Stollery Children's Hospital, 8440-112 St, Edmonton, AB, T6G 2B7, Canada.
Childs Nerv Syst. 2021 Mar;37(3):959-967. doi: 10.1007/s00381-020-04938-3. Epub 2020 Oct 28.
Having a child receive a neurosurgical diagnosis creates significant stress and anxiety in caregivers. The stress of these life-threatening and emotionally charged diagnoses may put caregivers at risk for developing post-traumatic stress disorder (PTSD). While PTSD has been studied in a variety of caregivers of pediatric populations, to the best of our knowledge, it has yet to be examined in caregivers commonly seen in general pediatric neurosurgical practices. This study was designed to gain an understanding of the prevalence of PTSD within this population.
A cross-sectional survey method was utilized. Participants completed both a survey to provide demographic information, and the Posttraumatic Stress Checklist for DSM-5 (PCL-5) which is used to make a provisional diagnosis of PTSD. Surveys were distributed both in person and online between December 2018 and April 2019.
One hundred sixty-eight surveys were included in the study. According to the DSM-5 diagnostic criteria, 44.6% (n = 75) of caregivers screened positively for a provisional diagnosis of PTSD. The specific neurosurgical diagnosis (p = 0.002), number of surgeries (p = 0.008), and category of the last surgery (p = 0.026) impacted the rate of PTSD symptoms in this population. Most caregivers who screened positive for PTSD experience a high level of disturbing memories and physical reactions to the events and avoid reminders of the medical experience. Caregivers also report a loss of interest in activities, feel distant from other people, and have difficulties with concentration and sleep. There was no significant relationship between caregivers who identified having a high level of anxiety before their child was diagnosed and who screened positive for PTSD.
This study has identified a higher number of caregivers screening positive for PTSD within pediatric neurosurgical patients, than previously reported in other populations. Specific neurosurgical diagnosis, number of surgeries, and category of last surgery all impact a positive screen for the condition. Caregivers who avoid remembering events surrounding their child's diagnosis are at a higher risk of having the condition. The results highlight the need to identify ways to decrease the impact of a pediatric neurosurgical diagnosis on the mental health of caregivers. Future research focused on early mental health intervention for caregivers of pediatric neurosurgical patients may be helpful in reducing the long-term impact of this difficult condition.
孩子接受神经外科诊断会给照顾者带来巨大的压力和焦虑。这些危及生命和充满情绪的诊断可能会使照顾者面临创伤后应激障碍（PTSD）的风险。虽然 PTSD 已在儿科人群的各种照顾者中进行了研究，但据我们所知，它尚未在普通儿科神经外科实践中常见的照顾者中进行检查。本研究旨在了解该人群中 PTSD 的患病率。
采用横断面调查方法。参与者完成了一份调查，提供了人口统计学信息，以及用于暂定 PTSD 诊断的创伤后应激检查表（PCL-5）。调查于 2018 年 12 月至 2019 年 4 月之间以面对面和在线的方式进行。
本研究共纳入 168 份调查。根据 DSM-5 诊断标准，44.6%（n=75）的照顾者对暂定 PTSD 诊断呈阳性。特定的神经外科诊断（p=0.002）、手术次数（p=0.008）和最后一次手术的类别（p=0.026）影响了该人群中 PTSD 症状的发生率。大多数对 PTSD 筛查呈阳性的照顾者会经历对事件的强烈记忆和身体反应，并避免想起医疗经历。照顾者还报告说对活动失去兴趣，与他人疏远，以及注意力和睡眠困难。在孩子被诊断之前就已经有较高焦虑水平的照顾者和对 PTSD 筛查呈阳性的照顾者之间没有显著关系。
本研究发现，儿科神经外科患者的照顾者中，筛查出 PTSD 的人数高于其他人群。特定的神经外科诊断、手术次数和最后一次手术的类别都会影响该疾病的阳性筛查。避免回忆孩子诊断相关事件的照顾者患有该疾病的风险更高。研究结果强调需要找到方法来降低儿科神经外科诊断对照顾者心理健康的影响。未来针对儿科神经外科患者照顾者的早期心理健康干预的研究可能有助于减轻这种困难状况的长期影响。
