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新生儿心脏手术后婴儿母亲的生活质量:心理社会因素的重要性。

Quality of Life of Mothers of Infants Subjected to Neonatal Cardiac Surgery: The Importance of Psychosocial Factors.

机构信息

Research Institute, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Department of Family and Community Health, 16142School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.

出版信息

World J Pediatr Congenit Heart Surg. 2022 May;13(3):324-331. doi: 10.1177/21501351221088832.

Abstract

The World Health Organization acknowledges quality of life (QOL) as subjectively perceived overall well-being by the individual and recognizes it as an essential construct for overall health and wellness. The purpose of this study was to examine the association of infant, environmental, and parental factors with the QOL of mothers of infants at four months post-hospital discharge from cardiac surgery. Secondary analysis of prospectively collected data from the REACH randomized clinical trial of telehealth home monitoring. The sample included mothers (n  =  148) of infants with congenital heart disease who provided data at four months post-discharge. Ten imputations were generated using fully conditional specification methods to address missing data and were combined. All analyses were performed on the imputed data. Mothers' QOL was the main outcome of the analysis, as measured by the Ulm Quality of Life Inventory for Parents. Predictors on QOL were identified based on the World Health Organization QOL framework which recognizes the multidimensional domains influencing QOL that include personal factors, environmental factors, and physical factors related to disease and functioning. The treatment and control groups did not differ on any study variable, thus data were collapsed and analyzed together. Final multivariable model found that the combination of dyadic adjustment, social support, parenting stress, and post-traumatic stress symptoms explained approximately three-quarters of the variance in QOL scores. QOL for mothers of infants with congenital heart disease is largely influenced by psychosocial factors. Future research targeted toward improving maternal QOL should include psychosocial interventions that address social networks and stress.

摘要

世界卫生组织承认生活质量(QOL)是个体主观感知的整体幸福感,并将其视为整体健康和健康的重要构建。本研究旨在探讨婴儿、环境和父母因素与心脏手术后四个月出院婴儿母亲生活质量的关系。这是对远程健康家庭监测的 REACH 随机临床试验中前瞻性收集数据的二次分析。样本包括患有先天性心脏病的婴儿的母亲(n=148),她们在出院后四个月提供了数据。使用完全条件规格方法生成了十个插补来解决缺失数据,并对其进行了合并。所有分析均在插补数据上进行。母亲的生活质量是分析的主要结果,用乌尔姆父母生活质量量表进行衡量。根据世界卫生组织生活质量框架确定了对生活质量有影响的预测因素,该框架认识到影响生活质量的多维领域,包括个人因素、环境因素以及与疾病和功能相关的身体因素。治疗组和对照组在任何研究变量上均无差异,因此将数据合并在一起进行分析。最终的多变量模型发现,对偶调整、社会支持、育儿压力和创伤后应激症状的组合解释了生活质量评分约四分之三的差异。患有先天性心脏病的婴儿母亲的生活质量在很大程度上受到心理社会因素的影响。针对改善产妇生活质量的未来研究应包括解决社交网络和压力的心理社会干预措施。

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