School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Drive, Ottawa, ON, Canada.
Ottawa Hospital Research Institute, Ottawa, ON, Canada.
BMC Pediatr. 2019 Jul 1;19(1):215. doi: 10.1186/s12887-019-1587-3.
Parents of children with chronic illness have reported decreased psychological and physical quality of life (QoL) relative to parents of children without such illness, which may be associated with the extent of complexity involved in the caregiving role. Given that coping strategies have been reported to influence QoL, our goal was to synthesize existing research about the association between coping strategies and QoL in caregivers of children with chronic illness. We were particularly interested in whether coping strategies may mediate the association between caregiving complexity and QoL, or may modify the association.
We developed an electronic search strategy to identify relevant citations in Medline, EMBASE, PsycINFO and CINAHL. Two reviewers independently assessed retrieved citations against pre-specified inclusion criteria in two stages of screening. One reviewer abstracted data on study characteristics, methods to address confounding, measurement tools, risk of bias, and results with respect to associations of interest. A second reviewer validated extracted data. We summarized results narratively.
2602 citations were screened and 185 full-text articles reviewed. The 11 articles that met inclusion criteria addressed 5 diseases and included a total of 2155 caregivers. Ten of the 11 included studies were cross-sectional. We identified some evidence that coping was associated with QoL: in three studies, coping strategies considered to be adaptive were positively associated with psychological QoL while in one study, maladaptive strategies were negatively associated with psychological QoL. Only two studies considered coping as a potential mediating variable in the association between caregiving complexity and parental QoL, with inconsistent findings and challenges in interpreting cross-sectional associations. No studies considered coping as a moderating variable. The variability among instruments used to measure key constructs, particularly coping strategies, made it difficult to synthesize results.
We found that coping strategies may be associated with psychological QoL among parents of children with chronic illness. We also identified important research gaps related to the consistent and clear measurement of coping strategies and their prospective association with QoL. Understanding how coping strategies are associated with QoL is important to inform the development of interventions to support families of children with chronic illness.
与没有此类疾病的儿童的父母相比，患有慢性疾病儿童的父母报告其心理和身体健康生活质量（QoL）下降，这可能与护理角色的复杂程度有关。由于应对策略已被报道会影响 QoL，我们的目标是综合现有的关于慢性疾病儿童父母的应对策略与 QoL 之间关系的研究。我们特别关注应对策略是否可以调节护理复杂性与 QoL 之间的关联，或者是否可以改变这种关联。
我们制定了电子搜索策略，以在 Medline、EMBASE、PsycINFO 和 CINAHL 中识别相关引文。两名审查员在两个筛选阶段独立评估检索到的引文是否符合预定义的纳入标准。一名审查员提取关于研究特征、解决混杂因素的方法、测量工具、偏倚风险和与关注关联相关的结果的数据。第二名审查员验证提取的数据。我们以叙述性方式总结结果。
筛选出 2602 条引文，审阅了 185 篇全文文章。符合纳入标准的 11 篇文章涉及 5 种疾病，共纳入 2155 名照顾者。11 项纳入研究中有 10 项为横断面研究。我们发现一些证据表明应对与 QoL 相关：在三项研究中，被认为是适应性的应对策略与心理 QoL 呈正相关，而在一项研究中，适应性策略与心理 QoL 呈负相关。只有两项研究考虑了应对作为护理复杂性与父母 QoL 之间关联的潜在中介变量，其结果不一致，并且在解释横断面关联时存在挑战。没有研究考虑应对作为调节变量。用于测量关键构念（特别是应对策略）的工具的可变性使得难以综合结果。
我们发现应对策略可能与患有慢性疾病的儿童的父母的心理 QoL 相关。我们还确定了与应对策略的一致和明确测量及其与 QoL 的前瞻性关联相关的重要研究空白。了解应对策略与 QoL 的关系对于为慢性疾病儿童的家庭提供支持的干预措施的发展非常重要。
