Department of Pediatrics.
Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta.
J Pediatr Psychol. 2021 Jun 3;46(5):557-569. doi: 10.1093/jpepsy/jsaa130.
Pediatric sickle cell disease (SCD) management can result in considerable caregiver distress. Parents of youth with chronic SCD pain may face the additional challenge of managing children's chronic pain and chronic illness. This study examined associations between parent psychological distress and child functioning and the moderating role of chronic pain among youth with SCD.
Youth presenting to pediatric outpatient comprehensive SCD clinics and their primary caregivers completed a battery of questionnaires. Parents reported on parenting stress, parent mental and physical health, and family functioning. Children completed measures of pain characteristics, depressive symptoms, catastrophic thinking, functional disability, and quality of life.
Patients (N = 73, Mage = 14.2 years, 57% female) and their caregivers (Mage = 41.1 years, 88% mothers, 88% Black) participated. Worse parent functioning was associated with worse child pain, functioning, quality of life, and depressive symptoms. Beyond the effects of SCD, chronic SCD pain magnified the negative associations between parenting stress frequency and child quality of life, parent physical health and child quality of life, and parent depressive symptoms and child depressive symptoms.
Chronic pain may exacerbate the relations between parent and child functioning beyond the effects of SCD alone. The management of both SCD and chronic pain may present additional challenges for parents that limit their psychosocial functioning. Family-focused interventions to support parents and youth with chronic SCD pain are warranted to optimize health outcomes.
小儿镰状细胞病(SCD)的管理可能会导致护理人员承受相当大的压力。患有慢性 SCD 疼痛的青少年的父母可能面临管理儿童慢性疼痛和慢性疾病的额外挑战。本研究调查了 SCD 青少年父母心理困扰与儿童功能之间的关联,以及慢性疼痛在其中的调节作用。
到儿科门诊综合 SCD 诊所就诊的青少年及其主要照顾者完成了一系列问卷。父母报告了育儿压力、父母的心理和身体健康以及家庭功能。儿童完成了疼痛特征、抑郁症状、灾难性思维、功能障碍和生活质量的测量。
共有 73 名患者(Mage = 14.2 岁,57%为女性)及其照顾者(Mage = 41.1 岁,88%为母亲,88%为黑人)参与了研究。父母的功能越差,儿童的疼痛、功能、生活质量和抑郁症状就越差。除了 SCD 的影响之外,慢性 SCD 疼痛加剧了育儿压力频率与儿童生活质量、父母身体健康与儿童生活质量以及父母抑郁症状与儿童抑郁症状之间的负向关联。
慢性疼痛可能会加剧父母和儿童功能之间的关系,超出 SCD 单独的影响。SCD 和慢性疼痛的管理可能会给父母带来额外的挑战,限制他们的社会心理功能。需要针对患有慢性 SCD 疼痛的父母和青少年开展以家庭为中心的干预措施,以优化健康结果。