Department of Neurology and Neurosurgery, 54473McGill University, Montréal, Québec Canada.
Department of Pediatrics, 54473McGill University, Montréal, Québec Canada.
J Child Neurol. 2020 Nov;35(13):901-907. doi: 10.1177/0883073820938645. Epub 2020 Jul 28.
Genetically determined leukoencephalopathies comprise a group of rare inherited white matter disorders. The majority are progressive diseases resulting in early death. We performed a cross-sectional pilot study including 55 parents from 36 families to assess the level of stress experienced by parents of patients with genetically determined leukoencephalopathies, aged 1 month to 12 years. Thirty-four mothers and 21 fathers completed the Parenting Stress Index-4th Edition. One demographic questionnaire was completed per family. Detailed clinical data was gathered on all patients. Statistical analysis was performed with total stress percentile score as the primary outcome. Mothers and fathers had significantly higher stress levels compared with the normative sample; 20% of parents had high levels of stress whereas 11% had clinically significant levels of stress. Mothers and fathers had comparable total stress percentile scores. We identified pediatric behavioral difficulties and gross motor function to be factors influencing stress in mothers. Our study is the first to examine parental stress in this population and highlights the need for parental support early in the disease course. In this pilot study, we demonstrated that using the Parenting Stress Index-4th Edition to assess stress levels in parents of patients with genetically determined leukoencephalopathies is feasible, leads to valuable and actionable results, and should be used in larger, prospective studies.
遗传性脑白质病是一组罕见的遗传性脑白质疾病。大多数是进行性疾病,导致早期死亡。我们进行了一项横断面试点研究,纳入了 36 个家庭的 55 名父母,以评估年龄在 1 个月至 12 岁的遗传性脑白质病患儿父母所经历的压力水平。34 名母亲和 21 名父亲完成了父母压力指数第 4 版。每个家庭完成一份人口统计学问卷。对所有患者均收集详细的临床数据。以总压力百分位评分作为主要结局进行统计分析。母亲和父亲的压力水平明显高于常模样本;20%的父母压力水平较高,11%的父母压力水平达到临床显著水平。母亲和父亲的总压力百分位评分相当。我们发现儿科行为问题和粗大运动功能是影响母亲压力的因素。我们的研究首次在该人群中检查了父母的压力,并强调了在疾病早期阶段为父母提供支持的必要性。在这项试点研究中,我们证明使用父母压力指数第 4 版评估遗传性脑白质病患儿父母的压力水平是可行的,会产生有价值且可操作的结果,应在更大的前瞻性研究中使用。