Prevalence and Predictors of Parental Grief and Depression after the Death of a Child from Cancer
Prevalence and Predictors of Parental Grief and Depression after the Death of a Child from Cancer
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DOI：
10.1089/jpm.2010.0037
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发表时间：
2010-11-01
影响因子：
2.8
通讯作者：
Heath, John A.
中科院分区：
文献类型：
--
作者：
McCarthy, Maria C.;Clarke, Naomi E.;Heath, John A.
目的：调查儿童死于癌症的父母的悲伤和抑郁模式，并研究与疾病负担和临终关怀相关的因素作为父母悲伤和抑郁结果的潜在预测因素。方法：58名父母完成了标准化的自我报告问卷，测量了长期悲伤障碍（复杂悲伤量表-修订版[ICG-R]）和抑郁（贝克抑郁量表-第二版[BDI-II]），并参与了结构化访谈，以了解他们对孩子的临终关怀和疾病负担的看法。大多数参与者是母亲（84%），儿童死亡后的平均时间长度为4.5年（标准差[SD] = 2.4）年（范围1.0-9.8年）。结果：长期悲伤障碍（PGD）的发生率与其他丧亲人群相似（10.3%）；然而，41%的父母符合与悲伤有关的分离困扰的诊断标准。22%的父母报告了临床上明显的抑郁症状。死亡后的时间和父母对肿瘤医生护理的感知预测了父母的悲伤症状，但不是抑郁症状。对孩子上个月生活质量的看法、对孩子死亡的准备以及经济困难也预示着悲伤和抑郁的结果。结论：少数父母符合PGD和抑郁症的标准，然而，几乎一半的样本经历了与持续渴望和渴望孩子相关的显著分离痛苦。死亡后的时间是父母心理困扰的重要预测指标。本研究还强调了临终因素在父母长期调整中的重要性，以及最佳姑息治疗的必要性，以确保父母的最佳结果。
Purpose: To investigate patterns of grief and depression in a sample of parents whose child had died of cancer, and to examine factors related to burden of illness and end-of-life care as potential predictors of parental grief and depression outcomes.Methods: Fifty-eight parents completed standardized self-report questionnaires measuring prolonged grief disorder (Inventory of Complicated Grief-Revised [ICG-R]) and depression (Beck Depression Inventory-Second Edition [BDI-II]) and participated in structured interviews designed to elicit their perceptions of their child's end-of-life care and burden of illness. The majority of participants were mothers (84%) and the mean length of time since child death was 4.5 (standard deviation [SD] = 2.4) years (range, 1.0-9.8 years).Results: Rates of prolonged grief disorder (PGD) were similar to those reported in other bereaved populations (10.3%); however, 41% of parents met diagnostic criteria for grief-related separation distress. Twenty-two percent of parents reported clinically significant depressive symptoms. Time since death and parental perception of the oncologist's care predicted parental grief symptoms but not depressive symptoms. Perceptions of the child's quality of life during the last month, preparedness for the child's death, and economic hardship also predicted grief and depression outcomes.Conclusions: A minority of parents met criteria for PGD and depression, however, almost half the sample was experiencing significant separation distress associated with persistent longing and yearning for their child. Time since death is a significant predictor of parental psychological distress. This study also highlights the importance of end-of-life factors in parents' long-term adjustment and the need for optimal palliative care to ensure the best possible outcomes for parents.