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先天性心脏病患儿手术后及四个月后父母创伤后应激症状的预测因素。

Predictors of Post-traumatic stress symptomology in parents of infants with Congenital Heart Disease post-surgery and after four months.

机构信息

University of Haifa, Department of Nursing, Israel; School of Nursing, University of Pennsylvania, USA.

School of Nursing, University of Pennsylvania, USA; Children's Hospital of Philadelphia, USA.

出版信息

J Pediatr Nurs. 2022 Jan-Feb;62:17-22. doi: 10.1016/j.pedn.2021.11.013. Epub 2021 Nov 25.

Abstract

PURPOSE

To identify predictors of post-traumatic stress symptomology among parents of infants with complex congenital heart defects at hospital discharge and after 4 months.

DESIGN & METHODS: A secondary analysis utilizing data from a larger RCT performed in three pediatric cardiac centers in North America. Analysis included 158 parent-infant dyads. Generalized Linear Modeling was used to identify predictors of parental post-traumatic symptomology at hospital discharge, and after 4 months. Considered predictors included demographics/SES, illness, and psychosocial parameters.

RESULTS

At discharge, parenting stress, education, and infant's medication number were linked to post-traumatic stress symptomology severity; Parenting stress, education, insurance type, and medications number predicted number of symptoms; Tube-assisted feeding predicted PTSD. At 4 months, parenting stress, ethnicity, and number of ED visits predicted PTSS severity; Parenting stress, ethnicity, and cardiologist visits predicted number of symptoms; Parenting stress, single ventricle physiology, and number of children predicted PTSD.

CONCLUSIONS & PRACTICAL IMPLICATIONS: Parental psychosocial factors, additionally to illness and sociodemographic indicators, can potentially risk parents to experience PTSS/PTSD. Nursing and other healthcare professionals can participate in early screening of such factors to determine familial risk.

TRIAL REGISTRATION

NCT01941667.

摘要

目的

在婴儿患有复杂先天性心脏缺陷出院时和 4 个月后,确定父母创伤后应激症状的预测因素。

设计与方法

利用北美三个儿科心脏中心进行的更大 RCT 的数据进行二次分析。分析包括 158 对父母-婴儿对。使用广义线性模型来确定父母在出院时和 4 个月后创伤后症状的预测因素。考虑的预测因素包括人口统计学/SES、疾病和心理社会参数。

结果

在出院时,育儿压力、教育程度和婴儿用药数量与创伤后应激症状的严重程度有关;育儿压力、教育程度、保险类型和用药数量预测症状数量;管饲与 PTSD 有关。4 个月时,育儿压力、种族和急诊就诊次数预测 PTSS 严重程度;育儿压力、种族和心脏病专家就诊次数预测症状数量;育儿压力、单心室生理和孩子数量预测 PTSD。

结论和实际意义

父母的心理社会因素,除了疾病和社会人口统计学指标外,还可能使父母面临创伤后应激症状/创伤后应激障碍的风险。护理和其他医疗保健专业人员可以参与早期筛查这些因素,以确定家族风险。

试验注册

NCT01941667。

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