Paediatric medical traumatic stress (PMTS) is a set of children’s and their parents’ psychological and physiological responses to pain, injury, serious illnesses, and other experiences with the medical environment. Paediatric cancer patients have the highest prevalence of PMTS as the illness involves a set of stressors that trigger many negative psychological reactions. Posttraumatic stress symptoms (PTSS) are one of the most common psychopathologies among cancer patients. We examined the incidence of PMTS in children with cancer and their parents due to coping with a serious illness and treatment complications. We analysed the following risk factors for PTSS: selected groups of individuals, medical interventions, complications, and treatment modalities. The study involved 183 parents of 133 children and 63 children and adolescents who were treated between 2009 and 2019 at Clinical Department of Paediatric Haematology and Oncology of Paediatric Clinic in Ljubljana. We collected the data using The Intensity of treatment rating scale 2.0 [IRT-2], PTSD checklist for Children/Parent [PCL-C/PR], The PTSD Checklist for DSM-5 [PCL-5] and The Child PTSD Symptoms Scale for DSM-5 [CPSS-5]. PMTS is frequently present in both, children and their parents, regardless of the cancer type, treatment duration, treatment outcome, and child’s age. Mothers, patients with relapse, patients who were diagnosed after age 5, patients with more intensive treatment, and parents of the latter are at higher risk for PMTS occurrence. Additionally, we found a decreasing trend of traumatic responses after five or more years post cancer diagnosis and that parents are more traumatized than children. Our findings will contribute to the systematic prevention of PMTS and medical trauma and to endeavour to use trauma-informed care.
Dogodki, povezani z različnimi boleznimi, poškodbami in kroničnimi stanji ter z njimi povezano zdravljenje in medicinske intervencije, predstavljajo najpogostejše potencialne travmatske izkušnje v otroštvu. V članku se avtorice sprašujemo o pojavu travmatskega stresa in medicinske travme pri otrocih in njihovih družinah. Pri prepoznavanju medicinske travme si lahko pomagamo s teoretičnim modelom dolgotrajne somatske grožnje, ki je bil oblikovan z namenom razločevanja med medicinsko in nemedicinsko travmo (ki je niso povzročili medicinski dogodki). Različne raziskave poročajo, da kar do 80 % otrok in njihovih družin doživlja nekoliko travmatskega stresa pri soočanju z življenjsko ogrožajočimi boleznimi, poškodbami ali bolečimi medicinskimi postopki. Približno 20–30 % staršev ter 15–25 % otrok in njihovih sorojencev pa celo doživlja trajen travmatski stres, ki ovira vsakodnevno delovanje in vpliva na sam potek zdravljenja ter okrevanja. Razvoj in potek pediatrične medicinske travme ponazarja model pediatričnega medicinskega travmatskega stresa, ki za posamezno fazo poteka navaja tudi cilje intervencij. Poleg psihologa ima pri preprečevanju travme, ki se lahko pojavi pri obravnavi otrok, mladostnikov in njihovih staršev, pomembno vlogo tudi zdravstveno osebje. Vsi strokovni oziroma zdravstveni delavci si moramo prizadevati, da obravnava in oskrba otrok vključuje zavedanje in ozaveščanje o travmi. Na ta način lahko namreč pomembno preprečimo ali zmanjšamo negativne posledice travme, do katere lahko pride v medicinskem okolju.
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