Quality of life among adolescents with sickle cell disease: mediation of pain by internalizing symptoms and parenting stress
Quality of life among adolescents with sickle cell disease: mediation of pain by internalizing symptoms and parenting stress
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DOI：
10.1186/1477-7525-6-60
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发表时间：
2008-08-09
影响因子：
3.6
通讯作者：
Dampier, Carlton
中科院分区：
文献类型：
--
作者：
Barakat, Lamia P.;Patterson, Chavis A.;Dampier, Carlton
背景：本研究旨在利用青少年和家长的报告，阐明镰状细胞病 (SCD) 青少年样本中疼痛、心理适应和家庭功能与健康相关生活质量 (HRQOL) 之间的关联。方法：42 名患有 SCD 的青少年（12 岁至 18 岁）及其主要照顾者完成了纸笔测量疼痛、青少年心理适应和 HRQOL。此外，主要照顾者完成了与疾病相关的养育压力的测量。医疗档案审查确定了疾病的严重程度。结果：皮尔逊相关性发现，疼痛频率与青少年和主要护理人员评定的 HRQOL 的身体和心理社会领域存在显着的负相关。一般来说，内化症状（即焦虑和抑郁）和疾病相关的养育压力也与较低的 HRQOL 显着相关。通过一系列回归分析对可能的中介模型进行的检查证实，与疾病相关的养育压力是疼痛频率与身体和心理社会 HRQOL 之间的中介。涉及内化症状的中介模型的发现不太一致。对于这些，父母评价的青少年抑郁和青少年焦虑充当疼痛频率和 HRQOL 关联的中介。结论：结果与现有文献一致，现有文献表明疼痛和 HRQOL 之间存在关联，并确定内化症状和家庭变量的伴随疼痛变量作为中介。改善 HRQOL 的努力应旨在解决 SCD 管理背景下与疼痛和养育压力相关的内化症状。
Background: This study aimed to clarify associations between pain, psychological adjustment, and family functioning with health-related quality of life (HRQOL) in a sample of adolescents with sickle cell disease (SCD) utilizing teen- and parent-report.Methods: Forty-two adolescents (between the ages of 12 and 18) with SCD and their primary caregivers completed paper-and-pencil measures of pain, teen's psychological adjustment, and HRQOL. In addition, primary caregivers completed a measure of disease-related parenting stress. Medical file review established disease severity.Results: Pearson correlations identified significant inverse associations of pain frequency with physical and psychosocial domains of HRQOL as rated by the teen and primary caregiver. Generally, internalizing symptoms (i.e. anxiety and depression) and disease-related parenting stress were also significantly correlated with lower HRQOL. Examination of possible mediator models via a series of regression analyses confirmed that disease-related parenting stress served as a mediator between pain frequency and physical and psychosocial HRQOL. Less consistent were findings for mediation models involving internalizing symptoms. For these, parent-rated teen depression and teen anxiety served as mediators of the association of pain frequency and HRQOL.Conclusion: Results are consistent with extant literature that suggests the association of pain and HRQOL and identify concomitant pain variables of internalizing symptoms and family variables as mediators. Efforts to improve HRQOL should aim to address internalizing symptoms associated with pain as well as parenting stress in the context of SCD management.