Patton Michaela, Stokoe Mehak, Forbes Caitlin, Nwaroh Chidera, Noel Melanie, Reynolds Kathleen, Schulte Fiona
Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada.
Hematology, Oncology, and Bone Marrow Transplant Program, Alberta Children's Hospital, Calgary, AB T3B 6A8, Canada.
Children (Basel). 2020 Nov 21;7(11):246. doi: 10.3390/children7110246.
Among youth with chronic non-cancer pain, 50% have parents with chronic pain. These youth report significantly more pain interference and posttraumatic stress symptoms (PTSS), and worse health-related quality of life (HRQL) than youth whose parents do not have chronic pain. Additionally, parent chronic pain is linked to increased child anxiety and depressive symptoms. Survivors of childhood cancer (SCCs) are at risk of pain and negative psychosocial outcomes and therefore may be especially vulnerable if their parents have chronic pain. Thus, the aims of the current study were to (1) identify rates of chronic pain among parents of SCCs, (2) test group differences in psychological symptoms in parents with chronic pain versus without, and (3) test group differences in pain interference, HRQL, anxiety, depression, and PTSS in SCCs with parents with chronic pain versus without.
122 SCCs (Mean age = 15.8, SD = 4.8, 45.7% male, Mean age at diagnosis = 5.9, SD = 4.7) and their parents were recruited from across Canada to complete online questionnaires. Parents were asked if they have had pain for at least three consecutive months and completed the brief symptom inventory (BSI) as a measure of psychological symptomatology. Survivors completed the pain questionnaire, patient reported outcomes measurement information system (PROMIS)-pain interference, anxiety, and depression measures, child posttraumatic stress scale, posttraumatic stress disorder checklist for the Diagnostic and Statistical Manual of Mental Disorders, and the pediatric quality of life inventory.
Forty-three (39%) parents of SCCs reported having chronic pain. Of the 29 survivors who had chronic pain, 14 (48%) also had parents with chronic pain. Parents with chronic pain reported significantly higher scores on the BSI than parents without chronic pain, (1, 116) = 5.07, = 0.026. SCCs with parents with versus without chronic pain reported significantly higher PTSS (1, 105) = 10.53, = 0.002 and depressive symptoms (1, 102) = 6.68, = 0.011. No significant differences were found across the other variables tested.
Findings suggest that survivors' parents' own pain is prevalent and is related to survivors' increased depressive symptoms and PTSS, but not anxiety, pain interference, or HRQL. Future research should explore whether parents may benefit from psychological intervention after their child has been diagnosed with cancer and how this could improve outcomes for their child.
在患有慢性非癌性疼痛的青少年中，50%的人的父母患有慢性疼痛。与父母没有慢性疼痛的青少年相比，这些青少年报告的疼痛干扰和创伤后应激症状（PTSS）明显更多，健康相关生活质量（HRQL）更差。此外，父母的慢性疼痛与孩子焦虑和抑郁症状的增加有关。儿童癌症幸存者（SCCs）有疼痛和负面心理社会结果的风险，因此，如果他们的父母患有慢性疼痛，他们可能特别容易受到影响。因此，本研究的目的是：（1）确定SCCs父母中慢性疼痛的发生率；（2）测试有慢性疼痛与无慢性疼痛的父母在心理症状方面的组间差异；（3）测试父母有慢性疼痛与无慢性疼痛的SCCs在疼痛干扰、HRQL、焦虑、抑郁和PTSS方面的组间差异。
从加拿大各地招募了122名SCCs（平均年龄 = 15.8岁，标准差 = 4.8岁，45.7%为男性，诊断时平均年龄 = 5.9岁，标准差 = 4.7岁）及其父母，以完成在线问卷。询问父母是否连续至少三个月有疼痛，并完成简短症状量表（BSI）作为心理症状学的测量工具。幸存者完成了疼痛问卷、患者报告结局测量信息系统（PROMIS）-疼痛干扰、焦虑和抑郁测量、儿童创伤后应激量表、《精神障碍诊断与统计手册》创伤后应激障碍检查表以及儿童生活质量量表。
43名（39%）SCCs的父母报告患有慢性疼痛。在29名患有慢性疼痛的幸存者中，14名（48%）的父母也患有慢性疼痛。有慢性疼痛的父母在BSI上的得分显著高于无慢性疼痛的父母，（1, 116） = 5.07，P = 0.026。父母有慢性疼痛与无慢性疼痛的SCCs报告的PTSS显著更高（1, 105） = 10.53，P = 0.002，抑郁症状也显著更高（1, 102） = 6.68，P = 0.011。在测试的其他变量中未发现显著差异。
研究结果表明，幸存者父母自身的疼痛很普遍，并且与幸存者抑郁症状和PTSS的增加有关，但与焦虑、疼痛干扰或HRQL无关。未来的研究应探讨父母在孩子被诊断患有癌症后是否能从心理干预中受益，以及这如何能改善孩子的结局。
