Snaman Jennifer M, Mazzola Emanuele, Helton Gabrielle, Feifer Deborah, Morris Sue E, Clark Lisa, Baker Justin N, Wolfe Joanne
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA.
Department of Pediatrics, Boston Children's Hospital, Boston, MA.
JCO Oncol Pract. 2023 Apr;19(4):e527-e541. doi: 10.1200/OP.22.00538. Epub 2023 Feb 1.
The early grief experience of parents of children who died of cancer remains understudied. Understanding psychosocial symptomology and functioning of parents early in their bereavement is essential to developing supportive interventions aimed at offsetting poor mental and physical outcomes.
Parents of children from two centers who died of cancer 6 to 24 months before were mailed a survey that included validated tools and additional Likert scale-based questions. We used correlation and univariate and multiple regression analyses to assess the associations between psychosocial and grief outcomes and parental social functioning.
One hundred twenty-five parents representing 88 children completed the survey. Most respondents identified as female (63%), White (84%), and non-Hispanic (91%). The mean time since child's death was 14.7 (range, 8-26) months. Bereaved parents' mean score for social functioning was only slightly below normative values, and most parents indicated post-traumatic growth and adaptive coping. Parents had high symptom levels for depression, anxiety, post-traumatic stress, and prolonged grief, with those identifying as female having significantly higher symptom scores. Using multivariate analysis, parental scores for resilience and continuing bonds were associated with higher social functioning scores and parental scores for depressive symptoms and prolonged grief were associated with lower social functioning scores.
Although bereaved parents exhibit resilience and positive coping, they also show high levels of psychosocial distress in the first 2 years after their child's death, which may reflect the typical parental bereavement experience. Screening for low parental social functioning may identify parents who would benefit from additional support early in bereavement.
死于癌症儿童的父母早期悲伤经历仍未得到充分研究。了解父母在丧亲早期的心理社会症状和功能对于制定旨在抵消不良心理和身体后果的支持性干预措施至关重要。
向来自两个中心的儿童的父母邮寄了一份调查问卷，这些儿童在6至24个月前死于癌症，问卷包括经过验证的工具和其他基于李克特量表的问题。我们使用相关性分析、单变量和多变量回归分析来评估心理社会和悲伤结果与父母社会功能之间的关联。
代表88名儿童的125名父母完成了调查。大多数受访者为女性（63%）、白人（84%）和非西班牙裔（91%）。自孩子死亡后的平均时间为14.7个月（范围为8 - 26个月）。丧亲父母的社会功能平均得分仅略低于正常水平，大多数父母表示有创伤后成长和适应性应对。父母在抑郁、焦虑、创伤后应激和持续性悲伤方面的症状水平较高，女性受访者的症状得分显著更高。使用多变量分析，父母的复原力得分和持续纽带得分与较高的社会功能得分相关，而父母的抑郁症状得分和持续性悲伤得分与较低的社会功能得分相关。
尽管丧亲父母表现出复原力和积极应对，但他们在孩子死亡后的头两年也表现出高水平的心理社会困扰，这可能反映了典型的父母丧亲经历。筛查父母社会功能低下可能有助于识别那些在丧亲早期能从额外支持中受益的父母。
