Trajectories of child and caregiver psychological adjustment in families of children with cancer.
Trajectories of child and caregiver psychological adjustment in families of children with cancer.
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DOI：
10.1037/hea0000619
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发表时间：
2018-08
期刊：
影响因子：
--
通讯作者：
Stettler N
中科院分区：
文献类型：
--
作者：
Katz LF;Fladeboe K;King K;Gurtovenko K;Kawamura J;Friedman D;Compas B;Gruhn M;Breiger D;Lengua L;Lavi I;Stettler N
描述从诊断到儿科癌症治疗第一年患者和护理人员心理健康的轨迹，并评估临床相关症状的发生率是否高于正常水平。我们检查了癌症儿童的内化和外化症状以及创伤后应激症状（PTSS）的平均水平，以及治疗第一年照顾者的抑郁，焦虑和PTSS;在每个时间点得分在临床范围内的患者和照顾者的比例;患者和照顾者症状的典型轨迹以及个体之间的轨迹是否不同。新诊断为癌症的儿童（法师=5.6岁;范围=2-18岁）的家庭（N=159）参加了一项短期前瞻性研究。主要照顾者每月提供自己和孩子的心理调整报告。平均而言，孩子们适应得很好。然而，与标准相比，在诊断时出现临床相关内化症状的儿童比例高于预期。平均而言，儿童的症状随着时间的推移而下降，尽管观察到了变异性。平均而言，照顾者的适应能力较差，随着时间的推移，报告抑郁和焦虑临床相关症状的比例很高。照顾者的症状也随着时间的推移而下降，但观察到相当大的变化。虽然大多数儿童在治疗的第一年内保持良好的适应能力，但许多照顾者都会出现与临床相关的心理困扰症状。针对高危患者和照顾者的干预措施的发展的影响进行了讨论。识别预测精神病理学轨迹中家庭间变异性的过程是重要的下一步。
To describe the trajectory of patient and caregiver mental health from diagnosis through the first year of treatment for pediatric cancer and assess whether rates of clinically relevant symptoms were elevated compared to norms. We examined mean levels of internalizing and externalizing symptoms and post-traumatic stress symptoms (PTSS) in children with cancer, and depression, anxiety and PTSS in caregivers through in the first year of treatment; the proportion of patients and caregivers that scored in the clinical range at each time point; the typical trajectory of symptoms in patients and caregivers and whether trajectories differed between individuals. Families (N=159) of children newly diagnosed with cancer (Mage=5.6 years; range=2–18 years) participated in a short-term prospective study. Primary caregivers provided monthly reports of their own and their child’s psychological adjustment. On average, children were well adjusted. However, compared to norms there was a higher than expected proportion of children with clinically relevant internalizing symptoms around the time of diagnosis. On average children’s symptoms declined over time, though variability was observed. Caregivers were less well-adjusted on average, with a high proportion reporting clinically relevant symptoms over time for depression and anxiety. Caregiver symptoms also declined over time, though considerable variability was observed. While most children remain well-adjusted during the first year of treatment, many caregivers experience clinically-relevant symptoms of psychological distress. Implications for development of interventions targeting at-risk patients and caregivers are discussed. Identifying processes that predict between-family variability in trajectories of psychopathology is an important next step.
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DOI：
10.1007/s00520-016-3136-z
发表时间：
2016-07
期刊：
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
影响因子：
--
作者：
Nam GE;Warner EL;Morreall DK;Kirchhoff AC;Kinney AY;Fluchel M
通讯作者：
Fluchel M
影响因子：
0.9
作者：
Fuemmeler, BF;Mullins, LL;Parkhurst, J
通讯作者：
Parkhurst, J
影响因子：
3.6
作者：
PERRIN, EC;STEIN, REK;DROTAR, D
通讯作者：
DROTAR, D
影响因子：
3.6
作者：
Jurbergs, Nichole;Long, Alanna;Phipps, Sean
通讯作者：
Phipps, Sean
影响因子：
45.3
作者：
Kazak, AE;Boeving, CA;Reilly, A
通讯作者：
Reilly, A