童年癌症幸存者的创伤后应激障碍及其生活质量

Posttraumatic stress disorder and quality of life in survivors from childhood cancer

目的:儿童的癌症在过去一直被认为是一种致命性的疾病,随着科学的进步,癌症的5年生存率已经从55.7%穴1947/1976雪增加到77.1%穴1974/1976雪,提高癌症儿童的生活质量已经成为非常重要的课题。资料来源:应用计算机在OVID搜索1995-01/2005-12与童年癌症幸存者的创伤后应激障碍及其生活质量相关的文献,检索词:“PTSD,Childhoodcancer熏Qualityoflife穴QOL雪”,限定语言种类为英文。同时在中国期刊全文数据库检索1998-01/2005-12与之内容相关的文献,检索词:“生活质量、癌症儿童、创伤后应激障碍”,限定语言种类为中文。资料选择:初审资料,选择与童年癌症幸存者的创伤后应激障碍及其生活质量相关的文献,并查找全文,删除描述性文献和重复性研究。资料提炼:在OVID搜索与童年癌症幸存者的创伤后应激障碍及其生活质量相关的文献40篇,而在中国期刊全文数据库搜索到9篇。删除描述性文献和重复性研究18篇,以31篇进行综述。资料综合:创伤后应激障碍是指由异常威胁性或灾难性心理创伤导致延迟出现和长期持续的精神障碍。其诊断标准为主观反应,必须包括重现创伤体验、回避/麻木和警惕性增高3类症状中每一个中的特定个数。癌症儿童创伤后应激障碍发生率各组研究报道不一。在癌症幸存者家里创伤后应激症状非常普遍。父母亲创伤后应激障碍的发生率和症状水平各组研究报道不一致。创伤后应激障碍症状与生活质量呈负相关。癌症幸存儿童创伤后应激障碍危险因素包括:年龄、性别、社会支持系统、癌症儿童的心身功能状况。同时癌症幸存者生活质量差,患者父母及患者本身对生活质量评价的一致性也比较差,心理干预与治疗可以改善童年时期癌症幸存者的生活质量。结论:癌症儿童创伤后应激障碍发生率及癌症幸存者父母亲的创伤后应激障碍的发生率和症状水平各组研究报道不一致。童年癌症幸存者的生活质量相对较低。

OBJECTIVE： Childhood cancer was believed a lethality disease in the past. With the development of science, 5-year survival rate of cancer has increased from 55.7% （1947/1976） to 77.1% （1974/1976）, so the improvement of quality of life （QOL） in childhood cancer has becoming very important. DATA SOURCES： The OVID database was searched for the articles of posttraumatic stress disorder （PTSD） and QOL in survivors with childhood cancer from January 1995 to December 2005 with the key words of ＂PTSD, Childhood cancer, Quality of life （QOL）＂ in English. Meanwhile, China Journal Full-text Database （CJFD） was undertaken to identify the related articles published between January 1998 and December 2005 with the key words of ＂Quality of life （QOL）, Children with cancer, posttraumatic stress disorder （PTSD）＂ in Chinese. STUDY SELECTION： The data were selected firstly, and articles of PTSD and QOL in survivors with childhood cancer were included, and the full-texts were searched. The described papers and repeated researches were excluded. DATA EXTRACTION： Totally 40 papers about PTSD and QOL for childhood cancer were searched out in the OVID, whereas 9 in the CJFD. A total of 18 described papers and repeated researches were deleted and 31 papers were used for review. DATA SYNTHESIS： PTSD was that severe psychological and physical symptoms result from abnormal threat or tragedy psychological trauma. To meet criteria for PTSD, the subject＇s response must include a specific number of symptoms from each of three broad categories： reexperiencing, avoidance/numbing, and increased arousal. The incidence rate of PTSD for childhood cancer was different in different research. Post-traumatic stress symptom was very common in the family of survivors. Incidence rate of PTSD and level of post-traumatic stress symptom for children＇s parents was also different in different study groups. Post-traumatic stress symptom was negatively correlated with QOL. Risk factors of PTSD for survivors of childhood cancer included age, gender, social support system and psychological and physical function of cancer children. QOL of survivors of childhood cancer was poor, and poor concordance was found between child and parent reports. Psychological treatment could improve QOL of survivors with childhood cancer. CONCLUSION： Incidence rate of PTSD for childhood cancer, incidence rate of PTSD and level of post-traumatic stress symptom for children＇s parents are different in different researches. QOL of survivors with childhood cancer is low.