Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA).
Department of Pediatrics, Children's National Hospital, Washington DC, USA.
Am J Hosp Palliat Care. 2022 Feb;39(2):228-236. doi: 10.1177/10499091211015913. Epub 2021 May 5.
Parents often suffer reduced mental health after their child's death; however, the trajectory and risk factors are not well described.
Describe the change in complicated grief, depression, and post-traumatic stress symptoms among parents between 6 and 13 months after their child's death in a pediatric intensive care unit (PICU), and factors associated with 13-month symptoms.
Parents whose children died in 1 of 8 PICUs affiliated with the Collaborative Pediatric Critical Care Research Network completed surveys 6 and 13 months after their child's death. Surveys included the Inventory of Complicated Grief (ICG), the Patient Health Questionnaire-8 (PHQ-8) for depression, and the Short Post-Traumatic Stress Disorder Rating Interview (SPRINT). Parents provided sociodemographics. Charts were reviewed for child characteristics.
One-hundred and fifty seven parents of 104 deceased children completed surveys at both time points. Mental health symptoms declined over time (mean (SD)): ICG (33.8 (15.4) vs. 30.5 (15.2), p < 0.001), PHQ-8 (9.0 (6.4) vs. 7.3 (5.8), p < 0.001), and SPRINT (14.1 (8.3) vs. 12.0 (8.2), p < 0.001). After controlling for 6-month scores, higher 13-month ICG was independently associated with sudden unexpected death; higher PHQ-8 with Black race, insecure attachment style, and sudden unexpected death; and higher SPRINT with having a high school level of education (compared to college degree or higher).
Mental health symptoms improve among parents during the first 13 months after their child's death; however, symptoms persist for many. Black parents and those whose children die suddenly may be high risk for poor adjustment during bereavement.
儿童死亡后，父母的心理健康往往会受到影响；然而，其轨迹和风险因素尚不清楚。
描述儿科重症监护病房（PICU）中患儿死亡 6 至 13 个月后父母的复杂悲伤、抑郁和创伤后应激症状的变化，并描述与 13 个月时症状相关的因素。
参与协作儿科危重症研究网络的 8 家 PICU 之一的患儿死亡后，其父母在死亡后 6 个月和 13 个月完成调查。调查包括复杂悲伤量表（ICG）、抑郁患者健康问卷-8（PHQ-8）和创伤后应激障碍短评量表（SPRINT）。父母提供社会人口统计学信息。查看病历了解患儿特征。
104 名死亡患儿的 157 名父母在两个时间点都完成了调查。精神健康症状随时间推移而下降（平均值（标准差））：ICG（33.8（15.4）vs. 30.5（15.2），p<0.001），PHQ-8（9.0（6.4）vs. 7.3（5.8），p<0.001），SPRINT（14.1（8.3）vs. 12.0（8.2），p<0.001）。控制 6 个月时的评分后，13 个月时较高的 ICG 与意外猝死独立相关；较高的 PHQ-8 与黑人种族、不安全依恋模式和意外猝死相关；较高的 SPRINT 与高中教育水平（与大学学位或更高水平相比）相关。
儿童死亡后 13 个月内，父母的精神健康症状有所改善；然而，许多父母仍存在症状。黑人父母和其子女突然死亡的父母在丧亲期间可能面临不良调整的高风险。
