Zonta Jaqueline Brosso, Okido Aline Cristiane Cavicchioli, de Lima Bruna Josiane, Martins Bianca Annie, Looman Wendy Sue, Lopes-Júnior Luis Carlos, Silva-Rodrigues Fernanda Machado, Lima Regina Aparecida Garcia de
Department of Nursing, Federal University of São Carlos (UFSCar), São Carlos 13565-905, Brazil.
School of Nursing, University of Minnesota (UMN), Minneapolis, MN 55455, USA.
Children (Basel). 2024 Nov 2;11(11):1347. doi: 10.3390/children11111347.
This study analyzed the stress experienced by family caregivers of children with special healthcare needs and identified associated factors.
A case-control study was conducted with the "cases" being caregivers of children with chronic conditions and the "controls" being caregivers of healthy children. Recruitment was carried out via social media and complemented by snowball sampling. A sociodemographic questionnaire and the Perceived Stress Scale were applied, with four saliva samples collected in one day (at 8:00 am, 30 min later, and 4 and 12 h later). The Area Under the Curve for total daily cortisol production was calculated using the log-trapezoidal method. The Wilcoxon test and repeated-measures ANOVA were used for statistical analysis.
In total, 100 caregivers participated, with 50 in the "case" group and 50 in the "control" group. Significant differences in stress scores and salivary cortisol levels were observed between the groups, with the other variables constant. In both groups, cortisol levels followed a typical circadian pattern. Family income was associated with perceived stress. Caregiver age significantly explained perceived stress ( = 0.0098) and total cortisol production. Caregiver occupation also influenced cortisol results.
Caregivers of children with chronic conditions showed higher perceived stress and lower cortisol production compared to those of healthy children. Family income, occupation, and caregiver age were associated with stress.
本研究分析了有特殊医疗需求儿童的家庭照顾者所经历的压力，并确定了相关因素。
进行了一项病例对照研究，“病例”为慢性病患儿的照顾者，“对照”为健康儿童的照顾者。通过社交媒体招募，并辅以滚雪球抽样。应用了社会人口学问卷和感知压力量表，一天内采集四份唾液样本（上午8:00、30分钟后、4小时后和12小时后）。使用对数梯形法计算每日总皮质醇分泌的曲线下面积。采用Wilcoxon检验和重复测量方差分析进行统计分析。
共有100名照顾者参与，“病例”组50名，“对照”组50名。在其他变量不变的情况下，两组在压力得分和唾液皮质醇水平上存在显著差异。两组的皮质醇水平均呈现典型的昼夜节律模式。家庭收入与感知压力相关。照顾者年龄对感知压力（=0.0098）和总皮质醇分泌有显著解释作用。照顾者职业也影响皮质醇结果。
与健康儿童的照顾者相比，慢性病患儿的照顾者表现出更高的感知压力和更低的皮质醇分泌。家庭收入、职业和照顾者年龄与压力相关。
