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儿科重症监护综合征背景下的父母创伤后应激症状:对家庭的影响及干预机会

Parental Posttraumatic Stress Symptoms in the Context of Pediatric Post Intensive Care Syndrome: Impact on the Family and Opportunities for Intervention.

作者信息

Riley Andrew R, Williams Cydni N, Moyer Danielle, Bradbury Kathryn, Leonard Skyler, Turner Elise, Holding Emily, Hall Trevor A

机构信息

Division of Pediatric Psychology, Department of Pediatrics, Institute on Development and Disability, Oregon Health & Science University and Doernbecher children's Hospital, Portland, Oregon.

Division of Pediatric Critical Care, Department of Pediatrics, Oregon Health & Science University and Doernbecher Children's Hospital, Portland, Oregon.

出版信息

Clin Pract Pediatr Psychol. 2021 Jun;9(2):156-166. doi: 10.1037/cpp0000399.

Abstract

OBJECTIVE

Pediatric intensive care unit (PICU) survivors and their families experience ongoing impacts on physical, cognitive, and psychosocial functioning, described as Post-Intensive Care Syndrome (PICS). The objective of this study was to determine whether the posttraumatic stress symptoms (PTSS) of parents predict the impact of critical illness on families following PICU admission beyond other factors (e.g., sex, race/ethnicity, age, insurance status, illness severity, family involvement or death).

METHOD

We conducted a retrospective analysis of data from 88 children aged 1 month to 18 years who were hospitalized with critical illness and acquired brain injury in the PICU and their families. Patients and their families participated in a 1-3 month post-discharge follow-up assessment, during which data on demographics, medical diagnoses, parent self-report of PTSS, and family impact of critical illness (via the Pediatric Quality of Life Family Impact Module) were collected. We used a hierarchical linear regression to determine whether parent PTSS predicted family impact above and beyond demographic and injury/illness factors.

RESULTS

One-third of parents reported elevated PTSS. Among those with complete available data = 56), PTSS were the only significant predictor of family impact (β = -.52, = -3.58, = .001), with the overall model accounting for 41% of variance.

CONCLUSION

In addition to the direct effects on parents of children who survive the PICU, PTSS may negatively impact families and interfere with rehabilitative progress. We provide a rationale and conceptual model for integrating interventions designed to address parent PTSS into post-PICU care.

摘要

目的

儿科重症监护病房(PICU)幸存者及其家人在身体、认知和心理社会功能方面持续受到影响,这被称为重症监护后综合征(PICS)。本研究的目的是确定父母的创伤后应激症状(PTSS)是否能预测重症监护病房入院后危重病对家庭的影响,而不仅仅取决于其他因素(如性别、种族/民族、年龄、保险状况、疾病严重程度、家庭参与情况或死亡)。

方法

我们对88名年龄在1个月至18岁之间、因危重病和获得性脑损伤入住PICU的儿童及其家人的数据进行了回顾性分析。患者及其家人在出院后1 - 3个月参加了随访评估,在此期间收集了人口统计学数据、医学诊断、父母自我报告的PTSS以及危重病对家庭的影响(通过儿童生活质量家庭影响模块)。我们使用分层线性回归来确定父母的PTSS是否能在人口统计学和损伤/疾病因素之外预测家庭影响。

结果

三分之一的父母报告PTSS升高。在那些有完整可用数据的父母中(n = 56),PTSS是家庭影响的唯一显著预测因素(β = -0.52,t = -3.58,p = 0.001),总体模型解释了41%的方差。

结论

除了对PICU存活儿童的父母有直接影响外,PTSS可能对家庭产生负面影响并干扰康复进程。我们提供了一个理论依据和概念模型,用于将旨在解决父母PTSS的干预措施纳入PICU后护理中。

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