父母的不良童年经历和PICU后的压力在儿童和父母中
Patrice Pryce1, Maalobeeka Gangopadhyay2, Jeffrey D Edwards1
1Section of Critical Care, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY.
概括
在儿童重症监护室 (PICU) 的孩子的父母中,不良童年经历 (ACE) 是常见的. 家长的ACE显著增加了父母在PICU后PTSD的风险,但不是在孩子身上.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 心理创伤学 心理创伤学
- 家庭心理健康 家庭心理健康
背景情况:
- 儿童重症监护室 (PICU) 的入院对儿童和家长来说都是压力的.
- 创伤后应激障碍 (PTSD) 是PICU出院后的一个常见结果.
- 患病前的创伤事件,如不良童年经历 (ACE),可能是PTSD的危险因素.
研究的目的:
- 评估在PICU环境中对家长ACE进行查的可行性.
- 为了确定PICU患者的父母中ACEs的患病率.
- 研究父母ACE和父母和孩子的PICU后PTSD症状之间的关联.
主要方法:
- 进行了一项单一中心前性观察研究.
- 145名儿童 (2-18岁) 和他们的父母被录取到儿科学术儿童医院.
- 收集的数据包括家长人口统计,ACE,应对能力,PICU压力因素和患者临床数据. 在退院后一个月评估PTSD症状.
主要成果:
- 95%的家长填写了ACE问卷,58%报告了至少一个ACE,14%报告了大量的ACE (≥4).
- 16%的家长符合临时PTSD的标准.
- 患有≥4个ACE的父母患PTSD的几率增加了10倍 (aOR=10.2,p=0.047).
- 56%的儿童被选为患PTSD的风险,与父母的ACE没有显著的关联.
结论:
- 在患有重症儿童的父母中,不良童年经历很普遍.
- 显著的父母ACE与父母在PICU入院后的PTSD有关.
- 家长的ACE似乎与儿童的PTSD风险无关.
- 在PICU中以家庭为中心的护理应该考虑父母的ACE来减轻压力.
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