Parenting stress and neurocognitive late effects in childhood cancer survivors.
Parenting stress and neurocognitive late effects in childhood cancer survivors.
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DOI：
10.1002/pon.3213
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发表时间：
2013-08
期刊：
影响因子：
3.6
通讯作者：
Van Horn, Hillary
中科院分区：
文献类型：
--
作者：
Patel, Sunita K.;Wong, Andrew L.;Cuevas, Michelle;Van Horn, Hillary
神经认知迟发效应的监测通常只关注儿童幸存者，很少关注潜在的家庭负担。我们调查了儿童神经认知效应对养育压力的影响，并假设儿童癌症幸存者的父母有更大的执行困难，经历更高的压力相对于父母的孩子有较少的不利影响。44名儿童的父母谁幸存的癌症涉及CNS定向治疗，并记录了神经认知缺陷完成了标准化问卷，评估他们的感知水平的压力和感知他们的孩子的执行功能能力在日常生活中。从基于性能的认知测试中获得的数据对儿童。多元回归模型研究了社会人口，临床和儿童的执行功能作为父母压力的预测因素。父母的压力的基础上的儿童的执行功能的差异进行了评估。父母的压力显着相关的性能为基础的和家长报告的措施，儿童执行功能。即使在控制了社会人口统计学和临床因素后，儿童执行功能也能显著预测父母的压力，最终模型占父母压力水平方差的42%。父母的压力显着差异时，发现比较高与低水平的儿童执行功能。然而，执行困难的性质似乎很重要，因为我们发现行为调节问题而不是元认知困难的儿童中的父母压力增加。在这项研究中发现的父母压力和神经认知问题之间的关联表明需要进一步的研究，沿着专业的监测和适当的干预。
Surveillance of neurocognitive late effects has typically focused on the pediatric survivor alone and rarely has focused on the potential family burden. We investigated the impact of child neurocognitive effects on parenting stress, and hypothesized that parents of childhood cancer survivors with greater executive difficulties experience higher stress relative to parents of children with less adverse impact. Parents of 44 children who survived cancer involving CNS-directed treatments and who had documented neurocognitive deficits completed standardized questionnaires assessing their perceived level of stress and perception of their child’s executive functioning abilities in daily life. Data from performance-based cognitive tests were obtained on the children. Multivariate regression models examined socio-demographic, clinical, and child’s executive functioning as predictors of parent stress. Differences in parenting stress based on child’s level of executive functioning were evaluated. Parent stress was significantly associated with both performance-based and parent report measures of child executive functioning. Child executive functioning significantly predicted parent stress even after controlling for socio-demographic and clinical factors, and the final model accounted for 42% of variance in parent stress levels. Significant differences in parent stress were found when comparing higher versus lower levels of child executive functioning. The nature of the executive difficulties, however, appears important, as we found increased parenting stress among children with behavioral regulation problems rather than metacognitive difficulties. The associations between parenting stress and neurocognitive problems found in this study suggests the need for further research, along with professional monitoring and appropriate intervention.
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