Emotional Aspects of Pediatric Post-Intensive Care Syndrome Following Traumatic Brain Injury
Emotional Aspects of Pediatric Post-Intensive Care Syndrome Following Traumatic Brain Injury
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DOI：
10.1007/s40653-020-00332-y
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发表时间：
2021-04-06
影响因子：
1.5
通讯作者：
Hall, Trevor A.
中科院分区：
文献类型：
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作者：
Bradbury, Kathryn R.;Williams, Cydni;Hall, Trevor A.
需要神经重症监护的创伤性脑损伤（TBI）儿童有神经认知、情感、身体和心理社会困难的风险，统称为重症监护后综合征。我们的研究评估了父母报告的情绪功能，并确定了急性恢复期情绪后遗症的危险因素。53名5至18岁因TBI住院的儿童在出院后1个月进行了评估。相关的伤害，儿童和家庭的具体变量进行了收集。使用PROMIS家长代理报告焦虑和抑郁症状简表评估情绪功能。我们使用卡方检验来评估有和没有焦虑和抑郁症状升高的儿童之间的差异。Logistic回归确定了显著变量中症状升高的预测因子。父母经常认可儿童的中度或重度焦虑（45.2%）和抑郁（32.1%）症状。伤害机制和父母创伤后应激障碍（PTSD）症状的升高与焦虑和抑郁症状的升高有关，而家庭直接参与事故/伤害仅与焦虑症状的升高有关。Logistic回归分析结果表明，只有父母PTSD症状升高是儿童焦虑和抑郁症状的重要预测因子。焦虑和抑郁症状在TBI的急性恢复期普遍存在。与先前的研究一致，焦虑和抑郁症状的升高与心理社会因素的关系比与损伤严重程度的关系更大。高水平的父母创伤后应激障碍症状及其与儿童内化症状的关系突出了TBI患者及其家人需要心理健康治疗。
Children with traumatic brain injury (TBI) requiring neurocritical care are at risk for neurocognitive, emotional, physical, and psychosocial difficulties, collectively known as Post-Intensive Care Syndrome. Our study assessed parent-reported emotional functioning and identified risk factors for emotional sequelae in the acute recovery phase. Fifty-three children between 5 and 18 years old hospitalized for TBI were assessed 1-month following discharge. Relevant injury-, child-, and family-specific variables were collected. Emotional functioning was assessed using PROMIS Parent Proxy Report Short Forms for Anxiety and Depressive Symptoms. We used Chi-square tests to evaluate differences between children with and without elevations in anxiety and depressive symptoms. Logistic regression determined predictors of elevations in symptoms among significant variables. Parents frequently endorsed moderate or worse anxiety (45.2%) and depressive (32.1%) symptoms among children. Mechanism of injury and elevated parent post-traumatic stress disorder (PTSD) symptoms were associated with elevated anxiety and depressive symptoms, while direct family involvement in the accident/injury was associated only with elevated anxiety symptoms. Results from logistic regression indicated that only elevated parent PTSD symptoms were a significant predictor for child anxiety and depressive symptoms. Anxiety and depressive symptoms are prevalent in the acute recovery phase of TBI. Consistent with previous research, elevations in anxiety and depressive symptoms were more related to psychosocial factors than injury severity. High levels of parent PTSD symptoms and their relationship with children's internalizing symptoms highlight the need for mental health treatment for TBI patients and their families.