Psychosocial predictors of distress in parents of children undergoing stem cell or bone marrow transplantation
Psychosocial predictors of distress in parents of children undergoing stem cell or bone marrow transplantation
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DOI：
10.1093/jpepsy/jsi002
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发表时间：
2005-03-01
影响因子：
3.6
通讯作者：
Rai, SN
中科院分区：
文献类型：
--
作者：
Phipps, S;Dunavant, M;Rai, SN
目的探讨干细胞或骨髓移植（BMT）患儿父母的心理社会因素（情绪障碍、知觉压力、照顾者负担）。方法对151例BMT患儿住院前的父母进行疾病史、病前儿童行为问题、家庭环境、社会支持和父母应对行为的调查。父母随后完成了对他们的情绪障碍，感知压力和负担的评估，每周一次，直到BMT后第6周，然后每月一次，直到BMT后第6个月。结果在骨髓移植过程中，父母的痛苦发生了显著变化。在校正人口统计学和医学因素后，确定了几个显着的预测父母的痛苦轨迹，包括以前的父母和病人的疾病相关的困扰，发病前的儿童内化行为问题，家庭环境的家庭关系维度，和父母回避的应对行为。使用分层建模方法开发多变量模型。最佳拟合模型约占50%的方差在父母的全球困扰。结论：在移植的急性期，父母的亚组有更高的痛苦增加的风险。这些发现可以帮助那些可能更需要干预以减少移植相关痛苦的父母。
Objective To examine psychosocial predictors of distress (mood disturbance, perceived stress, caregiver burden) in parents of children undergoing stem cell or bone marrow transplantation (BMT). Method Measures of prior illness experiences, premorbid child behavior problems, family environment, social support, and parental coping behavior were obtained from the resident parents of 151 children prior to the children's admission for BMT. Parents subsequently completed assessments of their mood disturbance, perceived stress, and caregiving burden on a weekly basis through week +6 post-BMT, and then monthly through month +6 post-BMT. Results Significant changes were observed in parental distress across the course of BMT. After correcting for demographic and medical factors, several significant predictors of parental distress trajectories were identified, including prior parent and patient illness-related distress, premorbid child internalizing behavior problems, the family relationship dimensions of the family environment, and parental avoidant coping behaviors. Multivariable models were developed using a hierarchical modeling approach. The best-fit model accounted for approximately 50% of the variance in parental global distress. Conclusions Subgroups of parents at higher risk for increased distress during the acute phase of transplant have been identified. These findings can help target parents who may be in greater need of intervention aimed at reducing transplant-related distress.