Department of Neurobiology, Care Sciences and Society (NVS), Division of Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Neuroscience (CNS), Center for Psychiatric Research, Karolinska University Hospital, Stockholm, Sweden.
PLoS One. 2020 May 26;15(5):e0233696. doi: 10.1371/journal.pone.0233696. eCollection 2020.
Children are impacted when parents are ill. This systematic review gives an overview of the current state of research and extracts what children and parents found helpful in the interventions aimed at informing children of their parent's illness.
This review was registered with PROSPERO and conducted in accordance with PRISMA guidelines. Five health and social science databases were searched from inception to November 2019 to identify original, peer-reviewed articles in English describing effective interventions. The authors selected and reviewed the studies independently, and any inconsistencies were resolved by discussion in face-to-face meetings and emails. A descriptive synthesis of evidence-based concepts from quantitative and qualitative studies was conducted.
A total of 13 892 titles and 144 full-text articles were reviewed with 32 selected for final inclusion, 21 quantitative, 11 qualitative and no mixed-method studies published from 1993 to November 2019. Most of the research was conducted in mental health, including substance abuse (n = 22), but also in cancer care (n = 6) and HIV care (n = 4). Most studies using quantitative method showed a small to moderately positive statistically significant intervention effect on the child's level of internalized symptoms. Content analysis of the results of studies employing qualitative methodology resulted in four concepts important to both children and parents in interventions (increased knowledge, more open communication, new coping strategies and changed feelings) and three additional concepts important to parents (observed changes in their children's behavior, the parent's increased understanding of their own child and the relief of respite).
In the literature there is evidence of mild to moderate positive effects on the child's level of internalized symptoms as well as concepts important to children and parent's worth noting when trying to bridge the still existing knowledge gaps. In further efforts the challenges of implementation as well as adaptation to differing clinical and personal situations appear key to address.
当父母患病时，孩子会受到影响。本系统评价概述了目前的研究现状，并提取了旨在告知孩子父母患病情况的干预措施中孩子和父母认为有用的内容。
本研究已在 PROSPERO 上注册，并按照 PRISMA 指南进行。从成立到 2019 年 11 月，我们在五个健康和社会科学数据库中搜索了原始的同行评审文章，以确定描述有效干预措施的英文文章。作者独立选择和审查研究，通过面对面会议和电子邮件讨论解决任何不一致的地方。对来自定量和定性研究的基于证据的概念进行描述性综合。
共审查了 13892 个标题和 144 篇全文文章，最终纳入 32 篇，其中 21 篇为定量研究，11 篇为定性研究，没有混合方法研究，发表时间从 1993 年至 2019 年 11 月。大多数研究都是在心理健康方面进行的，包括药物滥用（n=22），但也包括癌症护理（n=6）和艾滋病毒护理（n=4）。大多数使用定量方法的研究显示，干预对儿童内化症状水平具有小到中度的积极统计学效应。对采用定性方法的研究结果进行内容分析，得出了干预措施中对儿童和家长都重要的四个概念（增加知识、更开放的沟通、新的应对策略和改变的感受）以及对家长重要的三个额外概念（观察到孩子行为的变化、家长对自己孩子的理解增加以及得到缓解）。
文献中有证据表明，干预对儿童内化症状水平有轻度到中度的积极影响，以及对儿童和家长重要的概念，值得在试图弥合仍然存在的知识差距时注意。在进一步的努力中，实施的挑战以及对不同临床和个人情况的适应似乎是解决问题的关键。
