儿童期养育压力与先心病年轻成人情绪健康及心理弹性的关联

原文

OBJECTIVE: To describe the association between parenting stress levels during early childhood and subsequent emotional health outcomes and resilience of their children with congenital heart disease (CHD) as young adults. STUDY DESIGN: This prospective cohort study included 202 dyads of young adults with CHD and their caregivers. The young adults had undergone surgery with cardiopulmonary bypass at ≤ 6 months of life and were enrolled in a longitudinal study of neurodevelopmental outcomes in CHD. Resilience and general health status of the young adults were evaluated using self-report standardized questionnaires (14-Item Resilience Scale [RS-14] and 36-Item Short-Form Health Survey [SF-36]). Parenting stress in the preschool period was assessed using the Parenting Stress Index (PSI), completed by caregivers. RESULTS: An underlying mental health condition was self-reported by 120 (59%) of the young adults. Median PSI score (PSI total score = 58; interquartile ranges 46.25-71) indicated normal parenting stress levels. Mean SF-36 score (46, SD 11) was just below general population average (50), and mean RS-14 score (77, SD14) was similar to population average (76). Higher parenting stress was associated with lower young adults' resilience, with a unit increase in PSI total score associated with 0.14 (95% CI 0.02 - 0.26) decrease in RS-14 total score. CONCLUSIONS: Higher reported parenting stress during early childhood was associated with lower self-reported resilience in young adulthood for patients with CHD. This suggests that identification of an at-risk population early in life is possible and may provide an opportunity for targeted family-based interventions to improve psychosocial development with increased resilience.