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癌症患儿及其父母的儿科医学创伤应激:疾病和治疗因素导致的应激水平差异

Paediatric Medical Traumatic Stress in Children with Cancer and their Parents: Difference in Stress Levels Due to Illness and Treatment Factors.

作者信息

Klašnja Sandra, Hausmeister Ivana Kreft, Kavčič Marko, Masten Robert, Kitanovski Lidija

机构信息

Division of Pediatrics, Departmant of Haematooncology, University Medical Center Ljubljana, Bohoričeva 20, 1000 Ljubljana, Slovenia.

Department of Psychology, Faculty of Arts, University of Ljubljana, Ljubljana, Slovenia.

出版信息

J Child Adolesc Trauma. 2023 Feb 10;16(3):579-587. doi: 10.1007/s40653-023-00521-5. eCollection 2023 Sep.

Abstract

Pediatric medical traumatic stress (PMTS) is a set of children's and their parents' psychological and physiological responses to pain, injuries, serious illnesses, and other experiences with the medical environment. Pediatric cancer patients have the highest prevalence of PMTS as the illness its treatment involve a set of stressors that trigger many negative psychological reactions. The current study examined the difference in levels of traumatic stress in children with cancer and their parents due to medical factors (type of cancer, outcome, duration, and intensity of treatment, time since diagnosis, relapse, and hospitalization in ICU). The study involved 183 parents of 133 children and 62 children and adolescents who were treated between 2009 and 2019 at the Clinical Department of Pediatric Hematology and Oncology of University Children's Hospital in Ljubljana. We collected the data using The Intensity of Treatment Rating Scale 2.0 [IRT-2], PTSD Checklist for Children/Parent [PCL-C/PR], The PTSD Checklist for DSM-5 [PCL-5] and The Child PTSD Symptoms Scale for DSM-5 [CPSS-5]. Traumatic stress symptoms are frequently present in both children and their parents, regardless of the cancer type, treatment duration, and treatment outcome. Children with relapse, children with more intensive treatment, and parents of the latter are at higher risk for PMTS occurrence. Additionally, we found a decreasing trend of traumatic responses after five or more years post-cancer diagnosis. [Table: see text].

摘要

儿童医学创伤应激(PMTS)是儿童及其父母对疼痛、损伤、重病以及其他医疗环境相关经历所产生的一系列心理和生理反应。儿科癌症患者中PMTS的患病率最高,因为疾病及其治疗涉及一系列应激源,会引发许多负面心理反应。本研究调查了因医学因素(癌症类型、治疗结果、持续时间和强度、确诊后的时间、复发情况以及在重症监护病房的住院情况)导致的癌症患儿及其父母创伤应激水平的差异。该研究纳入了2009年至2019年期间在卢布尔雅那大学儿童医院儿科血液学和肿瘤学临床科室接受治疗的133名儿童的183名父母以及62名儿童和青少年。我们使用治疗强度评定量表2.0 [IRT - 2]、儿童/父母创伤后应激障碍检查表[PCL - C/PR]、DSM - 5创伤后应激障碍检查表[PCL - 5]以及DSM - 5儿童创伤后应激障碍症状量表[CPSS - 5]收集数据。无论癌症类型、治疗持续时间和治疗结果如何,创伤应激症状在儿童及其父母中都很常见。复发的儿童、接受更强化治疗的儿童以及后者的父母发生PMTS的风险更高。此外,我们发现癌症确诊五年或更久后创伤反应有下降趋势。[表格:见正文]

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Post-traumatic stress disorder and cancer.创伤后应激障碍与癌症。
Lancet Psychiatry. 2017 Apr;4(4):330-338. doi: 10.1016/S2215-0366(17)30014-7. Epub 2017 Jan 19.

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