Rensen Niki, Steur Lindsay M H, Schepers Sasja A, Merks Johannes H M, Moll Annette C, Grootenhuis Martha A, Kaspers Gertjan J L, van Litsenburg Raphaële R L
Pediatric Oncology-Hematology, Cancer Center Amsterdam, Amsterdam UMC, Emma Children's Hospital, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.
Eur J Psychotraumatol. 2019 Jul 22;10(1):1639312. doi: 10.1080/20008198.2019.1639312. eCollection 2019.
: Parents of children with cancer are at risk for sleep problems. If these problems persist, an important perpetuating factor might be ongoing parental distress. : The aim of this study is to assess the prevalence of sleep problems and the concurrence with distress in parents of children treated for cancer, and to identify predictors of this symptom clustering. : Parents completed the Medical Outcomes Study (MOS) Sleep Scale and Distress Thermometer for Parents (DT-P). Clinically relevant sleep problems were defined as a score >1SD above the norm and clinical distress as a thermometer score above the established cut-off of 4. Four parent categories were constructed: neither sleep problems nor distress; no distress but sleep problems; no sleep problems but distress; both sleep problems and distress. Predictive determinants (sociodemographic, medical, psychosocial) for each category were assessed with multilevel multinomial logistic regression. : Parents (202 mothers and 150 fathers) of 231 children with different cancers participated. Mean time since diagnosis was 3.3 ± 1.4 years (90% off-treatment). The prevalence of sleep problems was 37%. Fifty percent of parents reported neither sleep problems nor distress, 9% had only sleep problems, 13% only distress, and 28% reported both. Compared to parents without sleep problems or distress, parents who reported both were more likely to report parenting problems (OR 4.4, [2.2-9.1]), chronic illness (OR 2.8, [1.2-6.5]), insufficient social support (OR 3.7, [1.5-9.1]), pre-existent sleep problems (OR 6.2, [2.0-18.6]) and be female (OR 1.8, [1.1-4.2]). : Sleep problems are common in parents of children treated for cancer, and occur mostly in the presence of clinical distress. Future research must show which interventions are most effective in this group: mainly targeted at sleep improvement or with prominent roles for stress management or trauma processing.
患癌儿童的父母有睡眠问题的风险。如果这些问题持续存在,一个重要的促成因素可能是父母持续的痛苦。本研究的目的是评估接受癌症治疗儿童的父母中睡眠问题的患病率以及与痛苦的并发情况,并确定这种症状聚集的预测因素。父母完成了医学结局研究(MOS)睡眠量表和父母痛苦温度计(DT-P)。临床相关的睡眠问题定义为得分高于正常水平1个标准差以上,临床痛苦定义为温度计得分高于既定的临界值4。构建了四类父母:既无睡眠问题也无痛苦;无痛苦但有睡眠问题;无睡眠问题但有痛苦;既有睡眠问题又有痛苦。使用多水平多项逻辑回归评估每类父母的预测决定因素(社会人口统计学、医学、心理社会因素)。231名患有不同癌症儿童的父母(202名母亲和150名父亲)参与了研究。自诊断以来的平均时间为3.3±1.4年(90%处于非治疗期)。睡眠问题的患病率为37%。50%的父母表示既无睡眠问题也无痛苦,9%的父母只有睡眠问题,13%的父母只有痛苦,28%的父母表示两者都有。与没有睡眠问题或痛苦的父母相比,报告两者都有的父母更有可能报告育儿问题(比值比4.4,[2.2 - 9.1])、慢性病(比值比2.8,[1.2 - 6.5])、社会支持不足(比值比3.7,[1.5 - 9.1])、既往睡眠问题(比值比6.2,[2.0 - 18.6])以及女性(比值比1.8,[1.1 - 4.2])。接受癌症治疗儿童的父母中睡眠问题很常见,且大多在存在临床痛苦的情况下出现。未来的研究必须表明哪些干预措施对该群体最有效:主要针对改善睡眠,还是在压力管理或创伤处理方面发挥突出作用。