 11 至 13 个月增加。母亲报告了 363 次急性疾病、16 次住院和 124 次药物变化。父亲的发病率和药物变化模式相似,但频率较低。

结论

婴儿或儿童死亡后,针对父母的干预措施,特别是针对有慢性健康问题的父母,最好在死亡后 1 至 6 个月和 11 至 13 个月针对疾病预防和心理健康进行。

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