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先天性心脏病患儿父母的压力与生活质量:探究应对策略的中介和调节作用

Stress and Quality of Life in Parents of Children with Congenital Heart Disease: Exploring the Mediating and Moderating Effects of Coping Strategies.

作者信息

Cole Lianne B, Ridings Leigh, Mueller Martina, Costello John M, Phillips Shannon

机构信息

Department of Surgery, Boston Children's Hospital, Boston, MA, USA.

College of Nursing, Medical University of South Carolina, Charleston, SC, USA.

出版信息

Pediatr Cardiol. 2025 May 23. doi: 10.1007/s00246-025-03897-3.

Abstract

Parents of children with congenital heart disease (CHD) experience higher rates of stress compared with the general population, which adversely affects their health-related quality of life (HRQoL). The purpose of this cross-sectional study was to examine coping strategies as mediators and moderators between perceived stress and HRQoL in parents of children with CHD. The effects of sociodemographic factors on perceived stress and HRQoL were also explored. Parents of children with CHD were recruited to participate from October 2023 to July 2024. Participants completed a self-report, online questionnaire containing the Perceived Stress Scale (PSS), Brief COPE, PedsQL Family Impact module, and the Protocol for Responding to and Assessing Patients Assets, Risks, and Experiences (PRAPARE). SPSS v27.2 and the PROCESS macro extension were used for analysis of mediator and moderator effects of coping strategies. Participants included 53 parents who met criteria and agreed to participate in the study. Parents with Medicaid and other non-private insurance types had higher PSS scores than parents with private insurance. Avoidant coping, self-blame, and behavioral disengagement were positively correlated with PSS and negatively correlated with HRQoL. Regression analysis indicated that coping strategies did not directly mediate the relationship between PSS and HRQoL. Problem-focused coping, active coping, emotional support, acceptance, and self-distraction moderated the effects of PSS on HRQoL. More research is needed to develop and test evidence-based coping interventions that reduce stress and improve HRQoL in parents of children with CHD.

摘要

与普通人群相比,先天性心脏病(CHD)患儿的父母经历压力的比率更高,这对他们的健康相关生活质量(HRQoL)产生了不利影响。这项横断面研究的目的是检验应对策略作为CHD患儿父母感知压力与HRQoL之间的中介和调节因素。还探讨了社会人口学因素对感知压力和HRQoL的影响。2023年10月至2024年7月招募了CHD患儿的父母参与研究。参与者完成了一份自我报告的在线问卷,其中包含感知压力量表(PSS)、简易应对方式问卷(Brief COPE)、儿童生活质量量表家庭影响模块(PedsQL)以及患者资产、风险和经历应对与评估协议(PRAPARE)。使用SPSS v27.2和PROCESS宏扩展来分析应对策略的中介和调节作用。参与者包括53名符合标准并同意参与研究的父母。有医疗补助和其他非私人保险类型的父母的PSS得分高于有私人保险的父母。回避应对、自责和行为脱离与PSS呈正相关,与HRQoL呈负相关。回归分析表明,应对策略并未直接介导PSS与HRQoL之间的关系。以问题为中心的应对、积极应对、情感支持、接受和自我分心调节了PSS对HRQoL的影响。需要更多研究来开发和测试基于证据的应对干预措施,以减轻CHD患儿父母的压力并改善其HRQoL。

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