Early Traumatic Stress Responses in Parents Following a Serious Illness in Their Child: A Systematic Review

A systematic review of the literature investigating the early traumatic stress responses in parents of children diagnosed with a serious illness/injury. A literature review was conducted (September 2013) using Medline, PsycINFO, and CINAHL databases. Twenty-four studies related to parents of children hospitalized due to diagnosis of cancer, type 1 diabetes, meningococcal disease, trauma or serious injury, preterm birth and other serious illnesses requiring admission to intensive care were included. Parents were assessed for early traumatic stress symptoms within 3 months of their child’s diagnosis/hospitalization. Prevalence rates of acute stress disorder in parents ranged from 12 to 63 %. Prevalence of posttraumatic stress disorder ranged from 8 to 68 %. Variability was related to methodological factors including differences in study design, timing of assessments, measurement tools, and scoring protocols. Psychosocial factors rather than medical factors predicted parent distress. This review integrates and compares early traumatic reactions in parents with children suffering a range of serious illnesses. Findings suggest a high prevalence of acute and posttraumatic stress symptoms in parents. Methodological inconsistencies made comparison of early traumatic stress prevalence rates difficult. Risk factors associated with traumatic stress symptoms were identified.     

Psychological Outcomes in Fathers of Critically Ill Children in the Pediatric Intensive Care Unit: A Systematic Review

Journal of Clinical Psychology in Medical Settings - Systematically review evidence of psychological distress in fathers of children admitted to the pediatric intensive care unit (PICU). Two...     

ICU患者低钙血症发生率调查与危险因素分析

筛查大连地区ICU患者早期低钙血症发生率,并分析其危险因素.选择自2010年9月14日至2010年9月30日新入大连市8家三级医院ICU的患者.入选44例患者中低钙血症患者20例,低钙血症发生率为45.4％.入选患者中全身性感染低钙血症发生率最高为61.1％,随后依次为其他疾病、心血管疾病、创伤和神经系统疾病.低钙血症的危险因素为蛋白水平、血磷水平、乳酸水平以及日照时间长短.     

Correlates of Post-traumatic Growth Following a Myocardial Infarction: A Systematic Review

Journal of Clinical Psychology in Medical Settings - Correlates of post-traumatic growth (PTG) have been examined in the area of health psychology previously, with much focus on aspects of...     

ICU谵妄患者病因分析以及处理

分析急诊ICU患者出现谵妄症状的原因以及处理对策.分析总结我院急诊ICU 3年间所有患者的资料,发现20.2％的患者出现谵妄症状,原因为:(1)疾病相关；(2)药物相关；(3)监护环境等多种因素作用结果.经过调整治疗方案、加强心理护理后,需要镇静药物的仅为谵妄患者的19.7％.因此寻找谵妄原因很重要,治疗重点在于去除谵妄原因以及相关促发因素.     

ICU谵妄患者病因分析以及处理

分析急诊ICU患者出现谵妄症状的原因以及处理对策。分析总结我院急诊ICU3年间所有患者的资料,发现20．2％的患者出现谵妄症状,原因为：（1）疾病相关;（2）药物相关;（3）监护环境等多种因素作用结果。经过调整治疗方案、加强心理护理后,需要镇静药物的仅为谵妄患者的19．7％。因此寻找谵妄原因很重要,治疗重点在于去除谵妄原因以及相关促发因素。     

预立医疗照护计划在重症医学科中的应用研究进展

基于目前我国医疗压力较大,过度治疗现象突出等问题,站在现代医学观念和辩证思维角度来思考如何合理且有效地利用现有的医疗资源,减少不必要且增加患者痛苦的治疗,减轻患者家庭负担,让患者有尊严地离开。同时,借鉴国外经验结合我国文化背景对预立医疗照护计划的可行性和必要性进行阐述,对国内外预立医疗照护计划实施的现状进行对比,并分析国内外预立医疗照护计划实施差异的原因,提出针对性的措施,以期为我国重症医学科推行预立医疗照护计划提供建议,促进安宁疗护的进一步发展。     

临床胜任能力——以重症医学科医生面临的挑战为例

随着重症医学的发展,我国重症医学科医生临床胜任能力将面临着巨大挑战;他们不仅需要具备精湛的临床技术,同样重要的是还需要具备高超的合作、沟通能力,充沛的精力和体力,丰满的人文和哲学素养,以及终身的知识更新和实践能力提高.     

A Systematic Review of Sleep Associations in Parents and Children

This systematic review aimed to examine sleep associations in a) typically developing children and their parents, and b) children with neurodevelopmental disorders and their parents. Literature search was conducted on PubMed, PsycINFO, EMBASE and Scopus databases for articles examining sleep associations between parents and children. Thirty studies were included in the final review. Based on the first aim, sleep associations between parents and typically developing children were observed for sleep quality, sleep duration and sleep efficiency. However, evidence for associations between sleepiness levels in parents and children and sleep schedules related to bedtime or waketime was limited. Based on the second aim, children with neurodevelopmental disorders and their parents reported greater sleep disturbances in comparison to typically developing children and their parents. The review concluded that sleep in parents and children is interrelated across a number of sleep parameters. It also revealed some preliminary evidence on bidirectionality in parent-child sleep, which warrants further examination. The review highlights the need to examine the mediating role of environmental factors on the interactions between parent-child sleep. Rigorous, longitudinal designs should be employed to explore the pathways through which parents may impact their children’s sleep and functioning and vice-versa.

     

新生儿重症监护室中放弃治疗的伦理问题

对于新生儿重症监护室中的一部分危重新生儿,虽然可以借助高新尖的医疗技术挽留他们的性命,但却不能避免其出现影响远期生存质量的后遗症。因此患儿家属和医务人员陷入了是否对这些危重新生儿实施放弃治疗的两难困境。对NICU中放弃治疗的对象、伦理学依据、伦理学意义以及如何实施放弃治疗的问题加以讨论,为NICU医务人员提供有益参考。     

新生儿重症监护室中放弃治疗的伦理问题

对于新生儿重症监护室中的一部分危重新生儿,虽然可以借助高新尖的医疗技术挽留他们的性命,但却不能避免其出现影响远期生存质量的后遗症.因此患儿家属和医务人员陷入了是否对这些危重新生儿实施放弃治疗的两难困境.对NICU中放弃治疗的对象、伦理学依据、伦理学意义以及如何实施放弃治疗的问题加以讨论,为NICU医务人员提供有益参考.     

乌司他丁在ICU中的临床应用进展

乌司他丁具有抑制胰蛋白酶等胰酶的活性、稳定溶酶体膜以抑制溶酶体酶的释放及抑制心肌抑制因子的产生而常应用于重症急性胰腺炎及其他危重症的抢救治疗.     

Prevalence and Correlates of Posttraumatic Stress and Postpartum Depression in Parents of Infants in the Neonatal Intensive Care Unit (NICU)

The purpose of this study was to assess the prevalence and correlates of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) in mothers and fathers, and postpartum depression (PPD) in mothers, of infants in the Neonatal Intensive Care Unit (NICU). 86 mothers and 41 fathers completed measures of ASD and of parent perception of infant medical severity 3–5 days after the infant’s NICU admission (T1), and measures of PTSD and PPD 30 days later (T2). 35% of mothers and 24% of fathers met ASD diagnostic criteria at T1, and 15% of mothers and 8% of fathers met PTSD diagnostic criteria at T2. PTSD symptom severity was correlated with concurrent stressors and family history of anxiety and depression. Rates of ASD/PTSD in parents of hospitalized infants are consistent with rates in other acute illness and injury populations, suggesting relevance of traumatic stress in characterizing parent experience during and after the NICU.     

Perceptions of ADHD Among Diagnosed Children and Their Parents: A Systematic Review Using the Common-Sense Model of Illness Representations

Research on children and parents’ experiences of ADHD has grown in recent years, attracting attention to their subjective perception of ADHD as a disorder. Theoretical accounts of illness perception suggest that it is multi-dimensional, consisting of at least five core constructs (see the common-sense model of illness representations or CSM: Leventhal et al., in: Rachman (ed) Medical psychology, Pergamon, New York, vol 2, pp 7–30, 1980, in: Baum, Taylor, Singer (eds) Handbook of psychology and health: social psychological aspects of health, Earlbaum, Hillsdale, vol 4, pp 219–252, 1984). We suggest that the application of CSM in children/adolescents with ADHD and their parents may play an important role in understanding their coping behavior, treatment adherence, and emotional well-being. A systematic search identified 101 eligible studies that investigated the perception of ADHD among diagnosed children/adolescents and their parents. In general, these studies support the existence of the multiple facets of illness representations proposed by the CSM in both diagnosed youngsters and parents indicating substantial variability among both parents and youngsters on each of these facets. The comprehensive assessment of the representations of ADHD indicates imbalance attention to the different representations of ADHD in the literature; disproportional research attention has been paid to the perceived effectiveness of treatment (i.e., treatment control dimension) compared to other illness representations (e.g., timeline, consequence, and coherence), despite research showing their relevance to treatment adherence among other implications. The review identifies the limitation of existing relevant research, needed foci for future studies, specific testable hypotheses, and potential clinical implications of the multifaceted representations of ADHD among youngsters and carers alike.     

Adult Attachment Dimensions,World View Schemas,and the Psychological Health of Parents of Infants in a Neonatal Intensive Care Unit

This study reports the results of an exploration of the relationship of adult attachment dimensions (closeness, dependence, and anxiety) and world view assumptions (benevolence, meaningfulness, and worthiness) to psychological distress and psychological well-being in 142 parents (71 couples) of newborns recently hospitalized in a neonatal intensive care unit. The results of the Actor-Partner Interdependence Model, hierarchical multiple regression, and mediation analyses showed that parents who were more comfortable with attachment-dependence and parents who held more positive beliefs about benevolence and worthiness had less psychological distress and more well-being. In addition, parents with partners who were more comfortable with attachment-dependence had less psychological distress and more well-being. Attachment-dependence partially mediated the relationships of benevolence and worthiness with psychological distress and the relationship of benevolence with psychological well-being, whereas worthiness had a direct relationship with psychological well-being.     

Broader Autism Phenotype in Parents of Children with Autism: A Systematic Review of Percentage Estimates

The broader autism phenotype (BAP) is a collection of sub-diagnostic autistic traits more common in families of individuals with autism spectrum disorder (ASD) than in the general population. BAP is a latent construct that can be defined using different domains, measured using multiple instruments, and reported using different techniques. Therefore, estimates of BAP may vary greatly across studies. Our objective was to systematically review studies that reported occurrence of BAP in parents of children with ASD in order to quantify and describe heterogeneity in estimates. We systematically searched PubMed and Scopus using PRISMA guidelines for studies quantifying percentage of parents of children with ASD who had BAP. We identified 41 studies that measured BAP in parents of children with ASD. These studies used eight different instruments, four different forms of data collection, and had a wide range of sample sizes (N?=?4 to N?=?3299). Percentage with BAP ranged from 2.6% to 80%. BAP was more prevalent in fathers than mothers. Parental BAP may be an important tool for parsing heterogeneity in ASD etiology and for developing parent-mediated ASD interventions. However, the variety in measurement instruments and variability in study samples limits our ability to synthesize estimates. To improve measurement of BAP and increase consistency across studies, universal methods should be accepted and adopted across studies. A more consistent approach to BAP measurement may enable efficient etiologic research that can be meta-analyzed and may allow for a larger evidence base that can be used to account for BAP when developing parent-mediated interventions.     

Strategies to Engage Underrepresented Parents in Child Intervention Services: A Review of Effectiveness and Co-occurring Use

The purpose of this review was to estimate the impact of parent engagement strategies tested with underrepresented families of young children with social, emotional, or behavioral disorders, and describe the combinations in which these strategies are commonly used together. We conducted a systematic review using the PracticeWise Engagement Coding System to identify which strategies had the strongest empirical support for engaging underrepresented (i.e., minority race or ethnicity, or low income) families receiving psychosocial services for their children. Social network analyses were used to identify the frequency of strategy use and how strategies were combined to engage underrepresented families. Linear regression was used to estimate the impact of each strategy on parent engagement, using attrition as a proxy for non-engagement. Thirty-five studies met inclusion criteria. Parent attrition was predicted by larger sample sizes, lower maternal education, interventions that were more community or home-based, less therapist monitoring, positive reinforcement from therapists, and more pairing families with peers. Social network analyses suggested that more effective strategies were more frequently implemented alone and less effective strategies were commonly combined with each other. Our findings suggest that researchers and practitioners require guidance in selecting engagement strategies to reduce attrition of underrepresented families in treatment. Although we identified promising strategies for improving parent engagement in treatment for underrepresented children with social, emotional, or behavioral disorders, the frequent combining of engagement strategies in research means that there is little data on the independent effects of interventions to increase parent engagement for this population.     

Factors Associated with Delays of Days to Decades to Criminal Prosecutions of Child Sexual Abuse

Until the latter part of the 20th century, legal doctrines made it almost impossible to successfully prosecute in criminal court a case involving child sexual abuse (CSA), whether the complaint was timely or delayed. Many English-speaking countries have abrogated most formal legal barriers to prosecuting CSA cases, and courts are faced with the singular challenge of adjudicating sexual offenses against children that are reported to have happened years or decades earlier. We conducted analyses of 4,237 criminal complaints of CSA heard in Canadian criminal courts. There were several differences between timely and delayed prosecutions that led us to conclude that delayed prosecutions of CSA are common and due, in part, to the nature of the offense. Offense duration was associated with longer delays to prosecution. When the accused had access to the child through his position in the community, length of delay to prosecution was very long, particularly for male complainants. More research is needed on delayed CSA prosecutions, particularly given an apparent trend for jurisdictions to abolish barriers to criminal prosecutions of CSA that occurred years or decades earlier. Copyright © 2015 John Wiley & Sons, Ltd.     

Examining Factors Associated with Utilization of Chaplains in the Acute Care Setting

Journal of Religion and Health - Hospitalized persons want their spiritual needs addressed and discussed by the healthcare team, but medical providers and nurses lack the necessary training....