Stanzel Anna, Sierau Susan
Department of Clinical Child and Adolescent Psychology, Institute of Psychology, Leipzig University, Leipzig, Germany.
Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany.
J Child Adolesc Trauma. 2021 Aug 21;15(3):795-809. doi: 10.1007/s40653-021-00391-9. eCollection 2022 Sep.
The purpose of the present review was to systematically review, synthesize and quantify prevalence rates of subclinical and clinical psychological symptoms in children and adolescents who have undergone surgery. Systematic literature searches were conducted twofold in April 8, 2020 and March 7, 2021 in PsycInfo and PubMed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Manuscripts were screened against eligibility criteria and were included if they investigated psychological symptoms in children or adolescents (age between 1 to 21 years at the time of study) who were hospitalized for pediatric surgery. Means and standard deviations weighted by sample size were calculated. Eleven articles met inclusion criteria. The review revealed that a small but substantial number of children and adolescents are at an elevated risk for postoperative psychological symptoms and disorders. Up to 13% had symptoms consistent with a diagnosis of a posttraumatic stress disorder, 6% to 8% exhibited elevated symptoms of depression or anxiety, and about 25% showed internalizing and externalizing symptoms. This review provides preliminary evidence that children and adolescents experience significant psychological distress and posttraumatic stress symptoms after pediatric surgery. Apart from better training of clinicians, prevention, early psychological screening and psychosocial care in surgical wards of hospitals are recommended. Well-designed studies of high methodological quality are necessary to replicate existing findings and provide a broader base of evidence.
The online version contains supplementary material available at 10.1007/s40653-021-00391-9.
本综述的目的是系统回顾、综合并量化接受过手术的儿童和青少年亚临床及临床心理症状的患病率。根据系统评价和Meta分析的首选报告项目指南，于2020年4月8日和2021年3月7日在PsycInfo和PubMed上进行了两轮系统文献检索。根据纳入标准对稿件进行筛选，如果研究调查了因小儿外科手术住院的儿童或青少年（研究时年龄在1至21岁之间）的心理症状，则纳入。计算了按样本量加权的均值和标准差。11篇文章符合纳入标准。该综述显示，一小部分但数量可观的儿童和青少年术后出现心理症状和障碍的风险较高。高达13%的人有符合创伤后应激障碍诊断的症状，6%至8%的人表现出抑郁或焦虑症状升高，约25%的人表现出内化和外化症状。本综述提供了初步证据，表明儿童和青少年在小儿外科手术后会经历显著的心理困扰和创伤后应激症状。除了对临床医生进行更好的培训外，建议在医院外科病房进行预防、早期心理筛查和心理社会护理。需要进行高质量方法学设计的研究来重复现有发现并提供更广泛的证据基础。
在线版本包含可在10.1007/s40653-021-00391-9获取的补充材料。
