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理解儿科癌症患者及其父母长期心理社会适应差异:个体差异资源模型。

Understanding differences in the long-term psychosocial adjustment of pediatric cancer patients and their parents: an individual differences resources model.

机构信息

Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, MI, USA.

Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA.

出版信息

Transl Behav Med. 2019 May 16;9(3):514-522. doi: 10.1093/tbm/ibz025.

Abstract

The experience of childhood cancer is a major life stressor for children and their parents. There is substantial variability among pediatric cancer patients and their parents in their ability to cope with the cancer. Although other models typically focus on the psychological resources families use to broadly cope with a diagnosis of pediatric cancer, we present a model that focuses specifically how parents and children cope with the stress of invasive and often painful treatment episodes. Our resources model is further distinct with its focus on individual differences in personal (e.g., personality traits) and social (e.g., social support) resources and the role these differences may play in psychosocial adjustment of families confronting pediatric cancer. We use findings from the broader pediatric cancer research literature and our own 15-year program of research on individual differences in psychological resources and parents and children's responses to treatment episodes to provide empirical support for our model. Support was found for the six premises of the model: (a) parent resources influence their longer-term psychosocial adjustment, (b) parent resources influence children's responses to treatment episodes, (c) parent resources indirectly influence their longer-term psychosocial adjustment through their responses to treatment episodes, (d) children's personal resources influence how parent responses to treatment episodes, (e) children's resources influence their longer-term psychosocial adjustment, and (f) children's resources indirectly influence their longer-term psychosocial adjustment through their responses to treatment episodes. Understanding how the availability of resources influences parents and children confronting cancer provides a foundation for future research on individual differences in resources and offers other avenues through which clinicians can assess and treat families at risk for poor psychosocial adjustment during treatment and in their life beyond cancer treatments.

摘要

儿童癌症经历是儿童及其父母的主要生活应激源。在应对癌症的能力方面,儿科癌症患者及其父母存在很大的个体差异。尽管其他模型通常侧重于家庭用于广泛应对儿科癌症诊断的心理资源,但我们提出的模型则专门关注父母和孩子如何应对侵袭性且通常是痛苦的治疗过程的压力。我们的资源模型进一步与众不同,其重点是个人(例如,个性特征)和社会(例如,社会支持)资源中的个体差异,以及这些差异在面临儿科癌症的家庭的心理社会调整中可能发挥的作用。我们利用更广泛的儿科癌症研究文献中的发现以及我们自己关于心理资源以及父母和孩子对治疗过程的反应的个体差异的 15 年研究计划,为我们的模型提供了实证支持。该模型的六个前提得到了支持:(a)父母的资源会影响其长期的心理社会调整,(b)父母的资源会影响孩子对治疗过程的反应,(c)父母的资源通过其对治疗过程的反应间接影响其长期的心理社会调整,(d)孩子的个人资源会影响父母对治疗过程的反应,(e)孩子的资源会影响其长期的心理社会调整,(f)孩子的资源通过其对治疗过程的反应间接影响其长期的心理社会调整。了解资源的可用性如何影响面对癌症的父母和孩子,为未来关于资源个体差异的研究提供了基础,并为临床医生提供了其他途径,以评估和治疗在治疗期间和癌症治疗结束后可能面临不良心理社会调整风险的家庭。

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