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儿科重症监护病房患儿父母出院后的心理健康照护

Parental Mental Health Care After Their Child's Pediatric Intensive Care Hospitalization.

机构信息

Department of Pediatrics, Washington University in St. Louis, St. Louis, MO.

Department of Medicine, Division of Infectious Diseases, Washington University in St. Louis, St. Louis, MO.

出版信息

Pediatr Crit Care Med. 2020 Nov;21(11):941-948. doi: 10.1097/PCC.0000000000002559.

Abstract

OBJECTIVES

Post-traumatic stress disorder, depression, and anxiety have all been found in parents of PICU survivors. How these research findings translate to actual use of mental health services by parents remains unknown.

DESIGN

Retrospective observational cohort study.

SETTING

Insurance claims data from 2006 to 2013 obtained from the IBM MarketScan Commercial Database.

PATIENTS

Parents of PICU survivors.

INTERVENTIONS

We examined rates of: 1) mental health diagnoses, 2) outpatient mental health visits, and 3) prescriptions for antidepressants and anxiolytics among parents, 6 months before and 6 months after their child's PICU admission, using each parent as their own control.

MEASUREMENTS AND MAIN RESULTS

Of the 95,070 parents identified, 9.5% received a new mental health diagnosis in the 6 months after their child's PICU hospitalization, which represented a 110% increase from pre-PICU rates. A smaller proportion of parents were given new prescriptions for antidepressants (3.4%) and anxiolytics (3.9%) in the 6 months after their child's PICU hospitalization. Mothers were twice as likely to receive a new mental health diagnosis and be taking a new medication than fathers in the post-PICU period. The parental diagnosis of acute stress disorder or post-traumatic stress disorder increased by 87% from the pre-PICU to the post-PICU period.

CONCLUSIONS

After their child's PICU hospitalization, the proportion of parents with a new mental health diagnosis nearly doubled. Mothers were at nearly twice the risk of receiving a new mental health diagnosis and receiving a new mental health medication compared with fathers. The proportion of parents receiving mental healthcare is much lower than the proportion reporting mental health symptoms in long-term outcomes studies. Whether this indicates a gap in healthcare delivery for parents with mental health symptoms remains unknown.

摘要

目的

创伤后应激障碍、抑郁和焦虑在 PICU 幸存者的父母中均有发现。这些研究结果如何转化为父母实际使用心理健康服务,目前尚不清楚。

设计

回顾性观察队列研究。

设置

从 IBM MarketScan 商业数据库获得的 2006 年至 2013 年的保险索赔数据。

患者

PICU 幸存者的父母。

干预措施

我们检查了以下父母的心理健康诊断、门诊心理健康就诊次数和抗抑郁药和抗焦虑药处方的使用情况:1)在孩子进入 PICU 前 6 个月和后 6 个月,每个父母作为自己的对照;2)在孩子进入 PICU 前 6 个月和后 6 个月。

测量和主要结果

在 95070 名父母中,有 9.5%的父母在孩子进入 PICU 后 6 个月内被新诊断出患有心理健康问题,这一比例比进入 PICU 前的比例增加了 110%。在孩子进入 PICU 后 6 个月内,父母开抗抑郁药(3.4%)和抗焦虑药(3.9%)的比例较小。在 PICU 后时期,母亲被新诊断出心理健康问题和服用新药物的可能性是父亲的两倍。与 PICU 前时期相比,父母的急性应激障碍或创伤后应激障碍诊断增加了 87%。

结论

在孩子进入 PICU 后,新诊断出心理健康问题的父母比例几乎翻了一番。与父亲相比,母亲被新诊断出心理健康问题和接受新心理健康药物治疗的风险几乎是父亲的两倍。接受心理健康保健的父母比例远低于长期结果研究中报告心理健康症状的父母比例。这是否表明父母有心理健康症状的医疗保健服务存在差距尚不清楚。

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