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患有复杂疾病儿童的父母的医疗创伤性压力体验。

Experiences of medical traumatic stress in parents of children with medical complexity.

机构信息

Department of Pediatrics, University of Calgary, Calgary, Canada.

Alberta Children's Hospital Research Institute, Calgary, Canada.

出版信息

Child Care Health Dev. 2023 Mar;49(2):292-303. doi: 10.1111/cch.13042. Epub 2022 Aug 29.

Abstract

BACKGROUND AND OBJECTIVES

Parents of children with medical complexity (CMC) experience high levels of stress and adverse mental health outcomes. Pediatric medical traumatic stress (PMTS) could be an important contributor that has not yet been explored. PMTS describes parents' reactions to their child's illness and medical treatment and can lead to post-traumatic stress symptoms. This is the first study to describe the experiences and impact of PMTS among parents of CMC.

METHODS

We conducted semi-structured interviews with 22 parents of CMC. Reflexive thematic analysis was used to generate themes that described the experiences of PMTS and potential contributing factors in the healthcare setting. Themes were validated by study participants.

RESULTS

Parents experienced a spectrum of events and circumstances that impacted PMTS. These corresponded to three major themes: (a) the distinctive context of being the parent of a CMC, (b) interactions with healthcare providers that can hurt or heal and (c) system factors that set the stage for trauma. The consequences of repeated PMTS were a common point of emphasis among all the themes. Parents identified numerous changes that could mitigate PMTS such as acknowledgement of trauma and provision of proactive mental health support.

CONCLUSIONS

Our study highlights the issue of PMTS among parents of CMC and presents opportunities to mitigate their traumatic experiences. Supporting the integration of trauma-informed care practices, increasing awareness of PMTS and advocating for parental mental health services could better support parents and families.

摘要

背景和目的

患有复杂疾病的儿童(CMC)的父母会经历高度的压力和不良心理健康后果。儿科医疗创伤应激(PMTS)可能是一个尚未被探索的重要因素。PMTS 描述了父母对孩子疾病和医疗的反应,可能导致创伤后应激症状。这是第一项描述 CMC 父母 PMTS 经历和影响的研究。

方法

我们对 22 名 CMC 儿童的父母进行了半结构化访谈。采用反思性主题分析生成主题,描述了医疗环境中 PMTS 的经历和潜在的促成因素。主题由研究参与者验证。

结果

父母经历了一系列影响 PMTS 的事件和情况。这些事件对应三个主要主题:(a)作为 CMC 父母的独特背景,(b)与医疗保健提供者的互动可能会伤害或治愈,(c)为创伤创造条件的系统因素。反复发生 PMTS 的后果是所有主题的共同重点。父母指出了许多可以减轻 PMTS 的变化,例如承认创伤和提供积极的心理健康支持。

结论

我们的研究强调了 CMC 父母 PMTS 问题,并提出了减轻其创伤经历的机会。支持创伤知情护理实践的整合、提高对 PMTS 的认识以及倡导父母心理健康服务,可以更好地支持父母和家庭。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c17a/10087969/6024f46ffd1e/CCH-49-292-g001.jpg

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